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首页> 外文期刊>Best practice & research:Clinical obstetrics & gynaecology >Prophylaxis and treatment of foetal growth restriction
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Prophylaxis and treatment of foetal growth restriction

机译：预防和胎儿生长限制的治疗方法

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Foetal growth restriction (FGR) and associated placental pathologies such as pre-eclampsia and stillbirth arise in early pregnancy when inadequate remodelling of maternal spiral arteries leads to persistent high-resistance low-flow uteroplacental circulation. Current interventions concentrate on targeting the placental ischaemia-reperfusion injury and oxidative stress associated with an imbalance in angiogenic/anti-angiogenic factors. Recent meta analyses confirm that aspirin modestly reduces the risk for small-for-gestational-age pregnancy in high-risk women. A dose of = 100 mg starting by 16 weeks of gestation is recommended. In vitro and in vivo studies suggest that low-molecular-weight heparin may prevent FGR; further research is needed to confirm efficacy. Once FGR is diagnosed, no treatment will improve foetal growth. Potential FGR therapies such as phosphodiesterase type-5 inhibitors or maternal VEGF gene therapy aim to improve poor placentation and/or uterine blood flow. Melatonin, creatine and N-acetyl cysteine have potential as novel neuroprotective and cardioprotective agents in FGR. (C) 2018 Published by Elsevier Ltd.
机译：胎儿生长限制（FGR）和相关的胎盘病理如预妊娠早期引起的孕产病患者，当母体螺旋动脉的重塑不足导致持续的高抗性低流动子叶血管循环。目前的干预措施集中于靶向胎盘性缺血再灌注损伤和与血管生成/抗血管生成因子不平衡相关的氧化应激。最近的META分析证实阿司匹林谦虚地降低了高危女性小胎龄妊娠的风险。建议使用一剂＆ = 100毫克从妊娠16周开始。体外和体内研究表明，低分子量的肝素可能预防FGR;需要进一步研究来确认疗效。一旦诊断FGR，就没有治疗将改善胎儿生长。潜在的FGR疗法，例如磷酸二酯酶类型-5抑制剂或母体VEGF基因治疗的旨在改善妊娠和/或子宫血流不良。褪黑激素，肌酸和N-乙酰半胱氨酸具有作为FGR的新型神经保护和心脏保护剂的潜力。 （c）2018由elestvier有限公司出版

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