Uquillas Kristen R, Grubbs Brendan H, Prosper Ashley E, Chmait Ramen H, Grant Edward G, Walker Daphne K
From the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine (K.R.U., B.H.G., R.H.C.), and Department of Radiology (A.E.P., E.G.G., D.K.W.), Keck School of Medicine, University of Southern California, 2020 Zonal Ave, IRD 203, Los Angeles, CA 90033.
Radiographics. 2017 Oct;37(6):1831-1838. doi: 10.1148/rg.2017170020.
Fetal growth restriction is commonly defined as an estimated fetal weight (EFW) that is below the 10th percentile for gestational age. It is associated with an increased risk of intrauterine demise, neonatal morbidity, and neonatal death; therefore, antenatal detection and surveillance with the optimization of delivery timing are necessary to improve pregnancy outcomes. If the estimated due date has been verified and the EFW is below the 10th percentile for gestational age, the underlying cause should be investigated, since the clinical management, outcome, and counseling options are largely dependent on the cause of the growth restriction. Serial ultrasonography (US) for the evaluation of fetal growth and umbilical artery Doppler velocimetry are used to guide pregnancy management decisions. This article describes the accurate US detection and surveillance of fetal growth restriction, discusses the current obstetric and radiology literature regarding the use of Doppler velocimetry in the setting of fetal growth restriction, and describes the techniques for performing umbilical artery Doppler velocimetry. Although various Doppler techniques have been described in the setting of fetal growth restriction, only umbilical artery Doppler assessment is recommended to identify fetuses most at risk for poor outcome and to guide the timing of delivery. The use of other Doppler waveforms in this setting remains investigational. RSNA, 2017.
胎儿生长受限通常定义为估计胎儿体重（EFW）低于相应孕周的第10百分位数。它与宫内死亡、新生儿发病率和新生儿死亡风险增加相关；因此，产前检测和监测以及优化分娩时机对于改善妊娠结局是必要的。如果预产期已得到确认且EFW低于相应孕周的第10百分位数，则应调查潜在原因，因为临床管理、结局和咨询选择很大程度上取决于生长受限的原因。用于评估胎儿生长的系列超声检查（US）和脐动脉多普勒血流测定法用于指导妊娠管理决策。本文描述了胎儿生长受限的准确超声检测和监测，讨论了当前关于在胎儿生长受限情况下使用多普勒血流测定法的产科和放射学文献，并描述了进行脐动脉多普勒血流测定的技术。尽管在胎儿生长受限情况下已描述了各种多普勒技术，但仅推荐脐动脉多普勒评估来识别预后最差风险最高的胎儿并指导分娩时机。在此情况下使用其他多普勒波形仍处于研究阶段。RSNA，2017年。
