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
Debbink MP et al: Sonographic assessment of fetal growth abnormalities. Radiographics. 41(1):268-88, 2021
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
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
Meler E et al: Genetic syndromes associated with isolated fetal growth restriction. Prenat Diagn. 40(4):432-46, 2020
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
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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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
Debbink MP et al: Sonographic assessment of fetal growth abnormalities. Radiographics. 41(1):268-88, 2021
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
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
Meler E et al: Genetic syndromes associated with isolated fetal growth restriction. Prenat Diagn. 40(4):432-46, 2020
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
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
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