title: Role of uteroplacental and fetal Doppler in identifying fetal growth restriction at term.
abstract: Identification of the fetus at risk of adverse outcome at term is a challenge to both clinicians and researchers alike. Despite the fact that fetal growth restriction (FGR) is a known risk factor for stillbirth, at least two thirds of the stillbirth cases at term are not small for gestational age (SGA) - a commonly used proxy for FGR. However, the majority of SGA fetuses are constitutionally small babies and do not suffer from adverse perinatal outcome. The cerebroplacental ratio (CPR) is emerging as a marker of failure to reach growth potential at term. CPR is an independent predictor of intrapartum fetal distress, admission to the neonatal unit at term, stillbirth, perinatal death and neonatal morbidity. Raised uterine artery Doppler resistance in the third trimester is independently associated with significantly lower birthweight and CPR. The combination of the estimated fetal weight, CPR and uterine Doppler in the third trimester can identify the majority of fetuses at risk of stillbirth.
authors.affiliation: Fetal Medicine Unit, St George's Hospital, St George's University of London, Cranmer Terrace, London SW17 0RE, UK. Electronic address: akhalil@sgul.ac.uk.
authors.forename: Asma
authors.initials: A
authors.lastname: Khalil
authors.affiliation: Fetal Medicine Unit, St George's Hospital, St George's University of London, Cranmer Terrace, London SW17 0RE, UK. Electronic address: basky@pobox.com.
authors.forename: Basky
authors.initials: B
authors.lastname: Thilaganathan
mesh_terms: D005260:Female; D005316:Fetal Distress / Q000453:epidemiology; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging*; D005333:Fetus / Q000000981:diagnostic imaging; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging*; D066087:Perinatal Death; D010920:Placenta / Q000000981:diagnostic imaging; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D018570:Risk Assessment; D050497:Stillbirth / Q000453:epidemiology; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging*; D055988:Uterine Artery / Q000000981:diagnostic imaging*; D014599:Uterus / Q000000981:diagnostic imaging
keywords: cerberoplacental; failure to reach growth potential; fetal growth restriction; middle cerebral artery Doppler; ratio; umbilical artery Doppler; uteroplacental Doppler