Beischer N A, Abell D A, Drew J H
Aust N Z J Obstet Gynaecol. 1983 Nov;23(4):191-6. doi: 10.1111/j.1479-828x.1983.tb00576.x.
Fetal growth retardation ranks third after prematurity and malformations as a cause of perinatal deaths. Antenatal fetal monitoring (biochemical testing of fetoplacental function plus cardiotocography) has emerged as the most important means of reduction in the number of stillbirths and improvement in the quality of survival of infants who are born alive. Clinical acumen combined with biochemical and/or ultrasonographic testing will identify no more than 70% of growth retarded fetuses. However, not all small for dates fetuses are at risk, and many doomed to die in utero are not by definition, growth retarded. It should be the obstetrician's aim to identify the fetus at risk of death from hypoxia whether growth retarded or not. Biochemical and ultrasonographic methods of testing are not truly comparable, since some aim to identify the growth retarded fetus, irrespective of his state of health, whereas others aim to detect fetoplacental dysfunction, irrespective of whether or not the fetus is growth retarded. With present methods of antenatal diagnosis and treatment and timing of delivery determined by nonstressed cardiotocography, the physical and intellectual prognosis of growth retarded infants is most satisfactory; follow-up studies have shown that only about 2% of these infants are severely handicapped.
胎儿生长受限是围产期死亡的原因之一，仅次于早产和畸形，位列第三。产前胎儿监测（胎盘功能生化检测加胎心监护）已成为减少死产数量和提高存活新生儿生存质量的最重要手段。临床敏锐度结合生化和/或超声检查最多只能识别70%的生长受限胎儿。然而，并非所有小于孕周的胎儿都有风险，而且许多注定在子宫内死亡的胎儿从定义上讲并非生长受限。产科医生的目标应该是识别出无论是否生长受限但有因缺氧而死亡风险的胎儿。生化和超声检查方法并不具有真正的可比性，因为有些方法旨在识别生长受限胎儿，而不考虑其健康状况，而其他方法旨在检测胎盘功能障碍，而不管胎儿是否生长受限。采用目前的产前诊断和治疗方法以及由无应激胎心监护确定的分娩时机，生长受限婴儿的身体和智力预后非常令人满意；随访研究表明，这些婴儿中只有约2%有严重残疾。
