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Prevention of Recurrent Fetal Growth Restriction

Berghella, Vincenzo MD

doi: 10.1097/01.AOG.0000267203.55718.aa
Clinical Expert Series

Fetal growth restriction is associated with multiple short- and long-term consequences for the infant. A woman with a prior gestation complicated by fetal growth restriction has nearly a 20% risk of recurrence. Strategies to predict and prevent the recurrence are critical in obstetric management. Effective interventions for prevention of recurrent fetal growth restriction include the following: a reproductive plan because spacing of pregnancies impacts their outcome, optimization of maternal medical conditions, smoking cessation, accurate dating by first-trimester sonography and monitoring of fetal growth with serial sonograms, and low-dose aspirin (80–160 mg) started before 20 weeks. In women with nutritional deficiencies, optimizing caloric intake with low-protein (less than 25%) supplementation of 500–1,000 calories may prevent recurrent fetal growth restriction. In women living in areas endemic for malaria, antimalarial prophylaxis diminishes risk of recurrent fetal growth restriction.

Prevention is the most effective evidence-based management to avoid recurrence of fetal growth restriction.

From the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania.

Corresponding author: Vincenzo Berghella, MD, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Jefferson Medical College of Thomas Jefferson University, 834 Chestnut Street, Suite 400, Philadelphia, PA 19107, e-mail: vincenzo.berghella@jefferson.edu.

Financial Disclosure The author has no potential conflicts of interest to disclose.

© 2007 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.