ABSTRACT
Fetal growth restriction (FGR) is defined as a failure to achieve the endorsed growth potential. The diagnosis of fetal "smallness" is currently performed on the basis of an estimated fetal weight below a given threshold, most commonly the 10th centile. The chapter presents to aims in the clinical management of FGR, which should be to distinguish "true" FGR from constitutional small for gestational age and to establish whether there is an indication for elective delivery and if not how often monitoring should be performed. Umbilical artery (UA) Doppler is the only measure that provides both diagnostic and prognostic information for the management of FGR. There is compelling evidence that using UA Doppler in high-risk pregnancies improves perinatal outcomes, with a 29% reduction in perinatal deaths. Early studies on high-risk pregnancies showed that, though highly sensitive, cardiotocography has a 50% rate of false positives for the prediction of adverse outcome.
