Fetal growth restriction: ways to the solution of the problem. A literature review

Abstract

Fetal growth restriction is a condition that is defined as the inability of a fetus to reach its full genetically determined growth potential. The mechanism underlying the pathogenesis is a placental dysfunction in the form of inadequate supply of oxygen and nutrients to the fetus. Clinically, this is reflected by a drop in fetal size percentiles over the course of gestation. Worldwide, fetal growth restriction is a leading cause of stillbirth, neonatal mortality and morbidity in postnatal period. Prenatal identification of fetuses with this pathology significantly reduces the incidence of adverse perinatal outcomes. However, recognizing this pathology is often a hard challenge because fetal growth cannot be assessed using only a few biometric parameters of fetal size and the fetal growth potential is hypothetical. It is also necessary to distinguish between fetal growth restriction and a fetus small for gestational age to determine the correct the management of pregnancy and the timing of delivery. In this article, we present the approaches to the management of pregnancies and deliveries in fetal growth restriction, and we identify directions for further research in this area.