Stefan Savchev1, Francesc Figueras, Eduard Gratacos. 1. Fetal and Perinatal Research Centre, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
Abstract
OBJECTIVE: To provide a snapshot of the current trends in managing intrauterine growth restriction (IUGR) and to assess the agreement on the gestational age and the way of delivery in different clinical scenarios. METHODS: A PubMed search was performed to identify all original articles on IUGR in the last 6 years. The most active 20 authors were selected as experts and were invited to respond to a survey on their preferred gestational age for elective delivery in several IUGR cases depending on Doppler measurements (including umbilical artery (UA), middle cerebral artery, cerebroplacental ratio, uterine artery and ductus venosus), biophysical profile and cardiotocography. RESULTS: 15 of the 20 selected experts agreed to participate in the survey, of which 3 failed to meet the deadline to complete the survey. Management of IUGR was relatively uniform for abnormal UA, uterine artery or cerebroplacental ratio. Although average gestational age at delivery reflected a clear progression with accepted markers of severity, discrepancies of up to 4 weeks were found for abnormal middle cerebral artery Doppler and absent end-diastolic velocity in the UA, and of up to 8 weeks for reverse end-diastolic velocity in the UA and abnormalities in the ductus venosus Doppler. CONCLUSIONS: Management of IUGR is still far from being uniform among centers, with most controversy surrounding the management of early-onset IUGR. There is a need of prospective studies to address this issue.
OBJECTIVE: To provide a snapshot of the current trends in managing intrauterine growth restriction (IUGR) and to assess the agreement on the gestational age and the way of delivery in different clinical scenarios. METHODS: A PubMed search was performed to identify all original articles on IUGR in the last 6 years. The most active 20 authors were selected as experts and were invited to respond to a survey on their preferred gestational age for elective delivery in several IUGR cases depending on Doppler measurements (including umbilical artery (UA), middle cerebral artery, cerebroplacental ratio, uterine artery and ductus venosus), biophysical profile and cardiotocography. RESULTS: 15 of the 20 selected experts agreed to participate in the survey, of which 3 failed to meet the deadline to complete the survey. Management of IUGR was relatively uniform for abnormal UA, uterine artery or cerebroplacental ratio. Although average gestational age at delivery reflected a clear progression with accepted markers of severity, discrepancies of up to 4 weeks were found for abnormal middle cerebral artery Doppler and absent end-diastolic velocity in the UA, and of up to 8 weeks for reverse end-diastolic velocity in the UA and abnormalities in the ductus venosus Doppler. CONCLUSIONS: Management of IUGR is still far from being uniform among centers, with most controversy surrounding the management of early-onset IUGR. There is a need of prospective studies to address this issue.
Authors: Makarios Eleftheriades; Homeira Vafaei; Ismene Dontas; George Vaggos; Katerina Marinou; Panagiota Pervanidou; Neil J Sebire; George P Chrousos; Kypros H Nicolaides Journal: Pediatr Res Date: 2016-04-08 Impact factor: 3.756
Authors: Mariona Guitart-Mampel; Diana L Juarez-Flores; Lina Youssef; Constanza Moren; Laura Garcia-Otero; Vicente Roca-Agujetas; Marc Catalan-Garcia; Ingrid Gonzalez-Casacuberta; Ester Tobias; José C Milisenda; Josep M Grau; Fàtima Crispi; Eduard Gratacos; Francesc Cardellach; Glòria Garrabou Journal: J Cell Mol Med Date: 2019-04-02 Impact factor: 5.310