Kamphof Hester D, Posthuma Selina, Gordijn Sanne J, Ganzevoort Wessel
Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands.
Department of Obstetrics & Gynecology, Amsterdam UMC, University of Amsterdam, 1100 DD Amsterdam, The Netherlands.
Matern Fetal Med. 2022 Jul 22;4(3):186-196. doi: 10.1097/FM9.0000000000000161. eCollection 2022 Jul.
Fetal growth restriction (FGR) is the condition in which a fetus does not reach its intrinsic growth potential and in which the short-term and long-term risks of severe complications are increased. FGR is a frequent complication of pregnancy with a complex etiology and limited management options, other than timely delivery. The most common pathophysiological mechanism is placental insufficiency, due to many underlying causes such as maternal vascular malperfusion, fetal vascular malperfusion and villitis. Identifying truly growth restricted fetuses remains challenging. To date, FGR is often defined by a cut-off of the estimated fetal weight below a certain percentile on a population-based standard. However, small fetal size as a single marker does not discriminate adequately between fetuses or newborns that are constitutionally small but healthy and fetuses or newborns that are growth restricted and thus at risk for adverse outcomes. In 2016, the consensus definition of FGR was internationally accepted to better pinpoint the FGR population. In this review we will discuss the contemporary diagnosis and management issues. Different diagnostic markers are considered, like Doppler measurements, estimated fetal growth, interval growth, fetal movements, biomarkers, and placental markers.
胎儿生长受限（FGR）是指胎儿未达到其内在生长潜力且严重并发症的短期和长期风险增加的情况。FGR是一种常见的妊娠并发症，病因复杂，除了适时分娩外，治疗选择有限。最常见的病理生理机制是胎盘功能不全，其由许多潜在原因引起，如母体血管灌注不良、胎儿血管灌注不良和绒毛炎。识别真正生长受限的胎儿仍然具有挑战性。迄今为止，FGR通常根据基于人群标准的估计胎儿体重低于特定百分位数来定义。然而，仅以胎儿体型小作为单一指标，无法充分区分体质瘦小但健康的胎儿或新生儿与生长受限因而有不良结局风险的胎儿或新生儿。2016年，FGR的共识定义在国际上被接受，以更好地确定FGR人群。在本综述中，我们将讨论当代的诊断和管理问题。我们会考虑不同的诊断标志物，如多普勒测量、估计胎儿生长、生长间隔、胎动、生物标志物和胎盘标志物。
