US Duplex Doppler Velocimetry Fetal Middle Cerebral Artery To our knowledge, there are no trials evaluating the use of Doppler velocimetry of the fetal middle cerebral artery as an FGR screening tool in low-risk women. US Duplex Doppler Velocimetry Ductus Venosus To our knowledge, there are no trials evaluating the use of Doppler velocimetry of the fetal ductus venosus as a FGR screening tool in low-risk women. Variant 2: Growth disturbance. High risk for fetal growth restriction. Initial evaluation. As discussed above, the mainstay for evaluation of a fetus for FGR is assessment of fetal biometry. This typically occurs during transabdominal US of the uterus. If a fetus is identified as having FGR, confirmation of fetal well- being, such as with a BPP, is necessary. Doppler interrogation of the umbilical artery is a useful tool for timing of delivery for those with FGR. US Pregnant Uterus Transabdominal As opposed to those at low-risk for FGR, those at high-risk for FGR are especially important to identify. As discussed above, US is currently the primary method of identification of fetuses with FGR. Many various historical and clinical factors can suggest FGR, but US-derived fetal biometry is the only current means to confirm a clinical suspicion for FGR. US Duplex Doppler Velocimetry Fetal Umbilical Artery Fetal umbilical artery Doppler velocimetry has garnered the most research for those with known or suspected FGR. Alfirevic et al [35] in a meta-analysis of 20 controlled trials of umbilical artery Doppler US found that management incorporating umbilical artery duplex Doppler was associated with improved perinatal outcome in high-risk pregnancies, reduced antenatal admissions, inductions of labor, and Cesarean delivery for fetal distress, and reduced odds of perinatal death by 38%. Variant 3: Established fetal growth restriction. Follow-up evaluation.
Growth Disturbances Risk of Fetal Growth Restriction. US Duplex Doppler Velocimetry Fetal Middle Cerebral Artery To our knowledge, there are no trials evaluating the use of Doppler velocimetry of the fetal middle cerebral artery as an FGR screening tool in low-risk women. US Duplex Doppler Velocimetry Ductus Venosus To our knowledge, there are no trials evaluating the use of Doppler velocimetry of the fetal ductus venosus as a FGR screening tool in low-risk women. Variant 2: Growth disturbance. High risk for fetal growth restriction. Initial evaluation. As discussed above, the mainstay for evaluation of a fetus for FGR is assessment of fetal biometry. This typically occurs during transabdominal US of the uterus. If a fetus is identified as having FGR, confirmation of fetal well- being, such as with a BPP, is necessary. Doppler interrogation of the umbilical artery is a useful tool for timing of delivery for those with FGR. US Pregnant Uterus Transabdominal As opposed to those at low-risk for FGR, those at high-risk for FGR are especially important to identify. As discussed above, US is currently the primary method of identification of fetuses with FGR. Many various historical and clinical factors can suggest FGR, but US-derived fetal biometry is the only current means to confirm a clinical suspicion for FGR. US Duplex Doppler Velocimetry Fetal Umbilical Artery Fetal umbilical artery Doppler velocimetry has garnered the most research for those with known or suspected FGR. Alfirevic et al [35] in a meta-analysis of 20 controlled trials of umbilical artery Doppler US found that management incorporating umbilical artery duplex Doppler was associated with improved perinatal outcome in high-risk pregnancies, reduced antenatal admissions, inductions of labor, and Cesarean delivery for fetal distress, and reduced odds of perinatal death by 38%. Variant 3: Established fetal growth restriction. Follow-up evaluation.