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Fetal Growth Restriction

What is fetal growth restriction (FGR)?

Fetal growth restriction (FGR) is a condition in which an unborn baby (fetus) is smaller than expected for the number of weeks of pregnancy (gestational age). It is often described as an estimated weight less than the 10th percentile. This means that the baby weighs less than 9 out of 10 babies of the same gestational age. Newborn babies with FGR may be called “small for gestational age.”

FGR can begin at any time during pregnancy. With FGR, the baby does not grow well. FGR may affect the overall size of the baby and the growth of organs, tissues, and cells. This can cause many problems. But many newborns who are small may just be small. They may not have any problems.

What causes FGR?

Many things increase the risk for FGR. These include problems with the placenta or umbilical cord. The placenta may not attach well. Or the blood flow through the umbilical cord may be limited. Factors in both the mother and the baby may cause FGR.

Factors in the mother that can cause FGR include:

High blood pressure or other heart and blood vessel disease

Too few red blood cells (anemia)

Long-term lung or kidney conditions

Autoimmune conditions such as lupus

Very low weight

A large amount of excess weight (obese)

Poor nutrition or weight gain

Alcohol or drug use

Cigarette smoking

Factors in the baby that can cause FGR include:

Being one of a twin or triplets

Birth defects, such as heart defects

Problem with genes or chromosomes

What are the symptoms of FGR?

A pregnant woman doesn’t have symptoms of FGR. But a baby with FGR may have certain signs after birth, such as:

Low birth weight

Low blood sugar levels

Lower body temperature

High level of red blood cells

Trouble fighting infections

How is FGR diagnosed?

One of the main reasons for regular prenatal exams is to make sure your baby is growing well. During pregnancy, the size of your baby is estimated in different ways, including:

Fundal height. To check fundal height, your healthcare provider measures from the top of your pubic bone to the top of your uterus (fundus). Fundal height, measured in centimeters (cm), is about the same as the number of weeks of pregnancy after the 20th week. For example, at 24 weeks gestation, your fundal height should be close to 24 cm. If the fundal height is less than expected, it may mean FGR.

If your healthcare provider thinks you have FGR, you will have other tests. These include: 

Fetal ultrasound. Estimating fetal weight with ultrasound is the best way to find FGR. Ultrasound uses sound waves to create images of the baby in the womb. Sound waves will not harm you or the baby. Your healthcare provider or a technician will use the images to measure the baby. A diagnosis of FGR is based on the difference between actual and expected measurements at a certain gestational age.

Doppler ultrasound.   You may also have this special type of ultrasound to diagnose FGR. Doppler ultrasound checks the blood flow to the placenta and through the umbilical cord to the baby. Decreased blood flow may mean your baby has FGR.

You may have repeat ultrasound exams, Doppler studies, and other tests.

How is FGR managed?

Management depends on how serious the FGR is. This is based on the ultrasound (estimated fetal weight) and Doppler ultrasound (blood flow to the baby), as well is risk factors and the number of weeks gestation.

Treatment may include:

Frequent monitoring. This means you will have prenatal visits more often, and ultrasound and Doppler ultrasound exams. You may have other tests.

Tracking fetal movements. Your healthcare provider may also ask you to keep track of fetal movements. If so, he or she will give you instructions.

Corticosteroid medicine

Hospital stay

Early delivery or emergency cesarean

What are possible complications of FGR?

FGR can cause many serious complications. Your baby may need to be delivered early and stay in the hospital. Your baby may have trouble breathing, infections, and other problems. Stillbirths and death may occur. As your child grows, he or she will be at higher risk for heart and blood vessel problems.

How can FGR be prevented?

FGR can happen in any pregnancy. But some factors, like cigarette smoking or alcohol or medicine use, increase the risk for FGR. Regular and early prenatal care and a healthy diet and steady weight gain help to prevent FGR and other problems.

When should I call my healthcare provider?

Make sure your healthcare provider knows your health history. If you are counting fetal movements and find that the number has decreased, let your healthcare provider know. And if you notice other changes or if you have concerns about your pregnancy, call your healthcare provider.

Key points about fetal growth restriction

FGR is a condition in which the baby is smaller than expected for gestational age.  

Many factors increase the risk for FGR. They may be related to the placenta, mother, or baby.

Estimating fetal weight with ultrasound is the best way to identify FGR.

If FGR is diagnosed, you will need to be closely monitored.

Tips to help you get the most from a visit to your healthcare provider:

Know the reason for your visit and what you want to happen.

Before your visit, write down questions you want answered.

Bring someone with you to help you ask questions and remember what your provider tells you.

At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

Ask if your condition can be treated in other ways.

Know why a test or procedure is recommended and what the results could mean.

Know what to expect if you do not take the medicine or have the test or procedure.

If you have a follow-up appointment, write down the date, time, and purpose for that visit.

Know how you can contact your provider if you have questions.

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Selective Fetal Growth Restriction: What We Know and What We Don’t

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In this session, learners will be able to identify maternal and fetal indications for various fetal interventions and associated maternal-fetal outcomes and discuss prenatal counseling, obstetrical management, fetal therapy options, fetal surveillance and delivery planning for fetuses with select fetal anomalies. Learners will also be able to understand ongoing research endeavors related to maternal-fetal health and childhood outcomes.

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This seminar focuses on fetal diagnosis and treatment and was delivered at a virtual event titled, “Selective Fetal Growth Restriction: What We Know and What We Don’t” on December 8, 2023.

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Fetal Growth Restriction: A Comprehensive Review of Major Guidelines

Affiliations.

• 1 Resident.
• 2 Assistant Professor.
• 3 Professor.
• 4 Associate Professor.
• 5 Assistant Professor, Third Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece.
• PMID: 38134339
• DOI: 10.1097/OGX.0000000000001203

Importance: Fetal growth restriction (FGR) is a common pregnancy complication and a significant contributor of fetal and neonatal morbidity and mortality, mainly due to the lack of effective screening, prevention, and management policies.

Objective: The aim of this study was to review and compare the most recently published influential guidelines on the management of pregnancies complicated by FGR.

Evidence acquisition: A descriptive review of guidelines from the American College of Obstetricians and Gynecologists (ACOG), the Society for Maternal-Fetal Medicine, the International Federation of Gynecology and Obstetrics, the International Society of Ultrasound in Obstetrics and Gynecology, the Royal College of Obstetricians and Gynecologists, the Society of Obstetricians and Gynecologists of Canada (SOGC), the Perinatal Society of Australia and New Zealand, the Royal College of Physicians of Ireland, the French College of Gynecologists and Obstetricians (FCGO), and the German Society of Gynecology and Obstetrics on FGR was carried out.

Results: Several discrepancies were identified regarding the definition of FGR and small-for-gestational-age fetuses, the diagnostic criteria, and the need of testing for congenital infections. On the contrary, there is an overall agreement among the reviewed guidelines regarding the importance of early universal risk stratification for FGR to accordingly modify the surveillance protocols. Low-risk pregnancies should unanimously be evaluated by serial symphysis fundal height measurement, whereas the high-risk ones warrant increased sonographic surveillance. Following FGR diagnosis, all medical societies agree that umbilical artery Doppler assessment is required to further guide management, whereas amniotic fluid volume evaluation is also recommended by the ACOG, the SOGC, the Perinatal Society of Australia and New Zealand, the FCGO, and the German Society of Gynecology and Obstetrics. In case of early, severe FGR or FGR accompanied by structural abnormalities, the ACOG, the Society for Maternal-Fetal Medicine, the International Federation of Gynecology and Obstetrics, the Royal College of Obstetricians and Gynecologists, the SOGC, and the FCGO support the performance of prenatal diagnostic testing. Consistent protocols also exist on the optimal timing and mode of delivery, the importance of continuous fetal heart rate monitoring during labor, and the need for histopathological examination of the placenta after delivery. On the other hand, guidelines concerning the frequency of fetal growth and Doppler velocimetry evaluation lack uniformity, although most of the reviewed medical societies recommend an average interval of 2 weeks, reduced to weekly or less when umbilical artery abnormalities are detected. Moreover, there is a discrepancy on the appropriate timing for corticosteroids and magnesium sulfate administration, as well as the administration of aspirin as a preventive measure. Cessation of smoking, alcohol consumption, and illicit drug use are proposed as preventive measures to reduce the incidence of FGR.

Conclusions: Fetal growth restriction is a clinical entity associated with numerous adverse antenatal and postnatal events, but currently, it has no definitive cure apart from delivery. Thus, the development of uniform international protocols for the early recognition, the adequate surveillance, and the optimal management of growth-restricted fetuses seem of paramount importance to safely guide clinical practice, thereby improving perinatal outcomes of such pregnancies.

Publication types

• Aspirin / therapeutic use
• Fetal Growth Retardation / diagnosis
• Fetal Growth Retardation / prevention & control
• Gynecology*
• Infant, Newborn
• Obstetrics*
• Prenatal Care

Intrauterine growth restriction

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Citation, DOI, disclosures and article data

At the time the article was created Yuranga Weerakkody had no recorded disclosures.

At the time the article was last revised Karen Machang'a had no financial relationships to ineligible companies to disclose.

• Intrauterine growth restriction (IUGR)
• Intrauterine growth retardation
• Small for gestational age
• Small for gestational age (SGA)
• Intra uterine growth restriction
• Intra-uterine growth restriction (IUGR)
• Fetal growth restriction
• Fetal growth restriction (FGR)
• Intrauterine growth retardation (IUGR)

Intrauterine growth restriction (IUGR) or fetal growth restriction (FGR) is defined as an estimated fetal weight (EFW)  and/or abdominal circumference (AC) at one point in time during pregnancy being below 3 rd  percentile or EFW and/or AC below the 10 th percentile for gestational age with deranged Doppler parameters 14 .

An IUGR can be broadly divided into two main types:

type I: symmetrical intrauterine growth restriction

type II: asymmetrical intrauterine growth restriction

Some authors also enlist a third type termed: femur-sparing intrauterine growth restriction   10 .

On this page:

Clinical assessment, radiographic features, treatment and prognosis, differential diagnosis.

• Cases and figures

The symphysis fundal height (SFH)  can be a commonly used crude measurement.

IUGR can result from a vast number of causes:

placental insufficiency (commonest cause overall)

abnormal uteroplacental circulation

abnormal fetoplacental circulation

maternal conditions

maternal narcotics/smoking

maternal alcohol use: fetal alcohol syndrome

maternal diabetes: when severe maternal diabetes, there can be a paradoxical IUGR as opposed to fetal macrosomia

maternal malnutrition/starvation

maternal vascular conditions

certain medications

other placental causes

increased incidence with a single umbilical artery

fetal conditions

multifetal pregnancy

intrauterine infections

chromosomal anomalies

triploidy (IUGR is of early-onset)

Down syndrome (not a dominant feature)

chromosome 4p deletion syndrome  (Wolf-Hirschhorn syndrome)

chromosome 12p tetrasomy ( Pallister-Killian syndrome )

confined placental mosaicism (CPM)   13

other syndromic anomalies

Cornelia de Lange syndrome

Neu-Laxova syndrome

Pena Shokeir syndrome

Seckel syndrome

Silver-Russel syndrome

Smith-Lemli-Opitz syndrome

in utero substance exposure

e.g.  fetal hydantoin syndrome

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Antenatal ultrasound

Sonographic parameters include:

non-Doppler features

reduced abdominal circumference (AC) and/or EFW

AC and/or EFW <3 rd percentile

AC and/or EFW <10 th  percentile with deranged Doppler parameters

presence of oligohydramnios without ruptured membranes

increased head circumference (HC) to abdominal circumference (AC) ratio (in asymmetrical type)

advanced placental grade

Doppler features (will require a chart to calculate absolute values)

umbilical artery Doppler assessment

increased PI above 95 th  percentile

absent/reversed diastolic flow

umbilical venous Doppler assessment

presence of pulsatility

uterine arterial Doppler assessment

increased mean uterine artery PI above 95 th  percentile

presence of notching  in mid to late pregnancy

reduced below 5 th  percentile

While there is no cure, management is reliant on a structured antenatal surveillance program with timely intervention in order to minimize fetal compromise.

Complications

There are many including:

antepartum 

iatrogenic prematurity

perinatal stroke 

intrapartum

abnormal fetal status (fetal heart rate tracing) 

emergency Cesarean section 

need for active neonatal resuscitation 

hypothermia 

hypoglycemia 

hypocalcemia 

polycythemia 

coagulopathy 

hepatocellular dysfunction 

respiratory distress syndrome

necrotizing enterocolitis

intraventricular hemorrhage, especially in premature IUGR neonates <750 g

hypoxic-ischemic encephalopathy

increased risk of: 

short stature 

cerebral palsy 

developmental delay

behavioral and emotional problems 

lower IQ scores 

chronic lung disease 

future cardiovascular disease and hypertension

General considerations include:

incorrect dates

small for dates fetus

Quiz questions

• 1. Grant EG, Tessler FN, Perrella RR. Clinical Doppler imaging. AJR Am J Roentgenol. 1989;152 (4): 707-17. AJR Am J Roentgenol (citation) - Pubmed citation
• 2. Smith-bindman R, Chu PW, Ecker JL et-al. US evaluation of fetal growth: prediction of neonatal outcomes. Radiology. 2002;223 (1): 153-61. doi:10.1148/radiol.2231010876 - Pubmed citation
• 3. Altman DG, Hytten FE. Intrauterine growth retardation: let's be clear about it. Br J Obstet Gynaecol. 1989;96 (10): 1127-32. - Pubmed citation
• 4. Ott WJ. The diagnosis of altered fetal growth. Obstet. Gynecol. Clin. North Am. 1988;15 (2): 237-63. - Pubmed citation
• 5. Botsis D, Vrachnis N, Christodoulakos G. Doppler assessment of the intrauterine growth-restricted fetus. Ann. N. Y. Acad. Sci. 2006;1092 : 297-303. doi:10.1196/annals.1365.027 - Pubmed citation
• 6. Mandruzzato G, Antsaklis A, Botet F et-al. Intrauterine restriction (IUGR). J Perinat Med. 2008;36 (4): 277-81. doi:10.1515/JPM.2008.050 - Pubmed citation
• 7. Gerber S, Hohlfeld P, Viquerat F et-al. Intrauterine growth restriction and absent or reverse end-diastolic blood flow in umbilical artery (Doppler class II or III): A retrospective study of short- and long-term fetal morbidity and mortality. Eur. J. Obstet. Gynecol. Reprod. Biol. 2006;126 (1): 20-6. doi:10.1016/j.ejogrb.2005.07.008 - Pubmed citation
• 8. Baschat AA. Fetal growth restriction - from observation to intervention. J Perinat Med. 2010;38 (3): 239-46. doi:10.1515/JPM.2010.041 - Pubmed citation
• 9. Galan HL, Ferrazzi E, Hobbins JC. Intrauterine growth restriction (IUGR): biometric and Doppler assessment. Prenat. Diagn. 2002;22 (4): 331-7. doi:10.1002/pd.311 - Pubmed citation
• 10. Sanders RC, Winter TC. Clinical sonography, a practical guide. Lippincott Williams & Wilkins. (2006) ISBN:0781748690. Read it at Google Books - Find it at Amazon
• 11. Bamfo JE, Odibo AO. Diagnosis and management of fetal growth restriction. J Pregnancy. 2011;2011 : 640715. doi:10.1155/2011/640715 - Free text at pubmed - Pubmed citation
• 12. Merz E, Bahlmann F. Ultrasound in obstetrics and gynecology. Thieme Medical Publishers. (2005) ISBN:1588901475. Read it at Google Books - Find it at Amazon
• 13. Lestou VS, Kalousek DK. Confined placental mosaicism and intrauterine fetal growth. Arch. Dis. Child. Fetal Neonatal Ed. 1998;79 (3): F223-6. Arch. Dis. Child. Fetal Neonatal Ed. (link) - Free text at pubmed - Pubmed citation
• 14. L.J. Salomon, Z. Alfirevic, F. Da Silva Costa et-al. ISUOG Practice Guidelines: ultrasound assessment of fetal biometry and growth. (2019) Ultrasound in Obstetrics & Gynecology. 53 (6): 715. doi:10.1002/uog.20272 - Pubmed

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• Turner syndrome
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Screening for Late-Onset Fetal Growth Restriction in Antepartum Fetal Monitoring Using Deep Forest and SHAP

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• Jianhong Huo 6 ,
• Guohua Li 6 ,
• Chongwen Li 6 ,
• Guiqing Liu 8 ,
• Qinqun Chen 6 ,
• Jialu Li 6 ,
• Yuexing Hao 9 &
• Hang Wei 10  

Part of the book series: Lecture Notes on Data Engineering and Communications Technologies ((LNDECT,volume 207))

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Fetal growth restriction (FGR) is the second leading cause of perinatal death, of which late-onset fetal growth restriction (LFGR) accounts for 70%–80% and has a low detection rate. Cardiotocography (CTG) is a routine tool for antepartum fetal monitoring, continuously recording fetal heart rate (FHR) to assess the development of the fetus. Therefore, in this paper, we proposed a hybrid DF-SHAP model that screens LFGR in routine CTG monitoring using deep forest (DF) and Shapley Additive Explanation (SHAP). Firstly, principal component analysis, spearman correlation analysis and logistic regression analysis were implemented to explore significant FHR features for LFGR. After data preprocessing, deep forest multi-granularity scanning was introduced to probe the connection among the features. Then the cascade forest phase, which was designed to integrate random forest, extra trees, logistic regression and extreme gradient boosting as the basic classifiers, iteratively generated new layers and finally got the best performance model. Finally, SHAP was introduced to enhance the interpretability of DF and to interpret the impact of each feature on the predicted value. The experimental results showed that the proposed DF-SHAP model outperformed the state-of-the-art LFGR recognition models using CTG data and had good interpretability. This indicates that the DF-SHAP model is feasible for screening LFGR in antepartum fetal monitoring.

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Crovetto, F., et al.: First-trimester screening with specific algorithms for early-and late-onset fetal growth restriction. Ultrasound Obstet. Gynecol. 48 (3), 340–348 (2016)

Article   Google Scholar  

Feng, Y., Zheng, H., Fang, D., Mei, S., Zhong, W., Zhang, G.: Prediction of late-onset fetal growth restriction using a combined first- and second-trimester screening model. J. Gynecol. Obstet. Hum. Reprod. 51 (2), 102273 (2022)

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Lundberg, S.M., Lee, S.I.: A unified approach to interpreting model predictions. In: Advances in Neural Information Processing Systems, vol. 30 (2017)

Oros, D., Figueras, F., Cruz-Martinez, R., Meler, E., Gratacos, E.: Longitudinal changes in uterine, umbilical and fetal cerebral doppler indices in late-onset small-for-gestational age fetuses. Ultrasound Obstet. Gynecol. 37 (2), 191–195 (2011)

Pini, N., et al.: A machine learning approach to monitor the emergence of late intrauterine growth restriction. Front. Artif. Intell. 4 , 622616 (2021)

Qi, T.I., Sun, Y.L.: Clinical analysis of prenatal stressless fetal heart monitor combined with electronic fetal heart monitor. Chin. J. Fam. Plann. Gynecotokology 11 (1), 73–76 (2019)

Savchev, S., et al.: Evaluation of an optimal gestational age cut-off for the definition of early- and late-onset fetal growth restriction. Fetal Diagn. Ther. 36 (2), 99–105 (2014)

Signorini, M.G., Pini, N., Malovini, A., Bellazzi, R., Magenes, G.: Integrating machine learning techniques and physiology based heart rate features for antepartum fetal monitoring. Comput. Methods Programs Biomed. 185 , 105015 (2020)

Zhou, Z.H., Feng, J.: Deep forest: towards an alternative to deep neural networks. In: IJCAI, pp. 3553–3559 (2017)

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Acknowledgement

This work is supported by Natural Science Foundation of China No.61976052 and No.71804031, Medical Scientific Research Foundation of Guangdong Province No. A2019428 and National Undergraduate Innovation and Venture Training Project No. 202210572005.

Recommender: Associate Professor Bo Xu, Guangdong University of Finance and Economics in China.

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Jianhong Huo, Guohua Li, Chongwen Li, Qinqun Chen & Jialu Li

The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China

The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China

Guiqing Liu

Department of Human Centered Design, Cornell University, Ithaca, NY, USA

Yuexing Hao

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Correspondence to Hang Wei .

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Huo, J. et al. (2024). Screening for Late-Onset Fetal Growth Restriction in Antepartum Fetal Monitoring Using Deep Forest and SHAP. In: Cao, BY., Wang, SF., Nasseri, H., Zhong, YB. (eds) Intelligent Systems and Computing. ICFIE 2022. Lecture Notes on Data Engineering and Communications Technologies, vol 207. Springer, Singapore. https://doi.org/10.1007/978-981-97-2891-6_29

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