Sehgal A, Crispi F, Skilton M R, de Boode W-P
Neonatologist, Monash Newborn, Monash Children's Hospital, Monash University, Melbourne, VIC, Australia.
Department of Paediatrics, Monash University, Melbourne, VIC, Australia.
J Perinatol. 2017 Dec;37(12):1251-1258. doi: 10.1038/jp.2017.119. Epub 2017 Aug 24.
Fetal growth restriction (FGR) affects 7-10% pregnancies. Conventional and tissue Doppler imaging has noted cardiac compromise during fetal and early neonatal periods in this cohort. In this article, we discuss the use of salient ultrasound parameters across age groups. During fetal life, certain feto-placental sonographic parameters have been linked to adverse perinatal outcomes and are predictive of later life hypertension. During the early postnatal period altered morphometry (hypertrophied and globular hearts) with sub-clinical impairment of cardiac function has been noted in both term and preterm infants with FGR. Vascular imaging has noted thickened and stiffer arteries in association with significantly elevated blood pressure. Similar findings in the pediatric age groups indicate persistence of these alterations, and have formed the basis of intervention studies. Assessment methodology and clinical relevance of these parameters, especially in designing and monitoring of intervention strategies is discussed. Frontline care givers (obstetricians and neonatologists) are increasingly using point of care ultrasound to discern these manifestations of FGR during the sub-clinical phase.
胎儿生长受限（FGR）影响7%-10%的妊娠。传统超声和组织多普勒成像已发现该队列中的胎儿及新生儿早期存在心脏功能受损。在本文中，我们讨论了不同年龄组中显著超声参数的应用。在胎儿期，某些胎儿-胎盘超声参数与不良围产期结局相关，并且可预测日后发生高血压。在出生后早期，已注意到FGR的足月儿和早产儿均存在形态学改变（心脏肥大呈球形）以及心脏功能的亚临床损害。血管成像显示动脉增厚、僵硬，同时血压显著升高。在儿童年龄组中也有类似发现，表明这些改变持续存在，并构成了干预研究的基础。本文讨论了这些参数的评估方法及其临床意义，尤其是在干预策略的设计和监测方面。一线医护人员（产科医生和新生儿科医生）越来越多地使用床旁超声来识别FGR在亚临床阶段的这些表现。
