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Fetal growth issues 

Fetal growth issues
Chapter:
Fetal growth issues
Author(s):

Harini Narayan

DOI:
10.1093/med/9780199673643.003.0026
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date: 29 July 2021

This chapter addresses both symmetrical or asymmetrical intrauterine growth restriction (IUGR) and large for gestational age (LGA). Small for gestational age (SGA) includes pathologically growth-restricted fetuses as well as those just constitutionally small. LGA, defined as estimated fetal weight greater than the 90th centile for gestational age, has increased by 25% in recent years. Various aetiologies, epidemiology, pathophysiology, risk factors, the role and limitations of clinical assessments as well as perinatal implications of fetal growth issues are discussed. Biochemical markers for IUGR and ultrasound indices including Doppler measurements, customized serial biometry are described in line with national guidance. Optimal timing and mode of delivery and role of placental pathology are addressed. Increased maternal, fetal/ neonatal morbidity associated with macrosomia, lack of evidenced consensus for management or any benefits of early intervention in suspected LGA are discussed. Antenatal management options when a previous baby was either SGA or macrosomic are explored.

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