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Reprod. Med.
Special Issues
Fetal Growth Restriction
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Fetal Growth Restriction

A special issue of Reproductive Medicine (ISSN 2673-3897).

Deadline for manuscript submissions: closed (31 October 2021) | Viewed by 18291

Special Issue Editor

Dr. Dietmar Schlembach

E-Mail Website
Guest Editor
Vivantes - Netzwerk für Gesundheit GmbH, Klinikum Neukölln, Rudower Straße 48, 12351 Berlin, Germany
Interests: fetal growth restriction; preeclampsia; pregnancy-related complications; preterm birth; biomarkers for pregnancy complications; post-partum hemorrhage; abnormal invasive placenta; (Doppler) ultrasound; diagnosis and treatment of fetal anomalies

Special Issue Information

Dear Colleagues,

Fetal growth restriction (FGR) is a condition that affects 5–10% of pregnancies and is the second most common cause of perinatal mortality. 

FGR has to be distinguished from constitutional small for gestational age (SGA) fetuses and should be diagnosed in the presence of any factor associated with a poorer perinatal outcome, i.e., Doppler ultrasound, growth below the 3rd centile, oligohydramnios, and, possibly in the near future, maternal angiogenic factors. Differentiation into early- and late-onset FGR is useful for research and also clinical purposes. 

Proper management of FGR (including observation and planning mode and time of delivery) must consider the potential for fetal injury or death versus the risks of iatrogenic preterm delivery. Whereas early-onset FGR management protocols guide clinicians in decision-making, diagnosis and management of late FGR is still a challenge and matter of debate. 

I encourage authors and investigators within this complex field of universal interest to share their research and clinical experiences by submitting original research or review articles.

Dr. Dietmar Schlembach
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Reproductive Medicine is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • fetal growth restriction
  • intrauterine growth restriction
  • small for gestational age
  • early-onset/late-onset FGR
  • diagnosis of FGR
  • management of FGR
  • pathophysiology of FGR
  • genetics of FGR
  • perinatal outcome
  • long-term outcome

Published Papers (4 papers)

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Research

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11 pages, 1144 KiB  
Article
Biosensor for Detecting Fetal Growth Restriction in a Low-Resource Setting
by Anders Jacobsen, Christentze Schmiegelow, Bjarke Sørensen, Omari A. Msemo, Karsten Nielsen, Birgitte Bruun Nielsen, Sofie Lykke Møller, John P. A. Lusingu, Daniel T. R. Minja, Morten Hedegaard and Diana Riknagel
Reprod. Med. 2021, 2(1), 57-67; https://doi.org/10.3390/reprodmed2010007 - 15 Mar 2021
Cited by 1 | Viewed by 3260
Abstract
One strategy for improving detection of fetal growth restriction (FGR) is developing biosensors identifying placental dysfunction as a leading pathogenesis for FGR. The aim of this pilot study was to investigate the performance of a biosensor specified to detect placental dysfunction by means [...] Read more.
One strategy for improving detection of fetal growth restriction (FGR) is developing biosensors identifying placental dysfunction as a leading pathogenesis for FGR. The aim of this pilot study was to investigate the performance of a biosensor specified to detect placental dysfunction by means of maternal arterial turbulence acoustics in a low-resource setting. A cohort of 147 singleton pregnant women were prospectively followed with double-blinded biosensor tests, sonographic estimation of fetal weight (EFW) and Doppler flow at 26–28, 32–34 and 37–39 weeks of pregnancy. Full term live births with recorded birth weights (BWs) and without major congenital malformations were included. Outcomes were defined as (A) a solitary biometric measure (BW < 3rd centile) and as (B) a biometric measure and contributory functional measure (BW < 10th centile and antenatally detected umbilical artery pulsatility index > 95th centile). Data from 118 women and 262 antenatal examinations were included. Mean length of pregnancy was 40 weeks (SD ± 8 days), mean BW was 3008 g (SD ± 410 g). Outcome (A) was identified in seven (6%) pregnancies, whereas outcome (B) was identified in one (0.8%) pregnancy. The biosensor tested positive in five (4%) pregnancies. The predictive performance for outcome (A) was sensitivity = 0.29, specificity = 0.97, p = 0.02, positive predictive value (PPV) was 0.40 and negative predictive value (NPV) was 0.96. The predictive performance was higher for outcome (B) with sensitivity = 1.00, specificity = 0.97, p = 0.04, PPV = 0.20 and NPV = 1.00. Conclusively, these pilot-study results show future potential for biosensors as screening modality for FGR in a low-resource setting. Full article
(This article belongs to the Special Issue Fetal Growth Restriction)
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7 pages, 485 KiB  
Article
Fetal Umbilical Vein Flow in the Classification of Fetuses with Growth Restriction
by Daniele Farsetti, Francesca Pometti, Grazia Maria Tiralongo, Damiano Lo Presti, Ilaria Pisani, Giulia Gagliardi, Barbara Vasapollo, Gian Paolo Novelli and Herbert Valensise
Reprod. Med. 2021, 2(1), 50-56; https://doi.org/10.3390/reprodmed2010006 - 9 Mar 2021
Cited by 2 | Viewed by 3378
Abstract
Objectives: To assess umbilical vein (UV) blood flow in fetal growth restriction (FGR) and in pregnancy with small for gestational age (SGA) fetus. To evaluate the predictive capacity of UV blood flow (QUV) in the discrimination of SGA fetuses from FGR before and [...] Read more.
Objectives: To assess umbilical vein (UV) blood flow in fetal growth restriction (FGR) and in pregnancy with small for gestational age (SGA) fetus. To evaluate the predictive capacity of UV blood flow (QUV) in the discrimination of SGA fetuses from FGR before and after 32 weeks of pregnancy. Methods: Sixty-five women with a recent diagnosis of FGR or SGA fetuses were enrolled and underwent a complete fetal Doppler examination comprehending QUV. We collected SGA (n = 34), early-FGR (n = 9), and late-FGR (n = 22) fetuses. Results: UV diameter was lower in early and late-FGR compared to SGA, while time-averaged maximum velocity (TAMXV) was lower only in early-FGR. UV blood flow (QUV) and QUV corrected for estimated fetal weight (cQUV) were significantly lower in early-FGR and late-FGR compared to SGA. The receiver operating characteristic (ROC) curves analysis of cQUV showed a significant predictive capacity for SGA diagnosis before and after 32 weeks. Conclusions: The evaluation of UV blood flow allows distinguishing SGA fetuses from FGR. The assessment of UV flow should be taken into consideration in future research of new parameters to differentiate SGA from FGR. Full article
(This article belongs to the Special Issue Fetal Growth Restriction)
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10 pages, 779 KiB  
Article
Is the Cerebro-Placental Ratio Sufficient to Predict Adverse Neonatal Outcome in Small for Gestational Age Fetuses > 34 Weeks of Gestation?
by Jarmila A. Zdanowicz, Muriel Disler, Roland Gerull, Luigi Raio and Daniel Surbek
Reprod. Med. 2021, 2(1), 2-11; https://doi.org/10.3390/reprodmed2010002 - 2 Feb 2021
Viewed by 3578
Abstract
Fetuses with an estimated weight (EFW) below the 10th percentile are at risk for adverse perinatal outcome and clinical management remains a challenge. We examined EFW and cerebro-placental ratio (CPR) with regard to their predictive capability in the management and outcome of such [...] Read more.
Fetuses with an estimated weight (EFW) below the 10th percentile are at risk for adverse perinatal outcome and clinical management remains a challenge. We examined EFW and cerebro-placental ratio (CPR) with regard to their predictive capability in the management and outcome of such cases. Fetuses were first diagnosed as small after 34 weeks of gestation with an actual EFW below the 10th percentile at our tertiary academic center. We determined the optimum cutoff value for CPR and EFW in predicting adverse neonatal outcome. Mean gestational age at diagnosis was 36 weeks. One hundred and two cases were included in our study. We determined a CPR of 1.4 and an EFW of 2152 g to be the best cutoff value for predicting adverse fetal outcome, with an area under the curve (AUC) of 0.65 (95% CI 0.54–0.76); p = 0.009, and 0.76 (95% CI 0.66–0.86); p < 0.0001, respectively. However, when comparing EFW with CPR, EFW seems to be slightly better in predicting adverse fetal outcome in our group. While the use of CPR alone for the management of small fetuses is not sufficient, it is an important additional tool that may be of value in the clinical setting. Full article
(This article belongs to the Special Issue Fetal Growth Restriction)
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Review

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10 pages, 403 KiB  
Review
Monitoring, Delivery and Outcome in Early Onset Fetal Growth Restriction
by Andrea Dall’Asta, Monica Minopoli, Tullio Ghi and Tiziana Frusca
Reprod. Med. 2021, 2(2), 85-94; https://doi.org/10.3390/reprodmed2020009 - 12 Apr 2021
Cited by 2 | Viewed by 6872
Abstract
Early fetal growth restriction (FGR) remains a challenging entity associated with an increased risk of perinatal morbidity and mortality as well as maternal complications. Significant variations in clinical practice have historically characterized the management of early FGR fetuses. Nevertheless, insights into diagnosis and [...] Read more.
Early fetal growth restriction (FGR) remains a challenging entity associated with an increased risk of perinatal morbidity and mortality as well as maternal complications. Significant variations in clinical practice have historically characterized the management of early FGR fetuses. Nevertheless, insights into diagnosis and management options have more recently emerged. The aim of this review is to summarize the available evidence on monitoring, delivery and outcome in early-onset FGR. Full article
(This article belongs to the Special Issue Fetal Growth Restriction)
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