Pathophysiology of fetal growth restriction: Implications for diagnosis and surveillance

Obstetrical and Gynecological Survey

Volumn 59, Issue 8, 2004, Pages 617-627

  Baschat, Ahmet Alexander ^a  

^a UNIVERSITY OF MARYLAND   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

AMNION FLUID; ANEUPLOIDY; BEHAVIOR; BLOOD FLOW; BLOOD RHEOLOGY; CARDIOVASCULAR SYSTEM; CLINICAL FEATURE; COLOR ULTRASOUND FLOWMETRY; DELIVERY; DIAGNOSTIC APPROACH ROUTE; DIAGNOSTIC IMAGING; DISEASE SEVERITY; EARLY DIAGNOSIS; FETOMATERNAL TRANSFUSION; FETUS GROWTH; GENERAL PRACTITIONER; HEALTH SURVEY; HIGH RISK POPULATION; HUMAN; INTRAUTERINE GROWTH RETARDATION; MEDICAL SPECIALIST; PATHOPHYSIOLOGY; PLACENTA INSUFFICIENCY; REVIEW; ULTRASOUND; VIRUS INFECTION;

ABRUPTIO PLACENTAE; EMBRYONIC AND FETAL DEVELOPMENT; FEMALE; FETAL DISTRESS; FETAL GROWTH RETARDATION; HUMANS; PLACENTAL CIRCULATION; PLACENTAL INSUFFICIENCY; PRE-ECLAMPSIA; PREGNANCY; PREGNANCY COMPLICATIONS, CARDIOVASCULAR; UMBILICAL ARTERIES;

EID: 3242795996     PISSN: 00297828     EISSN: None     Source Type: Journal    
DOI: 10.1097/01.OGX.0000133943.54530.76     Document Type: Review

References (96)

1. Gardosi J, Chang A, Kalyan B, et al. Customised antenatal growth charts. Lancet 1992;339:283-287.
2. Lubchenco LO, Hansman C, Boyd E. Intrauterine growth as estimated from live born birth-weight data at 24-42 weeks of gestation. Pediatrics 1963;32:793.
3. Battaglia FC, Lubchenco LO. A practical classification of newborn infants by weight and gestational age. J Pediatr 1967;71:159-163.
4. Bernstein IM, Horbar JD, Badger GJ, et al. Morbidity and mortality among very-low-birth-weight neonates with intrauterine growth restriction. The Vermont Oxford Network. Am J Obstet Gynecol 2000;182:198-206.
5. Schreuder AM, McDonnell M, Gaffney G, et al. Outcome at school age following antenatal detection of absent or reversed end diastolic flow velocity in the umbilical artery. Arch Dis Child Fetal Neonatal Ed 2002;86:F108-114.
6. Barker DJ. Fetal growth and adult disease. Br J Obstet Gynaecol 1992;99:275-276.
7. Snijders RJM, Sherrod C, Gosden CM, et al. Fetal growth retardation: associated malformations and chromosome abnormalities. Am J Obstet Gynecol 1993;168:547-555.
8. Khoury MJ, Erickson D, Cordero JE, et al. Congenital malformations and intrauterine growth retardation: a population study. Pediatrics 1988;82:83-90.
9. Sickler GK, Nyberg DA, Sohaey R, et al. Polyhydramnios and fetal intrauterine growth restriction: ominous combination. J Ultrasound Med 1997;16:609-614.
10. Odegard RA, Vatten LJ, Nilsen ST, et al. Preeclampsia and fetal growth. Obstet Gynecol 2000;96:950-955.
11. Kupferminc MJ, Peri H, Zwang E, et al. High prevalence of the prothrombin gene mutation in women with intrauterine growth retardation, abruptio placentae and second trimester loss. Acta Obstet Gynecol Scand 2000;79:963-967.
12. Aplin J. Maternal influences on placental development. Semin Cell Dev Biol 2000;11:115-125.
13. Pardi G, Marconi AM, Cetin I. Placental-fetal interrelationship in IUGR fetuses-a review. Placenta 2002;23(suppl A):S136-S141.
14. Kaufmann P, Scheffen I. Placental development. In: Polin RA, Fox WW, eds. Fetal and Neonatal Physiology. Philadelphia: WB Saunders, 1998:59-70.
15. Maternal adaptations to pregnancy. In: Cunningham FG, Gant NF, Leveno KJ, et al., eds. Williams Obstetrics. New York: McGraw Hill, 2001:167-200.
16. Battaglia FC, Regnault TR. Placental transport and metabolism of amino acids. Placenta 2001;22:145-161.
17. Haggarty P. Placental regulation of fatty acid delivery and its effects on fetal growth-a review. Placenta 2002;23:S28-38.
18. Illsely NP. Glucose transporters in the human placenta. Placenta 2000;21:14-22.
19. Pijnenborg R, Bland JM, Robertson WB, et al. Uteroplacental arterial changes related to interstitial trophoblast migration in early human pregnancy. Placenta 1983;4:397-413.
20. Kingdom JC, Burrell SJ, Kaufmann P. Pathology and clinical implications of abnormal umbilical artery Doppler waveforms. Ultrasound Obstet Gynecol 1997;9:271-286.
21. Castellucci M, Kosanke G, Verdenelli F, et al. Villous sprouting: fundamental mechanisms of human placental development. Hum Reprod Update 2000;6:485-494.
22. Maini CL, Rosati P, Galli G, et al. Non-invasive radioisotopic evaluation of placental blood flow. Gynecol Obstet Invest 1985;19:196-206.
23. Molteni RA, Stys SJ, Battaglia FC. Relationship of fetal and placental weight in human beings: fetal/placental weight ratios at various gestational ages and birth weight distributions. J Reprod Med 1978;21:327-334.
24. Heinonen S, Taipale P, Saarikoski S. Weights of placentae from small-for-gestational age infants revisited. Placenta 2001;22:399-404.
25. Luckhardt M, Leiser R, Kingdom J, et al. Effect of physiologic perfusion-fixation on the morphometrically evaluated dimensions of the term placental cotyledon. J Soc Gynecol Investig 1996;3:166-171.
26. Bonds DR, Mwape B, Kumar S, et al. Human fetal weight and placental weight growth curves. A mathematical analysis from a population at sea level. Biol Neonate 1984;45:261-274.
27. White DR, Widdowson EM, Woodard HQ, et al. The composition of body tissues (11). Fetus to young adult. Br J Radiol 1991;64:149-159.
28. Ziegler EE, O'Donnell AM, Nelson SE, et al. Body composition of the reference fetus. Growth 1976;40:329-341.
29. Kingdom J, Huppertz B, Seaward G, et al. Development of the placental villous tree and its consequences for fetal growth. Eur J Obstet Gynecol Reprod Biol 2000;92:35-43.
30. Brosens I, Dixon HG, Robertson WB. Fetal growth retardation and the arteries of the placental bed. Br J Obstet Gynaecol 1977;84:656-663.
31. Meekins JW, Pijnenborg R, Hanssens M, et al. A study of placental bed spiral arteries and trophoblast invasion in normal and severe pre-eclamptic pregnancies. Br J Obstet Gynaecol 1994;101:669-674.
32. Aardema MW, Oosterhof H, Timmer A, et al. Uterine artery Doppler flow and uteroplacental vascular pathology in normal pregnancies and pregnancies complicated by pre-eclampsia and small for gestational age fetuses. Placenta 2001;22:405-411.
33. Ferrazzi E, Bulfamante G, Mezzopane R, et al. Uterine Doppler velocimetry and placental hypoxic-ischaemic lesion in pregnancies with fetal intrauterine growth restriction. Placenta 1999;20:389-394.
34. Sebire NJ, Talbert D. The role of intraplacental vascular smooth muscle in the dynamic placenta: a conceptual framework for understanding uteroplacental disease. Med Hypotheses 2002;58:347-351.
35. Kingdom JC, McQueen J, Connell JM, et al. Fetal angiotensin II levels and vascular (type I) angiotensin receptors in pregnancies complicated by intrauterine growth retardation. Br J Obstet Gynaecol 1993;100:476-482.
36. Harrington K, Carpenter RG, Goldfrad C, et al. Transvaginal Doppler ultrasound of the uteroplacental circulation in the early prediction of pre-eclampsia and intrauterine growth retardation. Br J Obstet Gynaecol 1997;104:674-681.
37. Bower S, Kingdom J, Campbell S. Objective and subjective assessment of abnormal uterine artery Doppler flow velocity waveforms. Ultrasound Obstet Gynecol 1998;12:260-264.
38. Rigano S, Bozzo M, Ferrazzi E, et al. Early and persistent reduction in umbilical vein blood flow in the growth-restricted fetus: a longitudinal study. Am J Obstet Gynecol 2001;185:834-838.
39. Yagel S, Anteby EY, Shen O, et al. Placental blood flow measured by simultaneous multigate spectral Doppler imaging in pregnancies complicated by placental vascular abnormalities. Ultrasound Obstet Gynecol 1999;14:262-266.
40. Giles WB, Trudinger BJ, Baird PJ. Fetal umbilical artery flow velocity waveforms and placental resistance: pathological correlation. Br J Obstet Gynaecol 1985;92:31-38.
41. Morrow RJ, Adamson SL, Bull SB, et al. Effect of placental embolization on the umbilical artery velocity waveform in fetal sheep. Am J Obstet Gynecol 1989;161:1055-1060.
42. Papageorghiou AT, Yu CK, Cicero S, et al. Second-trimester uterine artery Doppler screening in unselected populations: a review. J Matern Fetal Neonatal Med 2002;12:78-88.
43. Weiner CP. The relationship between the umbilical artery systolic/diastolic ratio and umbilical blood gas measurements in specimens obtained by cordocentesis. Am J Obstet Gynecol 1990;162:1198-1202.
44. Bilardo CM, Nicolaides KH, Campbell S. Doppler measurements of fetal and uteroplacental circulations: relationship with umbilical venous blood gases measured at cordocentesis. Am J Obstet Gynecol 1990;162:115-120.
45. Ferrazzi E, Bozzo M, Rigano S, et al. Temporal sequence of abnormal Doppler changes in the peripheral and central circulatory systems of the severely growth-restricted fetus. Ultrasound Obstet Gynecol 2002;19:140-146.
46. Hecher K, Bilardo CM, Stigter RH, et al. Monitoring of fetuses with intrauterine growth restriction: a longitudinal study. Ultrasound Obstet Gynecol 2001;18:564-570.
47. Al Ghazali W, Chita SK, Chapman MG, et al. Evidence of redistribution of cardiac output in asymmetrical growth retardation. Br J Obstet Gynaecol 1987;96:697-704.
48. Reed KL, Anderson CF, Shenker L. Changes in intracardiac Doppler flow velocities in fetuses with absent umbilical artery diastolic flow. Am J Obstet Gynecol 1987;157:774-779.
49. Gramellini D, Folli MC, Raboni S, et al. Cerebral-umbilical Doppler ratio as a predictor of adverse perinatal outcome. Obstet Gynecol 1992;79:416-420.
50. Wladimiroff JW, Tonge HM, Stewart PA. Doppler ultrasound assessment of cerebral blood flow in the human fetus. Br J Obstet Gynaecol 1986;93:471-475.
51. Akalin-Sel T, Nicolaides KH, Peacock J, et al. Doppler dynamics and their complex interrelation with fetal oxygen pressure, carbon dioxide pressure, and pH in growth-retarded fetuses. Obstet Gynecol 1994;84:439-444.
52. Arbeille P, Maulik D, Fignon A, et al. Assessment of the fetal PO2 changes by cerebral and umbilical Doppler on lamb fetuses during acute hypoxia. Ultrasound Med Biol 1995;21:861-870.
53. Baschat AA. Integrated fetal testing in growth restriction: combining multivessel Doppler and biophysical parameters. Ultrasound Obstet Gynecol 2003;21:1-8.
54. Hecher K, Campbell S. Characteristics of fetal venous blood flow under normal circumstances and during fetal disease. Ultrasound Obstet Gynecol 1996;7:68-83.
55. Rizzo G, Arduini D. Fetal cardiac function in intrauterine growth retardation. Am J Obstet Gynecol 1991;165:876-882.
56. Rizzo G, Capponi A, Pietropolli A, et al. Fetal cardiac and extracardiac flows preceding intrauterine death. Ultrasound Obstet Gynecol 1994;4:139-142.
57. Ribbert LS, Nicolaides KH, Visser GH. Prediction of fetal acidaemia in intrauterine growth retardation: comparison of quantified fetal activity with biophysical profile score. Br J Obstet Gynaecol 1993;100:653-656.
58. Baschat AA, Gembruch U, Harman CR. The sequence of changes in Doppler and biophysical parameters as severe fetal growth restriction worsens. Ultrasound Obstet Gynecol 2001;18:571-577.
59. Ribbert LS, Visser GH, Mulder EJ, et al. Changes with time in fetal heart rate variation, movement incidences and haemodynamics in intrauterine growth retarded fetuses: a longitudinal approach to the assessment of fetal well being. Early Hum Dev 1993;31:195-208.
60. Manning FA, Snijders R, Harman CR, et al. Fetal biophysical profile score. VI. Correlation with antepartum umbilical venous fetal pH. Am J Obstet Gynecol 1993;169:755-763.
61. Vintzileos AM, Fleming AD, Scorza WE, et al. Relationship between fetal biophysical activities and umbilical cord blood gas values. Am J Obstet Gynecol 1991;165:707-713.
62. Ribbert LS, Snijders RJ, Nicolaides KH, et al. Relationship of fetal biophysical profile and blood gas values at cordocentesis in severely growth-retarded fetuses. Am J Obstet Gynecol 1990;163:569-571.
63. Zeitlin J, Ancel PY, Saurel-Cubizolles MJ, et al. The relationship between intrauterine growth restriction and preterm delivery: an empirical approach using data from a European case-control study. BJOG 2000;107:750-758.
64. Ott WJ. Intrauterine growth restriction and Doppler ultrasonography. J Ultrasound Med 2000;19:661-665.
65. Strigini FA, De Luca G, Lencioni G, et al. Middle cerebral artery velocimetry: different clinical relevance depending on umbilical velocimetry. Obstet Gynecol 1997;90:953-957.
66. Hecher K, Spernol R, Stettner H, et al. Potential for diagnosing imminent risk for appropriate- and small for gestational fetuses by Doppler examination of umbilical and cerebral arterial blood flow. Ultrasound Obstet Gynecol 1995;5:247-255.
67. Severi FM, Bocchi C, Visentin A, et al. Uterine and fetal cerebral Doppler predict the outcome of third-trimester small-for-gestational age fetuses with normal umbilical artery Doppler. Ultrasound Obstet Gynecol 2002;19:225-228.
68. Baschat AA, Towbin J, Bowles NE, et al. Is adenovirus a fetal pathogen? Am J Obstet Gynecol 2003;189:758-763.
69. Magann EF, Chauhan SP, Barrilleaux PS, et al. Amniotic fluid index and single deepest pocket: weak indicators of abnormal amniotic volumes. Obstet Gynecol 2000;96:737-740.
70. Chamberlain PF, Manning FA, Morrison I, et al. Ultrasound evaluation of amniotic fluid volume. I. The relationship of marginal and decreased amniotic fluid volumes to perinatal outcome. Am J Obstet Gynecol 1984;150:245-249.
71. Chauhan SP, Sanderson M, Hendrix NW, et al. Perinatal outcome and amniotic fluid index in the antepartum and intrapartum periods: a meta-analysis. Am J Obstet Gynecol 1999;181:1473-1478.
72. Bukowski R. Fetal growth potential and pregnancy outcome. Semin Perinatol 2004;28:51-58.
73. Sabbagha RE. Intrauterine growth retardation. In: Sabbagha RE, ed. Diagnostic Ultrasound Applied to Obstetrics and Gynecology, 2nd ed. Philadelphia: JB Lippincott Co, 1987:112-131.
74. Tamura RK, Sabbagha RE. Percentile ranks of sonar fetal abdominal circumference measurements. Am J Obstet Gynecol 1980;138:475.
75. Baschat AA, Weiner CP. Umbilical artery Doppler screening for detection of the small fetus in need of antepartum surveillance. Am J Obstet Gynecol 2000;182:154-158.
76. Divon MY, Chamberlain PF, Sipos L, et al. Identification of the small for gestational age fetus with the use of gestational age-independent indices of fetal growth. Am J Obstet Gynecol 1986;155:1197-1201.
77. Tamura RK, Sabbagha RE, Pan WH, et al. Ultrasonic fetal abdominal circumference: comparison of direct versus calculated measurement. Obstet Gynecol 1986;67:833.
78. Weiner CP, Robinson D. The sonographic diagnosis of intrauterine growth retardation using the postnatal ponderal index and the crown heel length as standards of diagnosis. Am J Perinatol 1989;6:380-383.
79. Hadlock FP, Deter RL, Carpenter RJ, Park SK. Estimating fetal age: effect of head shape on BPD. AJR Am J Roentgenol 1981;137:83.
80. Smith PA, Johansson D, Tzannatos C, et al. Prenatal measurement of the fetal cerebellum and cisterna cerebellomedullaris by ultrasound. Prenat Diagn 1986;6:133.
81. Warsof SL, Cooper DJ, Little D, et al. Routine ultrasound screening for antenatal detection of intrauterine growth retardation. Obstet Gynecol 1986;67:33.
82. Sarmandal P, Grant JM. Effectiveness of ultrasound determination of fetal abdominal circumference and fetal ponderal index in the diagnosis of asymmetrical growth retardation. Br J Obstet Gynaecol 1990;97:118.
83. Hadlock FP, Deter RL, Harrist RB, et al. A data-independent predictor of intrauterine growth retardation: femur length/ abdominal circumference ratio. AJR Am J Roentgenol 1983;141:979.
84. McGowan LM, Harding JE, Roberts AB, et al. A pilot randomized controlled trial of two regimens of fetal surveillance for small-for-gestational age fetuses with normal results of umbilical artery Doppler velocimetry. Am J Obstet Gynecol 2000;182:81-86.
85. Neilson JP, Alfirevic Z. Doppler ultrasound for fetal assessment in high risk pregnancies (Cochrane review). The Cochrane Library, Issue 1. Oxford: Update Software, 2002.
86. Westergaard HB, Langhoff-Roos J, Lingman G, et al. A critical appraisal of the use of umbilical artery Doppler ultrasound in high-risk pregnancies: use of meta-analyses in evidence-based obstetrics. Ultrasound Obstet Gynecol 2001;17:466-476.
87. Gosling RG, King DH. Ultrasound angiology. In: Marcus AW, Adamson L, eds. Arteries and Veins, 2nd ed. Edinburgh: Churchill Livingstone, 1975:61-98.
88. Thompson RS, Trudinger BJ, Cook CM. Doppler ultrasound waveform indices: A/B ratio, pulsatility index and Pourcelot ratio. Br J Obstet Gynaecol 1988;95:581-588.
89. Hershkovitz R, Kingdom JC, Geary M, et al. Fetal cerebral blood flow redistribution in late gestation: identification of compromise in small fetuses with normal umbilical artery Doppler. Ultrasound Obstet Gynecol 2000;15:209-212.
90. Bahado-Singh RO, Kovanci E, Jeffres A, et al. The Doppler cerebroplacental ratio and perinatal outcome in intrauterine growth restriction. Am J Obstet Gynecol 1999;180:750-756.
91. Baschat AA, Galan HL, Bhide A, et al. Viability in early onset IUGR: is it time to reconsider intervention thresholds? Am J Obstet Gynecol 2003;189:S216.
92. Harrington K, Thompson MO, Carpenter RG, et al. Doppler fetal circulation in pregnancies complicated by pre-eclampsia or delivery of a small for gestational age baby: 2. Longitudinal analysis. Br J Obstet Gynaecol 1999;106:453-466.
93. Bilardo CM, Wolf H, Stigter RH, et al. Relationship between monitoring parameters and perinatal outcome in severe, early intrauterine growth restriction. Ultrasound Obstet Gynecol 2004;23:119-125.
94. Baschat AA. Doppler application in the delivery timing of the preterm growth-restricted fetus: another step in the right direction. Ultrasound Obstet Gynecol 2004;23:111-118.
95. Karsdorp VH, van Vugt JM, van Geijn HP, et al. Clinical significance of absent or reversed end diastolic velocity waveforms in umbilical artery. Lancet 1994;344:1664-1668.
96. Divon MY, Girz BA, Lieblich R, et al. Clinical management of the fetus with markedly diminished umbilical artery end-diastolic flow. Am J Obstet Gynecol 1989;161:1523-1527.