11 Obstetricians in the Netherlands manage early‐onset FGR differently from other countries, as they prefer to postpone labor despite AREDF until this is no longer feasible because of fetal distress or maternal indication. An iatrogenic, early delivery to prevent fetal hypoxia could lead to perinatal death, but delay of delivery in order to let the fetus gain maturity may lead to stillbirth. 4, 7, 8, 9, 10 If early‐onset FGR is diagnosed, the timing of the decision to initiate delivery becomes crucial. 4 Consequently, adverse perinatal outcome has been associated with this condition. AREDF, therefore, represents severe placental dysfunction, possibly resulting in early‐onset FGR and/or oligohydramnios. 1 In a growth‐restricted fetus, absent or reversed end‐diastolic Doppler flow (AREDF) in the umbilical artery can be observed as a result of the destruction of small arteries in the tertiary stem villi of the placenta. FGR can be caused by maternal, fetal or placental factors, 4, 6 but placental insufficiency, resulting from suboptimal uteroplacental perfusion and placental infarction, is by far the most common cause. 4 It is more often associated with hypertensive disorders and differs from late‐onset FGR in its clinical presentation. 4, 5 Of all cases of FGR, the incidence of early‐onset FGR is approximately 20%–30%. 2 If FGR is observed before 32 weeks’ gestation, it is defined as early‐onset FGR. 2, 3 The prevalence of FGR is between 3% and 10%. 1 In the Netherlands, the definition of FGR is an estimated fetal weight (EFW) below the 10th percentile, an abdominal circumference below the 10th percentile and a deflecting growth of at least 20 percentiles. It is also a major cause of perinatal morbidity and mortality. Fetal growth restriction (FGR) is a common but multifactorial and complex complication during pregnancy, defined by a fetus that has not reached its genetic growth potential.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |