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首页> 外文期刊>Best practice & research:Clinical obstetrics & gynaecology >Planning management and delivery of the growth-restricted fetus
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Planning management and delivery of the growth-restricted fetus

机译：规划管理和交付生长限制的胎儿

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A uniform approach to management of fetal growth restriction (FGR) improves outcome, prevents stillbirth, and allows appropriately timed delivery. An estimated fetal weight below the tenth percentile with coexisting abnormal umbilical artery (UA), middle cerebral artery (MCA), or cerebroplacental ratio Doppler index best identifies the small fetus requiring surveillance. Placental perfusion defects are more common earlier in gestation; accordingly, early-onset (= 32 weeks of gestation) and late-onset (32 weeks) FGR differ in clinical phenotype. In early-onset FGR, progression of UA Doppler abnormality determines clinical acceleration, while abnormal ductus venosus (DV) Doppler precedes deterioration of biophysical variables and stillbirth. Accordingly, late DV Doppler changes, abnormal biophysical variables, or an abnormal cCFG require delivery. In late-onset FGR, MCA Doppler abnormalities precede deterioration and stillbirth. However, from 34 to 38 weeks, randomized evidence on optimal delivery timing is lacking. From 38 weeks onward, the balance of neonatal versus fetal risks favors delivery. (C) 2018 Published by Elsevier Ltd.
机译：统一的胎儿生长受限（FGR）管理方法可改善结局，防止死产，并允许适当的定时分娩。估计胎儿体重低于第10百分位，同时伴有异常脐动脉（UA）、大脑中动脉（MCA）或脑胎盘比率多普勒指数最能识别需要监测的小胎儿。胎盘灌注缺陷在妊娠早期更常见；因此，早发（；=32周妊娠）和晚发（；32周）FGR的临床表型不同。在早发性FGR中，UA多普勒异常的进展决定临床加速，而静脉导管（DV）多普勒异常先于生物物理变量恶化和死产。因此，晚期DV多普勒变化、异常生物物理变量或异常cCFG需要分娩。在晚发性FGR中，MCA多普勒异常先于病情恶化和死产。然而，从34到38周，缺乏关于最佳分娩时间的随机证据。从38周开始，新生儿与胎儿风险的平衡有利于分娩。（C） 2018年爱思唯尔有限公司出版。

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