Intrauterine growth restriction

Haram, Kjell; Søfteland, Eirik; Bukowski, Radek

doi:10.1016/j.ijgo.2005.11.011

Cited by 48 publications

(36 citation statements)

References 67 publications

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“…7 If the earliest ultrasound is between 13 and 24 weeks of pregnancy and the last menstrual period (LMP) is certain, with regular menstruation, and there is a difference of less than 10 days between LMP and ultrasound, LMP estimate has fair accuracy. If the LMP is uncertain or irregular menstruation, ultrasound EDD is preferred.…”

Section: Determination Of Gestational Agementioning

confidence: 99%

Clinical study of IUGR cases and correlation of Doppler parameters with perinatal outcome

Sharma¹,

Chandnani²

2016

Int J Reprod Contracept Obstet Gynecol

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Section: Determination Of Gestational Agementioning

confidence: 99%

Clinical study of IUGR cases and correlation of Doppler parameters with perinatal outcome

Sharma¹,

Chandnani²

2016

Int J Reprod Contracept Obstet Gynecol

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“…64 However, of greatest value is an umbilical artery Doppler study: screening of high-risk populations using this method is the only surveillance method associated with a trend toward improvement in perinatal mortality. 65 The optimal frequency of such ultrasounds remains uncertain, but as a screening strategy they should probably only be performed at 28 and 34 weeks gestation unless clinical suspicions dictate more frequent surveillance. The effect of regular ultrasound surveillance on maternal anxiety should not be underestimated.…”

Section: Early Pregnancymentioning

confidence: 99%

Management of subsequent pregnancy after an unexplained stillbirth

Robson

Leader

2009

J Perinatol

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Purpose: To review the management of pregnancy after an unexplained stillbirth.Epidemiology: Approximately 1 in 200 pregnancies will end in stillbirth, of which about one-third will remain unexplained. Unexplained stillbirth is the largest single contributor to perinatal mortality. Subsequent pregnancies do not appear to have an increased risk of stillbirth, but are characterized by increased rates of intervention (induction of labor, elective cesarean section) and iatrogenic adverse outcomes (low birth weight, prematurity, emergency cesarean section and post-partum hemorrhage). Conclusions:There is no level-one evidence to guide management in this situation. Pre-pregnancy counseling is very important to detect and correct potential risk factors such as obesity, smoking and maternal disease. As timely delivery is the mainstay of management, early accurate determination of gestational age is vital. There is controversy regarding the pattern of surveillance, but evidence exists only for ultrasound and not for regular non-stress testing, nor formal fetal movement charting. There is an urgent need for more studies in this important area.

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“…Placental insufficiency is responsible for fetal loss in about 40% of all stillbirths and long-term neurological deficits [2][3][4][5]. The reduction of blood flow resistance in cerebral arteries in severe IUGR conditions, and reduced pulsatility index (PI) in the medial cerebral artery, predicts the 11-fold increased risk of intraventricular hemorrhage, periventricular leukomalacia, hypoxic ischemic encephalopathy, necrotizing enterocolitis, bronchopulmonary dysplasia, sepsis, and death [6].…”

Section: Introductionmentioning

confidence: 99%

The effect of intraumbilical fetal nutrition via a subcutaneously implanted port system on amino acid concentration by severe IUGR human fetuses

Tchirikov

Zhumadilov

Bapayeva

et al. 2017

Journal of Perinatal Medicine

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Objective: To determine if intrauterine intraumbilical supplementation with amino acids (AA) and glucose can improve neonatal outcome of severe growth restricted human fetuses (IUGR). Methods: Prospective pilot study of intrauterine treatment of severe IUGR fetuses [n = 14, 27 weeks of gestation (range 23-31)] with cerebroplacental ratio < 1, with longterm intraumbilical AA and glucose supplementation (10% of feto-placental blood volume/day) using a perinatal port system alone (n = 5) or combined with hyperbaric oxygenation (n = 1, HBO) vs. control group (n = 8). Results:The duration of continuous intraumbilical AA/ glucose supplementation was 11 (6-13) days. Daily intravascular fetal nutrition significantly prolonged the brain sparing to delivery interval by 24 (14-33) days vs. 5.6 (2-12) days in controls. Fetal nutrition reduced blood flow resistance in the placental circulation but did not affect the Doppler profile of cerebral arteries. Higher weight gain of 113.5 (36-539) g was observed following supplementation compared to 33.3 (8-98) g in the control group (P< 0.05). In spite of this, fetuses below 28 weeks of gestation did not sufficiently benefit from infused commercial AA. We found a reduced fetal plasma concentration of the essential AA histidine, threonine, lysine and arginine, and non-essential AA taurine, in severe IUGR fetuses in both groups. Longterm supplementation with a commercial AA formula led to a slight, but not significant, reduction of histidine, threonine, lysine, arginine, asparagine and glutamine. However, the concentration of tryptophan and glutamic acid slightly increased. HBO can be combined with AA supplementation via a port system. In one case, the port system was also successfully used for fetal blood transfusion. Conclusions: Intravascular treatment of IUGR with fetal nutrition can prolong pregnancy with severe placental insufficiency and brain sparing for many weeks. However, rather than normalizing AA concentrations, an enhanced AA imbalance was observed in IUGR fetuses following supplementation. These deviations in AA concentrations prevent the recommendation for use of commercial AA solutions for prenatal treatment of extreme preterm IUGR fetuses.

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Intrauterine growth restriction

Cited by 48 publications

References 67 publications

Clinical study of IUGR cases and correlation of Doppler parameters with perinatal outcome

Clinical study of IUGR cases and correlation of Doppler parameters with perinatal outcome

Management of subsequent pregnancy after an unexplained stillbirth

The effect of intraumbilical fetal nutrition via a subcutaneously implanted port system on amino acid concentration by severe IUGR human fetuses

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