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Ten‐year experience of protocol‐based management of small‐for‐gestational‐age fetuses: Perinatal outcome in late‐pregnancy cases diagnosed after 32 weeks

Ultrasound in Obstetrics & Gynecology Jan 15, 2021

Meler E, Mazarico E, Eixarch E, et al. - Via this retrospective cohort study, researchers sought to present their 10‐year experience of protocol‐based management of small‐for‐gestational‐age (SGA) fetuses, based on standardized clinical and Doppler criteria, in late‐pregnancy cases. The cohort included 1,197 pregnancies with estimated fetal weight (EFW) < 10th centile; 160 of these were delivered before 37 weeks' gestation. These pregnancies were classified at diagnosis as low‐risk SGA (n = 619; 51.7%) or fetal growth restriction (FGR) (n = 578; 48.3%). Follow up was performed in low‐risk SGA pregnancies at 2‐week intervals and delivery was conducted electively at 40 weeks. Follow up of FGR pregnancies was done at 1‐week intervals, or more frequently if there were signs of fetal deterioration, and delivery was conducted electively after 37 + 0 weeks' gestation. Findings suggest that for late pregnancy with a suspected SGA baby, protocol‐based risk stratification with different management and monitoring schemes, based on clinical and Doppler criteria, allows recognition and tailored assessment of high‐risk FGR, while enabling expectant management with safe perinatal outcome for low‐risk SGA fetuses.

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