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Guidelines on fetal growth restriction: a comparison of recent national publications

Pregnancies affected by suboptimal fetal growth pose a daily challenge for obstetricians, however international guidelines are inconsistent and show variation, so consensus is urgently needed to inform best clinical practice.

Authors

Julia Unterscheider, Keelin O'Donoghue

Year
2015
Journal Name
American Journal of Perinatology
Category
Journal Article
Keywords
Clinical guideline(s), Fetal growth restriction, Stillbirth
Full Citation

Unterscheider J, O'Donoghue K, Malone FD. Guidelines on fetal growth restriction: a comparison of recent national publications. American Journal of Perinatology. 2015;32(4):307-16. https://doi.org/10.1055/s-0034-1387927.

Link to Publication
https://doi.org/10.1055/s-0034-1387927

Abstract

There is international consensus that pregnancies affected by suboptimal fetal growth pose a daily challenge for obstetricians, and that guidance documents should be available to inform best practice of these pregnancies. Clinical practice guidelines should be evidence based and aimed at standardising and improving care for defined populations, including pregnancy. Poor fetal growth complicates around 10% of pregnancies, but there are uncertainties as to how best to look after and manage these pregnancies. This review aimed to compare and contrast recommendations published in several international guidelines from professional organisations in Obstetrics and Gynaecology, including the US, UK, Canada and Ireland. Guidelines used different terminology and had different approaches to screening and diagnosis of poor fetal growth. There were also different opinions on which management strategy was best and recommendations on timing of birth also varied. This review highlights the disparities that exist between various national protocols on the management of fetal growth problems in pregnancy, despite access to the same published literature. There are some important and outstanding questions in this field needing urgent resolution with respect to terminology, definition, surveillance, and timing of birth, and this paper calls for an urgent international consensus on some of these core issues.

Pregnancy Loss Research Group

Pregnancy Loss Research Group, Department of Obstetrics & Gynaecology, University College Cork, Fifth Floor, Cork University Maternity Hospital, Wilton, Cork, T12 YE02, Ireland,

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