Donald School Journal of Ultrasound in Obstetrics and Gynecology

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VOLUME 15 , ISSUE 1 ( January-March, 2021 ) > List of Articles

REVIEW ARTICLE

Early- and Late-onset Intrauterine Growth Retardation

Apostolos Zavlanos, Ioannis Tsakiridis, Ioannis Chatzikalogiannis, Apostolos Athanasiadis

Keywords : Complications, Delivery, Diagnosis, Fetal growth restriction, Intrauterine growth retardation, Management, Other, Prevention, Small-for-gestational-age, Ultrasound

Citation Information : Zavlanos A, Tsakiridis I, Chatzikalogiannis I, Athanasiadis A. Early- and Late-onset Intrauterine Growth Retardation. Donald School J Ultrasound Obstet Gynecol 2021; 15 (1):97-108.

DOI: 10.5005/jp-journals-10009-1686

License: CC BY-NC 4.0

Published Online: 00-03-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim and objective: The scope of this literature review was to synthesize the available evidence on the diagnosis and management of early and late-intrauterine growth retardation (IUGR). Background: Intrauterine growth retardation is a common obstetric complication affecting about one out of 10 pregnancies and may be associated with both short- and long-term adverse outcomes. Review results: Risk factors for IUGR include maternal, fetal and placental parameters like smoking, chromosomal abnormalities and placental mosaicism. Early-IUGR, usually correlated with preeclampsia, is difficult to manage, while late-IUGR may not be promptly diagnosed, but is associated with lower mortality. In addition, both entities follow different patterns of progression. For each case, ultrasound growth evaluation at 2-weeks intervals and regular Doppler monitoring are needed, along with cardiotocography. Moreover, a normal umbilical artery Doppler pattern in the third trimester endorses a normal pregnancy in the early-IUGR, but as for the clinical follow-up of late-IUGR fetuses, cerebroplacental ratio is the appropriate parameter for monitoring. Thus, timing of delivery is usually affected by these factors. Finally, the combined first-trimester screening might help in the prediction of IUGR. Conclusion: The diagnosis of fetal hypoxia in the third trimester remains a challenge for modern obstetrics. Hence, all fetal-maternal units should adopt and follow their own protocol for the management of IUGR. Clinical significance: IUGR remains a major problem in both developing and developed countries and several causes have been identified. More research in the field of prevention and the appropriate timing of delivery would probably improve perinatal outcomes of the affected fetuses.


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