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Current practice in the diagnosis and management of fetal growth restriction: An international survey
INTRODUCTION: The aim of this survey was to evaluate the current practice in respect of diagnosis and management of fetal growth restriction among obstetricians in different countries. MATERIAL AND METHODS: An e‐questionnaire was sent via REDCap with “click thru” links in emails and newsletters to o...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9812103/ https://www.ncbi.nlm.nih.gov/pubmed/36214456 http://dx.doi.org/10.1111/aogs.14466 |
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author | Fantasia, Ilaria Zamagni, Giulia Lees, Christoph Mylrea‐Foley, Bronacha Monasta, Lorenzo Mullins, Edward Prefumo, Federico Stampalija, Tamara |
author_facet | Fantasia, Ilaria Zamagni, Giulia Lees, Christoph Mylrea‐Foley, Bronacha Monasta, Lorenzo Mullins, Edward Prefumo, Federico Stampalija, Tamara |
author_sort | Fantasia, Ilaria |
collection | PubMed |
description | INTRODUCTION: The aim of this survey was to evaluate the current practice in respect of diagnosis and management of fetal growth restriction among obstetricians in different countries. MATERIAL AND METHODS: An e‐questionnaire was sent via REDCap with “click thru” links in emails and newsletters to obstetric practitioners in different countries and settings with different levels of expertise. Clinical scenarios in early and late fetal growth restriction were given, followed by structured questions/response pairings. RESULTS: A total of 275 participants replied to the survey with 87% of responses complete. Participants were obstetrician/gynecologists (54%; 148/275) and fetal medicine specialists (43%; 117/275), and the majority practiced in a tertiary teaching hospital (56%; 153/275). Delphi consensus criteria for fetal growth restriction diagnosis were used by 81% of participants (223/275) and 82% (225/274) included a drop in fetal growth velocity in their diagnostic criteria for late fetal growth restriction. For early fetal growth restriction, TRUFFLE criteria were used for fetal monitoring and delivery timing by 81% (223/275). For late fetal growth restriction, indices of cerebral blood flow redistribution were used by 99% (250/252), most commonly cerebroplacental ratio (54%, 134/250). Delivery timing was informed by cerebral blood flow redistribution in 72% (176/244), used from ≥32 weeks of gestation. Maternal biomarkers and hemodynamics, as additional tools in the context of early‐onset fetal growth restriction (≤32 weeks of gestation), were used by 22% (51/232) and 46% (106/230), respectively. CONCLUSIONS: The diagnosis and management of fetal growth restriction are fairly homogeneous among different countries and levels of practice, particularly for early fetal growth restriction. Indices of cerebral flow distribution are widely used in the diagnosis and management of late fetal growth restriction, whereas maternal biomarkers and hemodynamics are less frequently assessed but more so in early rather than late fetal growth restriction. Further standardization is needed for the definition of cerebral blood flow redistribution. |
format | Online Article Text |
id | pubmed-9812103 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-98121032023-01-05 Current practice in the diagnosis and management of fetal growth restriction: An international survey Fantasia, Ilaria Zamagni, Giulia Lees, Christoph Mylrea‐Foley, Bronacha Monasta, Lorenzo Mullins, Edward Prefumo, Federico Stampalija, Tamara Acta Obstet Gynecol Scand Fetal Medicine INTRODUCTION: The aim of this survey was to evaluate the current practice in respect of diagnosis and management of fetal growth restriction among obstetricians in different countries. MATERIAL AND METHODS: An e‐questionnaire was sent via REDCap with “click thru” links in emails and newsletters to obstetric practitioners in different countries and settings with different levels of expertise. Clinical scenarios in early and late fetal growth restriction were given, followed by structured questions/response pairings. RESULTS: A total of 275 participants replied to the survey with 87% of responses complete. Participants were obstetrician/gynecologists (54%; 148/275) and fetal medicine specialists (43%; 117/275), and the majority practiced in a tertiary teaching hospital (56%; 153/275). Delphi consensus criteria for fetal growth restriction diagnosis were used by 81% of participants (223/275) and 82% (225/274) included a drop in fetal growth velocity in their diagnostic criteria for late fetal growth restriction. For early fetal growth restriction, TRUFFLE criteria were used for fetal monitoring and delivery timing by 81% (223/275). For late fetal growth restriction, indices of cerebral blood flow redistribution were used by 99% (250/252), most commonly cerebroplacental ratio (54%, 134/250). Delivery timing was informed by cerebral blood flow redistribution in 72% (176/244), used from ≥32 weeks of gestation. Maternal biomarkers and hemodynamics, as additional tools in the context of early‐onset fetal growth restriction (≤32 weeks of gestation), were used by 22% (51/232) and 46% (106/230), respectively. CONCLUSIONS: The diagnosis and management of fetal growth restriction are fairly homogeneous among different countries and levels of practice, particularly for early fetal growth restriction. Indices of cerebral flow distribution are widely used in the diagnosis and management of late fetal growth restriction, whereas maternal biomarkers and hemodynamics are less frequently assessed but more so in early rather than late fetal growth restriction. Further standardization is needed for the definition of cerebral blood flow redistribution. John Wiley and Sons Inc. 2022-10-10 /pmc/articles/PMC9812103/ /pubmed/36214456 http://dx.doi.org/10.1111/aogs.14466 Text en © 2022 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG). https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Fetal Medicine Fantasia, Ilaria Zamagni, Giulia Lees, Christoph Mylrea‐Foley, Bronacha Monasta, Lorenzo Mullins, Edward Prefumo, Federico Stampalija, Tamara Current practice in the diagnosis and management of fetal growth restriction: An international survey |
title | Current practice in the diagnosis and management of fetal growth restriction: An international survey |
title_full | Current practice in the diagnosis and management of fetal growth restriction: An international survey |
title_fullStr | Current practice in the diagnosis and management of fetal growth restriction: An international survey |
title_full_unstemmed | Current practice in the diagnosis and management of fetal growth restriction: An international survey |
title_short | Current practice in the diagnosis and management of fetal growth restriction: An international survey |
title_sort | current practice in the diagnosis and management of fetal growth restriction: an international survey |
topic | Fetal Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9812103/ https://www.ncbi.nlm.nih.gov/pubmed/36214456 http://dx.doi.org/10.1111/aogs.14466 |
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