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Section 3 - Late Prenatal – Fetal Problems

Published online by Cambridge University Press:  15 November 2017

David James
Affiliation:
University of Nottingham
Philip Steer
Affiliation:
Imperial College London
Carl Weiner
Affiliation:
University of Kansas
Bernard Gonik
Affiliation:
Wayne State University, Detroit
Stephen Robson
Affiliation:
University of Newcastle
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Summary

Modern antenatal care aims to optimize both maternal and fetal outcomes. The various methods of prenatal fetal surveillance are directed towards early detection and, sometimes, prevention of chronic fetal hypoxia. The fetal response to acute or chronic hypoxia varies and is modified by the preceding fetal condition. Prenatal fetal surveillance tools are useful in pregnancies that are at high risk of developing chronic fetal hypoxia, but less so for acute events (e.g., placental abruption). There is evidence that fetal surveillance in unselected low-risk population is not cost-effective and leads to unnecessary interventions. Therefore routine prenatal fetal surveillance techniques or tests are not universally adopted in this group.

Type
Chapter
Information
High-Risk Pregnancy
Management Options
, pp. 207 - 578
Publisher: Cambridge University Press
First published in: 2017

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References

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Further Reading

Baschat, AA, Neurodevelopment after fetal growth restriction. Fetal Diagn Ther 2014; 36: 136–42.CrossRefGoogle ScholarPubMed
Baschat, AA, Cosmi, E, Bilardo, CM, et al. Predictors of neonatal outcome in early-onset placental dysfunction. Obstet Gynecol 2007; 109: 253–61.CrossRefGoogle ScholarPubMed
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: 571–7.CrossRefGoogle ScholarPubMed
Baschat, AA, Viscardi, RM, Hussey-Gardner, B, et al. Infant neurodevelopment following fetal growth restriction: Relationship with antepartum surveillance parameters. Ultrasound Obstet Gynecol 2009; 33: 4450.CrossRefGoogle ScholarPubMed
Frøen, JF, Gardosi, JO, Thurmann, A, Francis, A, Stray-Pedersen, B. Restricted fetal growth in sudden intrauterine unexplained death. Acta Obstet Gynecol Scand 2004; 83: 801–7.Google ScholarPubMed
GRIT Study Group. A randomised trial of timed delivery for the compromised preterm fetus: short term outcomes and Bayesian interpretation. BJOG 2003; 110: 2732.CrossRefGoogle Scholar
Lees, CC, Marlow, N, van Wassenaer-Leemhuis, A, et al. 2 year neurodevelopmental and intermediate perinatal outcomes in infants with very preterm fetal growth restriction (TRUFFLE): a randomised trial. Lancet 2015; 385: 2162–72.CrossRefGoogle ScholarPubMed
Metzger, BE, Lowe, LP, Dyer, AR, et al.; HAPO Study Cooperative Research Group. Hyperglycemia and adverse pregnancy outcome. N Engl J Med 2008; 358: 19912002.Google Scholar
Poon, L, Kametas, NA, Maiz, A, et al. First trimester prediction of hypertensive disorders in pregnancy. Hypertension 2009; 53: 812–18.CrossRefGoogle ScholarPubMed
Thornton, JG, Hornbuckle, J, Vail, A, et al.; GRIT Study Group. Infant wellbeing at 2 years of age in the Growth Restriction Intervention Trial (GRIT): multicentred randomised controlled trial. Lancet 2004; 364: 513–20.Google ScholarPubMed
Vainio, M, Kujansuu, E, Iso-Mustajarvi, M, Maenpaa, J. Low dose acetylsalicylic acid in prevention of pregnancy-induced hypertension and intrauterine growth retardation in women with bilateral uterine artery notches. BJOG 2002; 109: 161–7.CrossRefGoogle ScholarPubMed
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