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Fetal Growth Restriction
Anne Kennedy, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Fetal growth restriction (FGR)
              • Small for gestational age (SGA)
            • Synonyms

              • Intrauterine growth restriction (IUGR)
            • Definitions

              • Terms used are those recommended by American Society of Obstetrics and Gynecology (ACOG), Society of Maternal Fetal Medicine (SMFM)
              • FGR: Estimated fetal weight (EFW) or abdominal circumference (AC) < 10th percentile for gestational age (GA)
                • Suggests fetus is pathologically small but will include some some constitutionally small fetuses
              • Early-onset FGR if diagnosis made at < 32 weeks GA
                • Early-onset FGR was used to describe uniformly small fetus, attributed to intrinsic fetal abnormality (e.g., aneuploidy)
              • Late-onset FGR if diagnosis made at > 32 weeks GA
                • Late-onset FGR was used when AC small compared with head circumference (HC), attributed to placental insufficiency
              • Severe FGR: EFW < 3rd percentile for GA (approximates 2 standard deviations below mean)
              • SGA: Birth weight < 10th percentile for GA (some will be constitutionally small but healthy)

            IMAGING

            • Ultrasonographic Findings

              • Imaging Recommendations

                DIFFERENTIAL DIAGNOSIS

                  PATHOLOGY

                  • General Features

                    CLINICAL ISSUES

                    • Presentation

                      • Demographics

                        • Natural History & Prognosis

                          • Treatment

                            DIAGNOSTIC CHECKLIST

                            • Consider

                              • Image Interpretation Pearls

                                • Reporting Tips

                                  Selected References

                                  1. Debbink MP et al: Sonographic assessment of fetal growth abnormalities. Radiographics. 41(1):268-88, 2021
                                  2. Dall'Asta A et al: Etiology and perinatal outcome of periviable fetal growth restriction associated with structural or genetic anomaly. Ultrasound Obstet Gynecol. 55(3):368-74, 2020
                                  3. Lees CC et al: ISUOG Practice Guidelines: diagnosis and management of small-for-gestational-age fetus and fetal growth restriction. Ultrasound Obstet Gynecol. 56(2):298-312, 2020
                                  4. Meler E et al: Genetic syndromes associated with isolated fetal growth restriction. Prenat Diagn. 40(4):432-46, 2020
                                  5. Society for Maternal-Fetal Medicine (SMFM). Electronic address: [email protected] et al: Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction: (Replaces Clinical Guideline Number 3, April 2012). Am J Obstet Gynecol. 223(4):B2-17, 2020
                                  6. American College of Obstetricians and Gynecologists' Committee on Practice Bulletins—Obstetrics and the Society forMaternal-FetalMedicin.: ACOG Practice Bulletin No. 204: Fetal Growth Restriction. Obstet Gynecol. 133(2):e97-e109, 2019
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      • Top Differential Diagnoses

                                        • Clinical Issues

                                          • Diagnostic Checklist

                                            TERMINOLOGY

                                            • Abbreviations

                                              • Fetal growth restriction (FGR)
                                              • Small for gestational age (SGA)
                                            • Synonyms

                                              • Intrauterine growth restriction (IUGR)
                                            • Definitions

                                              • Terms used are those recommended by American Society of Obstetrics and Gynecology (ACOG), Society of Maternal Fetal Medicine (SMFM)
                                              • FGR: Estimated fetal weight (EFW) or abdominal circumference (AC) < 10th percentile for gestational age (GA)
                                                • Suggests fetus is pathologically small but will include some some constitutionally small fetuses
                                              • Early-onset FGR if diagnosis made at < 32 weeks GA
                                                • Early-onset FGR was used to describe uniformly small fetus, attributed to intrinsic fetal abnormality (e.g., aneuploidy)
                                              • Late-onset FGR if diagnosis made at > 32 weeks GA
                                                • Late-onset FGR was used when AC small compared with head circumference (HC), attributed to placental insufficiency
                                              • Severe FGR: EFW < 3rd percentile for GA (approximates 2 standard deviations below mean)
                                              • SGA: Birth weight < 10th percentile for GA (some will be constitutionally small but healthy)

                                            IMAGING

                                            • Ultrasonographic Findings

                                              • Imaging Recommendations

                                                DIFFERENTIAL DIAGNOSIS

                                                  PATHOLOGY

                                                  • General Features

                                                    CLINICAL ISSUES

                                                    • Presentation

                                                      • Demographics

                                                        • Natural History & Prognosis

                                                          • Treatment

                                                            DIAGNOSTIC CHECKLIST

                                                            • Consider

                                                              • Image Interpretation Pearls

                                                                • Reporting Tips

                                                                  Selected References

                                                                  1. Debbink MP et al: Sonographic assessment of fetal growth abnormalities. Radiographics. 41(1):268-88, 2021
                                                                  2. Dall'Asta A et al: Etiology and perinatal outcome of periviable fetal growth restriction associated with structural or genetic anomaly. Ultrasound Obstet Gynecol. 55(3):368-74, 2020
                                                                  3. Lees CC et al: ISUOG Practice Guidelines: diagnosis and management of small-for-gestational-age fetus and fetal growth restriction. Ultrasound Obstet Gynecol. 56(2):298-312, 2020
                                                                  4. Meler E et al: Genetic syndromes associated with isolated fetal growth restriction. Prenat Diagn. 40(4):432-46, 2020
                                                                  5. Society for Maternal-Fetal Medicine (SMFM). Electronic address: [email protected] et al: Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction: (Replaces Clinical Guideline Number 3, April 2012). Am J Obstet Gynecol. 223(4):B2-17, 2020
                                                                  6. American College of Obstetricians and Gynecologists' Committee on Practice Bulletins—Obstetrics and the Society forMaternal-FetalMedicin.: ACOG Practice Bulletin No. 204: Fetal Growth Restriction. Obstet Gynecol. 133(2):e97-e109, 2019