Fetal growth restriction (FGR)

Fetal growth restriction (FGR) is a complex condition. Growth abnormalities that result from intrinsic fetal factors, including aneuploidy, congenital malformations, and fetal infection have a poor prognosis that is often not improved by any treatment or intervention. FGR that results from inadequate substrates for fetal nutrition, metabolism, and decreased oxygen availability usually has a better prognosis.

Treatment of FGR

There is inadequate evidence from randomized trials that specific antenatal treatment for the effected fetus is beneficial. Several approaches have been utilized, such as nutritional supplementation, plasma volume expansion, low-dose aspirin, heparin, bed rest, maternal oxygen therapy, and beta-mimetics/calcium channel blockers to improve blood flow to the placenta. Unfortunately, none of these have been shown to be consistently beneficial.

Outcomes of FGR

Studies have found a broad range of long-term outcomes for FGR, including some decreases in IQ and a sharply increased risk of cerebral palsy. FGR may also have a negative impact on intellectual outcome even in the presence of catch-up growth. Generally, the worst outcomes are seen in the more severely growth-restricted infants who are preterm and show significantly impaired umbilical flow.

For growth-restricted fetuses with intact neurologic function, the prognosis is quite favorable when the cause is related to substrate deprivation, the timing of delivery is carefully addressed, the fetus remains well oxygenated, and the infant receives skilled neonatal care.

Long-Term Outcomes of FGR

With FGR, there may also be harmful effects on adult health. One thought called the Barker hypothesis proposed that the endocrine-metabolic reprogramming that enabled the growth restricted fetus to compensate for the hostile environment might lead to a metabolic syndrome later in life. This occurrence may involve a development of hypertension, hypercholesterolemia, impaired glucose tolerance, and ischemic heart disease.

Carnegie Imaging for Women blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!