title: Intrauterine growth restriction: screening, diagnosis, and management.
abstract: BACKGROUND
  Intrauterine growth restriction (IUGR) is an obstetrical complication, which by definition would screen in 10% of fetuses in the general population. The challenge is to identify the subset of pregnancies affected with pathological growth restriction in order to allow intervention that would decrease morbidity and mortality.
  
  
  OBJECTIVE
  The purpose of this guideline is to provide summary statements and recommendations and to establish a framework for screening, diagnosis, and management of pregnancies affected with IUGR.
  
  
  METHODS
  Affected pregnancies are compared with pregnancies in which the fetus is at an appropriate weight for its gestational age. History, physical examination, and laboratory investigations including biochemical markers and ultrasound characteristics of IUGR are reviewed, and a management strategy is suggested.
  
  
  METHODS
  Published literature in English was retrieved through searches of PubMed or MEDLINE, CINAHL, and The Cochrane Library in January 2013 using appropriate controlled vocabulary via MeSH terms (fetal growth restriction and small for gestational age) and key words (fetal growth, restriction, growth retardation, IUGR, low birth weight, small for gestational age). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies.
  
  
  METHODS
  The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table).
  
  
  RESULTS
  Implementation of the recommendations in this guideline should increase clinician recognition of IUGR and guide intervention where appropriate. Optimal long-term follow-up of neonates diagnosed as IUGR may improve their long-term health.
authors.affiliation: Toronto ON.
authors.forename: Andrea
authors.initials: A
authors.lastname: Lausman
authors.affiliation: Toronto ON.
authors.forename: John
authors.initials: J
authors.lastname: Kingdom
mesh_terms: D002170:Canada; D019468:Disease Management; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D005865:Gestational Age; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008403:Mass Screening; D018743:Perinatal Care / Q000379:methods / Q000592:standards; D011247:Pregnancy; D018570:Risk Assessment; D012307:Risk Factors; D016216:Ultrasonography, Prenatal / Q000379:methods*
keywords: Doppler; diagnosis; intrauterine growth restriction (IUGR); management; placenta; screening; ultrasound