title: Screening, diagnosis, and management of intrauterine growth restriction.
abstract: OBJECTIVE
  To provide comprehensive background knowledge relevant to the SOGC Maternal-Fetal Medicine Committee-approved guideline entitled "Intrauterine Growth Restriction: Screening, Diagnosis, and Management."
  
  
  METHODS
  Publications in English were retrieved through searches of PubMed or Medline, CINAHL, and the Cochrane Library in January 2011 using appropriate controlled vocabulary via MeSH terms (fetal growth restriction and small for gestational age) and any key words (fetal growth, restriction, growth retardation, intrauterine growth restriction [IUGR], low birth weight, small for gestational age). Results were restricted to systematic reviews, randomized controlled trials or controlled clinical trials, and high-quality prospective and retrospective observational studies. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies.
  
  
  RESULTS
  Evidence obtained from at least one properly randomized controlled trial, Cochrane Reviews, and high quality cohort data have been combined to provide clinicians with evidence to optimize their practice for screening, diagnosis, and management of intrauterine growth restriction.
  
  
  CONCLUSIONS
  Considerable advances have been made to improve clinicians' ability to screen, diagnose, and manage pregnancies with suspected IUGR more effectively, including several properly randomized controlled trials. Pregnancies with late-onset IUGR may be managed equally effectively by early delivery or delayed delivery (with increased surveillance) anticipating favourable outcomes. By contrast, many aspects of the management of early-onset IUGR require further clinical trials.
authors.affiliation: Maternal-Fetal Medicine Division, Department of Obstetrics and Gynaecology, University of Toronto, St. Michael's Hospital, Toronto ON.
authors.forename: Andrea
authors.initials: A
authors.lastname: Lausman
authors.affiliation: Maternal-Fetal Medicine Division, Department of Obstetrics and Gynaecology, University of Toronto, Mount Sinai Hospital, Toronto ON.
authors.forename: Fergus P
authors.initials: FP
authors.lastname: McCarthy
authors.affiliation: Maternal-Fetal Medicine Division, Department of Obstetrics and Gynaecology, University of Toronto, Mount Sinai Hospital, Toronto ON.
authors.forename: Melissa
authors.initials: M
authors.lastname: Walker
authors.affiliation: Maternal-Fetal Medicine Division, Department of Obstetrics and Gynaecology, University of Toronto, Mount Sinai Hospital, Toronto ON.
authors.forename: John
authors.initials: J
authors.lastname: Kingdom
mesh_terms: D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D011247:Pregnancy; D016216:Ultrasonography, Prenatal