Abstract
Objective This study aims to compare recommendations from recently published national clinical
guidelines for pregnancies complicated by fetal growth restriction (FGR).
Materials and Methods Clinical guidelines informing best practice management of pregnancies with FGR issued
by the American Congress of Obstetricians and Gynecologists, the Society of Obstetricians
and Gynaecologists of Canada and the Royal College of Obstetricians and Gynaecologists
in the United Kingdom are reviewed together with the published literature on this
topic.
Results Each of the guidelines uses different terminology to describe pregnancies affected
by suboptimal fetal growth; all of them agree that an estimated fetal weight < 10th
centile should alert clinicians to small fetal size. All guidelines describe risk
factor screening for improved detection of FGR and acknowledge the limited accuracy
achieved with fundal height measurement. No agreement is reached over the value of
fetal weight customization. All colleges have varied opinions regarding methods of
Doppler surveillance, however agree that umbilical artery Doppler is beneficial as
primary surveillance tool.
Conclusions The results of this review relay significant inconsistencies and call for an urgent
and practical international consensus on this important and common clinical topic.
Current data were used to develop a clinical practice guideline for Ireland, which
will be presented in context with this review.
Keywords
fetal growth restriction - IUGR - SGA - clinical practice guidelines - practice bulletin
