Fetal growth restriction: observation over time

Fetal growth restriction during pregnancy is a complex problem, which can lead to unexpected perinatal mortality. Traditionally, we define the growth of a fetus as abnormal when the fetus has an estimated weight below the 10th percentile. In that case, a baby belongs to the 10% smallest children for that gestational age. The child is small but it is not clear whether it’s 'too' small or just healthy and small in predisposition. In addition, within the 90% of the “normal” weight children, there are also children who do not reach their intrinsic growth potential. Precisely this group of children is nowadays missed and therefore at risk for perinatal morbidity. The cause of fetal growth restriction often lies in the reduced functioning of the placenta, which results in a sub-optimal blood and oxygen flow via the umbilical cord to the baby. To detect this 'missed' group of growth-restricted children placental biomarkers in maternal blood were used and growth velocities during pregnancy ultrasound calculated. It was shown that the combination of biomarkers and growth velocities provides a better prediction of growth restriction and thus more children with growth restriction can be detected. By early stage detection, better care for both mother and child can be offered.