title: Preventing stillbirths through improved antenatal recognition of pregnancies at risk due to fetal growth restriction.
abstract: Most stillbirths used to be categorized as 'unexplained' and were considered, by implication, unavoidable. Recent evidence indicates that they represent a combined challenge for public health and for clinical services. Independent case reviews have found that many deaths are associated with a failure to recognize risk factors and to afford them the appropriate standard of care. The majority of normally formed fetal deaths had preceding, unrecognized intrauterine growth failure. Improved training and adoption of standardized protocols has led to increased antenatal detection of fetal growth restriction, and this in turn has resulted in significant reductions in stillbirths in areas with high uptake of the training programme. A comprehensive, evidence-based growth assessment protocol (GAP) is currently being rolled out across the NHS to implement this strategy for stillbirth prevention.
authors.affiliation: Perinatal Institute, Birmingham B15 3BU, UK. Electronic address: jgardosi@perinatal.org.uk.
authors.forename: J
authors.initials: J
authors.lastname: Gardosi
authors.affiliation: Perinatal Institute, Birmingham B15 3BU, UK.
authors.forename: S
authors.initials: S
authors.lastname: Giddings
authors.affiliation: Perinatal Institute, Birmingham B15 3BU, UK.
authors.forename: S
authors.initials: S
authors.lastname: Buller
authors.affiliation: Perinatal Institute, Birmingham B15 3BU, UK.
authors.forename: M
authors.initials: M
authors.lastname: Southam
authors.affiliation: Perinatal Institute, Birmingham B15 3BU, UK.
authors.forename: M
authors.initials: M
authors.lastname: Williams
mesh_terms: D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis*; D006801:Humans; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012307:Risk Factors; D013222:State Medicine / Q000458:organization & administration*; D050497:Stillbirth / Q000453:epidemiology*; D006113:United Kingdom / Q000453:epidemiology
keywords: Antenatal surveillance; FGR; Fetal growth restriction; IUGR; Intrauterine growth restriction; Perinatal mortality; Stillbirth