title: Guidelines on fetal growth restriction: a comparison of recent national publications.
abstract: OBJECTIVE
  This study aims to compare recommendations from recently published national clinical guidelines for pregnancies complicated by fetal growth restriction (FGR).
  
  
  METHODS
  Clinical guidelines informing best practice management of pregnancies with FGR issued by the American Congress of Obstetricians and Gynecologists, the Society of Obstetricians and Gynaecologists of Canada and the Royal College of Obstetricians and Gynaecologists in the United Kingdom are reviewed together with the published literature on this topic.
  
  
  RESULTS
  Each of the guidelines uses different terminology to describe pregnancies affected by suboptimal fetal growth; all of them agree that an estimated fetal weight < 10th centile should alert clinicians to small fetal size. All guidelines describe risk factor screening for improved detection of FGR and acknowledge the limited accuracy achieved with fundal height measurement. No agreement is reached over the value of fetal weight customization. All colleges have varied opinions regarding methods of Doppler surveillance, however agree that umbilical artery Doppler is beneficial as primary surveillance tool.
  
  
  CONCLUSIONS
  The results of this review relay significant inconsistencies and call for an urgent and practical international consensus on this important and common clinical topic. Current data were used to develop a clinical practice guideline for Ireland, which will be presented in context with this review.
authors.affiliation: Department of Obstetrics and Gynaecology, Royal College of Surgeons in Ireland, Dublin, Ireland.
authors.forename: Julia
authors.initials: J
authors.lastname: Unterscheider
authors.affiliation: Department of Obstetrics and Gynaecology, University College Cork, Cork University Maternity Hospital, Cork, Ireland.
authors.forename: Keelin
authors.initials: K
authors.lastname: O'Donoghue
authors.affiliation: Department of Obstetrics and Gynaecology, Royal College of Surgeons in Ireland, Dublin, Ireland.
authors.forename: Fergal D
authors.initials: FD
authors.lastname: Malone
mesh_terms: D002170:Canada; D005260:Female; D047109:Fetal Development / Q000502:physiology; D005317:Fetal Growth Retardation / Q000175:diagnosis*; D005333:Fetus / Q000098:blood supply; D006801:Humans; D007494:Ireland; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D012307:Risk Factors; D014463:Ultrasonography; D014469:Umbilical Arteries / Q000000981:diagnostic imaging; D006113:United Kingdom; D014481:United States