US Pregnant Uterus Transabdominal Once a diagnosis of FGR has been considered and/or made, serial evaluation of fetal growth is performed to assess the degree to which the fetus is compensating within this abnormal milieu [1,8,11]. Decreasing percentile growth would suggest the need for more intensive monitoring for assessment of fetal well-being or perhaps delivery depending upon clinical parameters, including gestational age. US Duplex Doppler Velocimetry Fetal Middle Cerebral Artery In a systematic review, middle cerebral artery Doppler indexes, which were thought to indicate cerebral redistribution, suggested that SGA fetuses with abnormal middle cerebral artery Doppler velocimetry were associated with neurodevelopmental problems at follow-up of SGA fetuses. The authors called for more adequately controlled studies with long-term follow-up before clear conclusions could be drawn [46]. Among Summary of Recommendations Variant 1: US pregnant uterus transabdominal is usually appropriate for the initial imaging of pregnant women who are at low risk for FGR. Variant 2: US pregnant uterus transabdominal is usually appropriate for the initial imaging of pregnant women who are at high risk for FGR. For those who are found to have growth restriction, US duplex Doppler velocimetry fetal umbilical artery and US pregnant uterus BPP are usually appropriate. Variant 3: US pregnant uterus BPP, US pregnant uterus transabdominal, US duplex Doppler velocimetry fetal umbilical artery, US duplex Doppler velocimetry ductus venosus, and US duplex Doppler velocimetry fetal middle cerebral artery are usually appropriate for follow-up evaluation in pregnant women with established FGR. These procedures are complementary (ie, all tests should be performed). Supporting Documents The evidence table, literature search, and appendix for this topic are available at https://acsearch. acr.org/list.
Growth Disturbances Risk of Fetal Growth Restriction. US Pregnant Uterus Transabdominal Once a diagnosis of FGR has been considered and/or made, serial evaluation of fetal growth is performed to assess the degree to which the fetus is compensating within this abnormal milieu [1,8,11]. Decreasing percentile growth would suggest the need for more intensive monitoring for assessment of fetal well-being or perhaps delivery depending upon clinical parameters, including gestational age. US Duplex Doppler Velocimetry Fetal Middle Cerebral Artery In a systematic review, middle cerebral artery Doppler indexes, which were thought to indicate cerebral redistribution, suggested that SGA fetuses with abnormal middle cerebral artery Doppler velocimetry were associated with neurodevelopmental problems at follow-up of SGA fetuses. The authors called for more adequately controlled studies with long-term follow-up before clear conclusions could be drawn [46]. Among Summary of Recommendations Variant 1: US pregnant uterus transabdominal is usually appropriate for the initial imaging of pregnant women who are at low risk for FGR. Variant 2: US pregnant uterus transabdominal is usually appropriate for the initial imaging of pregnant women who are at high risk for FGR. For those who are found to have growth restriction, US duplex Doppler velocimetry fetal umbilical artery and US pregnant uterus BPP are usually appropriate. Variant 3: US pregnant uterus BPP, US pregnant uterus transabdominal, US duplex Doppler velocimetry fetal umbilical artery, US duplex Doppler velocimetry ductus venosus, and US duplex Doppler velocimetry fetal middle cerebral artery are usually appropriate for follow-up evaluation in pregnant women with established FGR. These procedures are complementary (ie, all tests should be performed). Supporting Documents The evidence table, literature search, and appendix for this topic are available at https://acsearch. acr.org/list.