Clinician performed ultrasound in fetal growth restriction: fetal, neonatal and pediatric aspects

• Published in: Journal of perinatology Vol. 37; no. 12; pp. 1251 - 1258
• Main Authors: Sehgal, A, Crispi, F, Skilton, M R, de Boode, W -P
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01.12.2017; Nature Publishing Group
• Subjects: 692/308; 692/699; Age groups; Arteries; Arteries - diagnostic imaging; Arteries - pathology; Blood pressure; Cardiovascular diseases; Diagnosis; Doppler effect; Echocardiography, Doppler; Female; Fetal growth retardation; Fetal Growth Retardation - diagnostic imaging; Fetal Growth Retardation - pathology; Fetal Heart - diagnostic imaging; Fetal Heart - pathology; Fetus; Fetuses; Gestational Age; Growth retardation; Health risk assessment; Heart; Heart Defects, Congenital - diagnosis; Heart Defects, Congenital - etiology; Heart diseases; Humans; Hypertension; Infant, Newborn; Infant, Premature; Infants; Intervention; Life prediction; Medicine; Medicine & Public Health; Morphometry; Neonates; Newborn babies; Parameters; Pediatric research; Pediatric Surgery; Pediatrics; Perinatal Death; Placenta; Placenta - blood supply; Placenta - diagnostic imaging; Pregnancy; Risk factors; state-of-the-art; Ultrasonic imaging; Ultrasonics in obstetrics; Ultrasonography, Prenatal; Ultrasound; Ultrasound imaging; Australia
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/jp.2017.119

Fetal growth restriction (FGR) affects 7–10% pregnancies. Conventional and tissue Doppler imaging has noted cardiac compromise during fetal and early neonatal periods in this cohort. In this article, we discuss the use of salient ultrasound parameters across age groups. During fetal life, certain feto-placental sonographic parameters have been linked to adverse perinatal outcomes and are predictive of later life hypertension. During the early postnatal period altered morphometry (hypertrophied and globular hearts) with sub-clinical impairment of cardiac function has been noted in both term and preterm infants with FGR. Vascular imaging has noted thickened and stiffer arteries in association with significantly elevated blood pressure. Similar findings in the pediatric age groups indicate persistence of these alterations, and have formed the basis of intervention studies. Assessment methodology and clinical relevance of these parameters, especially in designing and monitoring of intervention strategies is discussed. Frontline care givers (obstetricians and neonatologists) are increasingly using point of care ultrasound to discern these manifestations of FGR during the sub-clinical phase.