Abstract
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.
Key words
fetal growth restriction (FGR) - intrauterine growth restriction (IUGR) - small for
gestational age (SGA) - Doppler sonography - computerised cardiotocography
