Small for gestational age (SGA) and fetal growth restriction (FGR) is difficult to define exactly. In this pregnancy condition, the fetus does not reach its biological growth potential as a consequence of impaired placental function, which may be because of a variety of factors. Fetuses with FGR are at risk for perinatal morbidity and mortality, and poor long-term health outcomes, such as impaired neurological and cognitive development, and cardiovascular and endocrine diseases in adulthood. At present no gold standard for the diagnosis of SGA/FGR exists. The first aim of this review is to: summarize areas of consensus and controversy between recently published national guidelines on small for gestational age or fetal growth restriction; highlight any recent evidence that should be incorporated into existing guidelines. Another aim to summary a number of interventions which are being developed or coming through to clinical trial in an attempt to improve fetal growth in placental insufficiency. Key words: fetal growth restriction (FGR), Small for gestational age (SGA)
Background: The aim of this study was to establish reference range with gestation for Doppler parameters in the fetal pulmonary venous blood of normal fetal growth, and indices reflecting left atrial pressure changes. Materials and Methods: Cross-sectional data were collected from 168 normal fetal growth between 28 and 40 weeks of gestation. Investigations of fetal pulmonary veins was performed by Doppler echocardiography to measure parameters: peak systolic velocity (S), peak diastolic velocity (D), end-diastolic velocity (A), and to calculate : peak velocity index for veins (PVIV), pulsatility index for viens (PIV). Regression analysis was used to detemine reference ranges with gestation. Results: Mean maternal age of study population was 29.79 ± 5.47 years old, and mean gestational age was 35.55 ± 2.73 weeks, average birth weight of fetus was 2547 ± 647 gr. A significant increase was observed in S, D, A with advancing gestation. Meanwhile, PVIV and PIV was decreasing significantly by advancing the gestational age. Conclusion: A reference range with gestation for Doppler parameters of fetal pulmonary venous blood of normal fetal growth has been established In the case of a normally growing fetus with a gestational age of 28 to 40 weeks, fetal pulmonary venous Doppler parameters are strongly correlated with gestational age. The flow velocity of the S, D, and A waves increases with gestational age. Peak velocity index (PVIV) and pulse index (PI) decrease with gestational age.
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