M.E. ZHELEZOVA¹, T.P. ZEPHIROVA¹, S.S. KANYUKOV²

¹Kazan State Medical Academy — Branch Campus of the RMACPE MOH Russia, Kazan

²Republican Clinical Hospital, Kazan

Contact details:

Zhelezova M.E. ― MD, Associate Professor of the Department of Obstetrics and Gynecology.

Address: 51 B. Krasnaya Str., Kazan, Russian Federation, 420012, tel. (843) 236-34-51, e-mail: gelezovam@gmail.com

Objective ― to conduct a systematic analysis of scientific foreign and domestic studies on the problems of diagnosis, observation, management of pregnancy and childbirth in women with fetal intrauterine growth retardation syndrome.

Material and methods. The analysis of domestic and foreign scientific articles published over the past 8 years on the Pubmed platform, systematic reviews of Cochrane, MEDLINE, related to IUGR, lightweight fetuses and preeclampsia has been carried out.

Results. Numerous studies show that prenatal identification of fetuses with growth retardation significantly reduces the incidence of adverse perinatal outcomes and stillbirth. However, at present, most fetuses with fetal growth retardation remain undiagnosed, there is no single protocol regulating the timing and indications for delivery, including operative abdominal (especially for the early intrauterine growth retardation phenotype). Accounting for clinical and anamnestic data, a number of biochemical markers, indicators of dopplerometry in the uterine arteries, umbilical arteries, middle cerebral artery, cerebro-placental ratio significantly improve the diagnosis of fetal intrauterine growth syndrome. From a clinical point of view, taking into account the various perinatal outcomes, differential diagnosis of fetal growth retardation and fetuses, defined as small for the gestational period (SGP), is of fundamental importance. For a long time, the pulsation index in the umbilical artery was considered to be a reliable marker of fetal growth retardation, however, recent studies have shown its low prognostic value as an independent criterion in the differentiation of fetal growth retardation and being small for gestational age. Regarding late fetal growth retardation, the most reliable parameter correlating with adverse perinatal outcomes is the cerebral-placental ratio.

Conclusion. Early diagnosis of IUGR, timely delivery, adequate observation and correction of predictable postnatal complications will significantly improve the morbidity and mortality rates of newborns with intrauterine growth retardation syndrome.

Key words: intrauterine growth retardation, low-weight to the period of gestation, feto-placental insufficiency, dopplerometry, preeclampsia.

(For citation: Zhelezova M.E., Zephirova T.P., Kanyukov S.S. Fetal growth retardation: modern approaches to the diagnosis and management of pregnancy. Practical medicine. 2019. Vol. 17, № 4, P. 8-14)

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