title: [Second trimester growth restriction and underlying fetal anomalies].
abstract: OBJECTIVE
  To determine the incidence of chromosomal abnormalities, syndromic association and fetal defects associated with second trimester fetal growth restriction (FGR) in a tertiary referral center.
  
  
  METHODS
  Retrospective review of all cases referred between 14 and 27 weeks with an abdominal circumference (AC)<5(th) centile between 2008 and 2012. Multiple pregnancies were excluded. Medical records were retrieved to look for the presence of associated malformations, aneuploidy and outcomes.
  
  
  RESULTS
  A total of 8626 fetuses had ultrasonographic examination between 14 and 27 weeks. Of these, there were 239 cases (2.8%) with evidence of FGR as based on AC measurement. Thirty-seven fetuses had an abnormal karyotype or an identified syndromic association (15%). The most common chromosomal defect was Trisomy 18 (10 cases, 4.2%), 67 had at least one associated morphological abnormality without aneuploidy or syndromic association (28%). Most common associated abnormalities were relative short femur (5%), omphalocele (5%) and gastroschisis (4%). Last 135 cases were isolated fetal growth retardation (5%). Maternal age was higher (33 yr ± 5 yr versus 31 yr ± 5.6 yr, P < 0.01) and the z-score for the AC lower (2.5 ± 1 versus 2.15 ± 0.6) in the group with abnormal karyotype or syndromic association than in the group without associated malformation. Amniotic fluid was more often increased in the group with an abnormal karyotype or associated malformation (14% and 17%) than in the group without malformations (0%, P < 0.01).
  
  
  CONCLUSIONS
  This study describes abnormalities and outcomes associated with second trimester fetal growth retardation in a large population of patients. Our results suggest that the absence of associated malformation, degree of growth restriction, maternal age and the amniotic fluid index may help in the prenatal management and counseling of this high risk population.
authors.affiliation: Service d'obstétrique et de médecine materno-fœtale, université Paris Descartes, hôpital Necker-Enfants-Malades, Assistance publique-Hôpitaux de Paris, 149, rue de Sèvres, 75015 Paris, France. Electronic address: sarah.vanlie@wanadoo.fr.
authors.forename: S
authors.initials: S
authors.lastname: Vanlieferinghen
authors.affiliation: Service d'obstétrique et de médecine materno-fœtale, université Paris Descartes, hôpital Necker-Enfants-Malades, Assistance publique-Hôpitaux de Paris, 149, rue de Sèvres, 75015 Paris, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Bernard
authors.affiliation: Service d'obstétrique et de médecine materno-fœtale, université Paris Descartes, hôpital Necker-Enfants-Malades, Assistance publique-Hôpitaux de Paris, 149, rue de Sèvres, 75015 Paris, France.
authors.forename: L J
authors.initials: LJ
authors.lastname: Salomon
authors.affiliation: Service d'obstétrique et de médecine materno-fœtale, université Paris Descartes, hôpital Necker-Enfants-Malades, Assistance publique-Hôpitaux de Paris, 149, rue de Sèvres, 75015 Paris, France.
authors.forename: G E
authors.initials: GE
authors.lastname: Chalouhi
authors.affiliation: Service d'obstétrique et de médecine materno-fœtale, université Paris Descartes, hôpital Necker-Enfants-Malades, Assistance publique-Hôpitaux de Paris, 149, rue de Sèvres, 75015 Paris, France.
authors.forename: N E
authors.initials: NE
authors.lastname: Russell
authors.affiliation: Service d'obstétrique et de médecine materno-fœtale, université Paris Descartes, hôpital Necker-Enfants-Malades, Assistance publique-Hôpitaux de Paris, 149, rue de Sèvres, 75015 Paris, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Ville
mesh_terms: D000653:Amniotic Fluid; D002869:Chromosome Aberrations / Q000196:embryology*; D002887:Chromosomes, Human, Pair 18; D000013:Congenital Abnormalities / Q000235:genetics; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging / Q000235:genetics*; D006801:Humans; D007621:Karyotyping; D008423:Maternal Age; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies; D014314:Trisomy; D000073842:Trisomy 18 Syndrome; D014463:Ultrasonography
keywords: Aneuploidy; Aneuploïdie; Diagnostic anténatal; Fetal growth retardation; Prenatal diagnosis; Retard de croissance intra-utérin; Ultrasonography; Échographie