Comparison between Protocols for Management of Fetal Growth Restriction

• Published in: Revista Brasileira de ginecologia e obstetrícia 2023-02, Vol.45 (2), p.96-103
• Main Authors: Leal, Caio Ribeiro Vieira, Rezende, Karen Pereira, Macedo, Evilane do Carmo Patrício de, Rezende, Guilherme de Castro, Corrêa Júnior, Mário Dias
• Format: Article
• Language: English
• Subjects: Cardiotocography; Doppler velocimetry; Female; Fetal growth restriction; Fetal Growth Retardation - diagnostic imaging; Fetal Growth Retardation - therapy; Fetus - blood supply; Gestational Age; Humans; OBSTETRICS & GYNECOLOGY; Pregnancy; Prematurity; Protocols; Review; Ultrasonography; Ultrasonography, Doppler; Ultrasonography, Prenatal; Umbilical Arteries - diagnostic imaging
• ISSN: 0100-7203; 1806-9339; 1806-9339
• DOI: 10.1055/s-0043-1764493

This comprehensive review compares clinical protocols of important entities regarding the management of fetal growth restriction (FGR), published since 2015. Five protocols were chosen for data extraction. There were no relevant differences regarding the diagnosis and classification of FGR between the protocols. In general, all protocols suggest that the assessment of fetal vitality must be performed in a multimodally, associating biophysical parameters (such as cardiotocography and fetal biophysical profile) with the Doppler velocimetry parameters of the umbilical artery, middle cerebral artery, and ductus venosus. All protocols reinforce that the more severe the fetal condition, the more frequent this assessment should be made. The timely gestational age and mode of delivery to terminate the pregnancy in these cases can vary much between the protocols. Therefore, this paper presents, in a didactic way, the particularities of different protocols for monitoring FGR, in order to help obstetricians to better manage the cases.