Intrauterine growth restriction.
This study reviewed the screening, diagnosis, prophylaxis, and treatment of intrauterine growth restriction using the PubMed database for key words and the Cochrane database for systematic reviews. Identification of risk factors and measurement of symphysis-fundus height are currently the screening standards. Diagnosis is verified by ultrasonography. Accuracy of diagnosis may be improved by using customized fetal growth curves, symphysis-fundus height charts, and 3-dimensional ultrasonographic evaluation and measuring umbilical artery Doppler dimensional ultrasonographic evaluation measuring umbilical artery Doppler impedance. Prophylaxis with acetylsalicylic acid, started in the first or second trimester or combined with heparin before conception, may reduce the incidence of growth restriction in specific groups at high risk. Active management may reduce incidence in patients with mild to moderate asthma, and targeted treatment of infections may also be beneficial. Antenatal corticosteroid treatment also reduces the perinatal morbidity and mortality associated with IUGR. Bed rest has no demonstrated beneficial effects.
Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway. kjell.haram@broadpark.no
K
K
Haram
E
E
Søfteland
R
R
Bukowski
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000653:Amniotic Fluid; D001241:Aspirin / Q000627:therapeutic use; D001510:Bed Rest; D005260:Female; D047109:Fetal Development / Q000502:physiology*; D005317:Fetal Growth Retardation / Q000175:diagnosis* / Q000628:therapy*; D005865:Gestational Age; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D006931:Hyperbaric Oxygenation; D021621:Imaging, Three-Dimensional; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012307:Risk Factors; D016216:Ultrasonography, Prenatal / Q000379:methods
D000305:Adrenal Cortex Hormones; D006493:Heparin; D001241:Aspirin