Successful management of early onset fetal growth restriction: A case report

Abstract

FGR (Fetal Growth Restriction) is a condition in which a fetus fails to attend its predetermined biological genetic growth potential. Growth-restricted fetuses are at increased risk of perinatal mortality and morbidity. Growth restricted babies also have poor long term outcomes of cardiovascular, neurological, cognitive or neurological system. The present case of Early FGR where patient presented to us at at 29+6 weeks of gestation with lag in fetal growth of 3 weeks & an Amniotic fluid Index of 3.2 cm and her pregnancy could be successfully prolonged up to 35+2 two weeks of gestation. The protocol for management of the fetus was as per Delphi consensus and ISUOG guidelines, and we could prolong pregnancy to the maximum possible gestation and delivered a low birth weight fetus with good Apgar score and who did not require Neonatal Intensive Care Unit admission. Tools for diagnosis and follow up of FGR fetus are customized growth charts, sequential ultrasound measurements focusing on declining/crossing growth centiles, functional parameters such as Doppler waveform analysis (umbilical artery (UA), fetal middle cerebral artery, and ductus venosus), Biophysical profile scoring, Cardio tocography and serum biomarkers.