Early-onset fetal growth restriction: comparison of two management protocols in a single tertiary center

Abstract

Objective

Compare the neonatal outcomes of two protocols of diagnosis and surveillance of pregnancies complicated by early-onset FGR in a tertiary hospital.

Methods

This is a retrospective cohort study of pregnant women diagnosed with early-onset FGR between 2017 and 2020. We compared the obstetric and perinatal outcomes between two different management protocols (before and after 2019).

Results

Seventy-two cases of early-onset FGR were diagnosed in the forementioned period: 45 (62.5%) were managed according to protocol 1 and 27 (37.5%) according to protocol 2. Mean gestational age at delivery was significantly different between groups: 34.9 ± 3.1 weeks (95% CI 34.0–35.9) in group 1 and 32.3 ± 4.4 weeks (95% CI 30.4–33.9) in group 2. 74.1% (20) of newborns in group 2 were admitted in de NICU, a significant difference when compared with 46.7% of group 1. There were no statistically significant differences in the remaining serious neonatal adverse outcomes.

Conclusions

This is the first study published comparing two different protocols of management of FGR. The implementation of the new protocol seems to have led to a decrease in the number of fetuses labeled as growth restricted and to a decrease in the gestational age of delivery of such fetuses, but without increasing the rate of serious neonatal adverse outcomes.

Synopsis

The implementation of the 2016 ISUOG guidelines for the diagnosis of fetal growth restriction seems to have led to a decrease in the number of fetuses labeled as growth restricted and to a decrease in the gestational age of delivery of such fetuses, but without increasing the rate of serious neonatal adverse outcomes.

Keywords:

• Fetal growth retardation
• doppler ultrasound
• neonatal intensive care
• prenatal care
• prenatal ultrasonography

Author contribution

Joana Barros, André Graça and Rui Marques Carvalho participated in the conception and design of this work, revised it critically and provided relevant intellectual content and approved the final version we present here.

Ana Dagge participated in the conception and design of this work, and was responsible for the acquisition, analysis and interpretation of data as well as for writing this manuscript.

Declaraion statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.