Planning management and delivery of the growth-restricted fetus

Baschat, Ahmet

doi:10.1016/j.bpobgyn.2018.02.009

Cited by 90 publications

(132 citation statements)

References 89 publications

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“…Progressive deterioration of UA Doppler velocimetry warrants more intensive monitoring every 2-3 days when absent or reversed UA-EDF is present. There is no consensus on monitoring frequency, however, suggested management strategies have been described elsewhere 29,42,67 .…”

Section: How To Monitormentioning

confidence: 99%

ISUOG Practice Guidelines: diagnosis and management of small‐for‐gestational‐age fetus and fetal growth restriction

Lees

Stampalija

Baschat

et al. 2020

Ultrasound in Obstet & Gyne

453

454

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ISUOG Practice Guidelines: diagnosis and management of small-for-gestational-age fetus and fetal growth restriction Clinical Standards CommitteeThe International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) is a scientific organization that encourages sound clinical practice, and high-quality teaching and research related to diagnostic imaging in women's healthcare. The ISUOG Clinical Standards Committee (CSC) has a remit to develop Practice Guidelines and Consensus Statements as educational recommendations that provide healthcare practitioners with a consensus-based approach, from experts, for diagnostic imaging. They are intended to reflect what is considered by ISUOG to be the best practice at the time at which they are issued. Although ISUOG has made every effort to ensure that Guidelines are accurate when issued, neither the Society nor any of its employees or members accepts any liability for the consequences of any inaccurate or misleading data, opinions or statements issued by the CSC. The ISUOG CSC documents are not intended to establish a legal standard of care, because interpretation of the evidence that underpins the Guidelines may be influenced by individual circumstances, local protocol and available resources. Approved Guidelines can be distributed freely with the permission of ISUOG (

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Section: How To Monitormentioning

confidence: 99%

ISUOG Practice Guidelines: diagnosis and management of small‐for‐gestational‐age fetus and fetal growth restriction

Lees

Stampalija

Baschat

et al. 2020

Ultrasound in Obstet & Gyne

453

454

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“…A biophysical profile (BPP) uses a combination of ultrasound and cardiotocography. The biophysical profile assumes that the real-time ultrasound foetal observation combined with assessment of selected parameters may offer better prognostic value than the CTG alone [42]. The assessment of foetal movements, foetal breathing movements and foetal tone combined with non-stress test and estimation of amniotic fluid volume has been suggested to reduce the false negative results observed with the non-stress test or foetal movements alone.…”

Section: A Foetal Biophysical Profilementioning

confidence: 99%

Management of hypertension in pregnancy — prevention, diagnosis, treatment and long-term prognosis. A position statement of the Polish Society of Hypertension, Polish Cardiac Society and Polish Society of Gynaecologists and Obstetricians

Prejbisz¹,

Dobrowolski²,

Kosiński³

et al. 2019

Arterial Hypertension

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Disclaimer: The position statement represent the views of the authors and were produced after careful consideration of the scientific and medical knowledge and the evidence available at the time of their dating. The authors and societies are not responsible in the event of any contradiction, discrepancy, and/or ambiguity between the position statement and any other official recommendations or guidelines issued by the relevant public health authorities, in particular in relation to good use of healthcare or therapeutic strategies. Health professionals are encouraged to take the position statement fully into account when exercising their clinical judgment as well as in the determination and the implementation of preventive, diagnostic, or therapeutic medical strategies. 118 www.ah.viamedica.pl ABPM -ambulatory blood pressure monitoring ACE-I -angiotensin-converting enzyme inhibitor AF -atrial fibrillation AFI -amniotic fluid index AFL -atrial flutter AGA -appropriate for gestational age AHI -apnea hypopnea index AKI -acute kidney injury ALT -alanine transaminase ARB -angiotensin receptor blocker ARR -aldosterone-to-renin ratio AST -aspartate aminotransferase AT -atrial tachycardia BAV -bicuspid aortic valve BMI -body mass index BNP -B-nariuretic peptide BP -blood pressure Bpm -beats per minute BPP -biophysical profile CABG -coronary artery bypass graft CAD -coronary artery disease CKD -chronic kidney disease CNS -central nervous system CoA -coarctation of the aorta CPAP -continuous positive airway pressure CPR -cerebroplacental ratio CTG -cardiotocography CV -cardiovascular DBP -diastolic blood pressure DIC -disseminated intravascular coagulation DM -diabetes mellitus ECMO -extracorporeal membrane oxygenation ECG -electrocardiography EF -ejection fraction ESC -European Society of Cardiology ESH -European Society of Hypertension EVA -early vascular ageing FDA -Food and Drug Administration FHR -foetal heart rate FIGO -International Federation of Gynaecology and Obstetrics FMD -fibromuscular dysplasia FMF -Fetal Medicine Foundation FPS -frame per second GFR -glomerular filtration rate HELLP -hemolysis, elevated liver enzymes, low platelet countuterine growth restriction IVF -in vitro fertilisation LBBB -left bundle branch block LBW -low birth weight LDH -lactate dehydrogenase LQTS -long QT syndrome LVAD -left ventricular assist device LVEF -left ventricular ejection fraction MAP -mean arterial pressure MCA -middle cerebral artery MCS -mechanical circulatory support MDT -multidisciplinary team MRA -mineralocorticoids renceptor antagonist MRAs -mineralocorticoids renceptor antagonists MRI -magnetic resonance imaging NSTEMI -non-ST elevation myocardial infarction NT-BNP -N-terminal pro-BNP NTS -non-stress-test OGTT -oral glucose tolerance test OSA -obstructive sleep apnoea p.o. -per os PA -primary aldosteronism PAPP-A -pregnancy associated placental protein PCI -percutaneous coronary intervention PE -pre-eclampsia PI -pulsatility index PlGF -placental growth factor PPCM -peripartum cardiomyopathy PPGL -pheochromocytoma a...

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“…It is important to note that early-onset FGR should be assessed differently than late-onset FGR. In early-onset FGR progressive deterioration is reflected in abnormal venous Doppler parameters, while in late-onset FGR this manifests primarily in cerebral Doppler sonography (▶ Table 2) [1,41].…”

Section: Sga/fgr Managementmentioning

confidence: 99%

“…In FGR normal resistance ratios also indicate a low risk of unfavourable perinatal outcome and low perinatal mortality [9]. The prognosis worsens depending on the degree of increase in resistance [41]. In so-called ARED flow (absent/reversed end-diastolic flow) about 70 % of the placental vessels are occluded [44], which in "reversed end-diastolic flow" increases the risk of perinatal mortality by a factor of 5.…”

Section: Doppler Ultrasound ▪ Umbilical Arterymentioning

confidence: 99%

Fetal Growth Restriction – Diagnostic Work-up, Management and Delivery

Schlembach

2020

Geburtshilfe Frauenheilkd

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Fetal or intrauterine growth restriction (FGR/IUGR) affects approximately 5 – 8% of all pregnancies and refers to a fetus not exploiting its genetically determined growth potential. Not only a major cause of perinatal morbidity and mortality, it also predisposes these fetuses to the development of chronic disorders in later life. Apart from the timely diagnosis and identification of the causes of FGR, the obstetric challenge primarily entails continued antenatal management with optimum timing of delivery. In order to minimise premature birth morbidity, intensive fetal monitoring aims to prolong the pregnancy and at the same time intervene, i.e. deliver, before the fetus is threatened or harmed. It is important to note that early-onset FGR (< 32 + 0 weeks of gestation [wks]) should be assessed differently than late-onset FGR (≥ 32 + 0 wks). In early-onset FGR progressive deterioration is reflected in abnormal venous Doppler parameters, while in late-onset FGR this manifests primarily in abnormal cerebral Doppler ultrasound. According to our current understanding, the “optimum” approach for monitoring and timing of delivery in early-onset FGR combines computerized CTG with the ductus venosus Doppler, while in late-onset FGR assessment of the cerebral Doppler parameters becomes more important.

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Planning management and delivery of the growth-restricted fetus

Cited by 90 publications

References 89 publications

ISUOG Practice Guidelines: diagnosis and management of small‐for‐gestational‐age fetus and fetal growth restriction

ISUOG Practice Guidelines: diagnosis and management of small‐for‐gestational‐age fetus and fetal growth restriction

Management of hypertension in pregnancy — prevention, diagnosis, treatment and long-term prognosis. A position statement of the Polish Society of Hypertension, Polish Cardiac Society and Polish Society of Gynaecologists and Obstetricians

Fetal Growth Restriction – Diagnostic Work-up, Management and Delivery

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