CURRENT CONCEPTS OF FETAL GROWTH RESTRICTION - PART I - CAUSES, CLASSIFICATION, AND PATHOPHYSIOLOGY

Objective: To update basic concepts and management strategies of fetal growth restriction (FGR). Data source: An English literature search w as conducted for pertinent articles related to FGR from 1976 to 1997. Original research articles, review articles, and book chapters were re viewed. Methods of study selection: This study was divided into two pa rts. For this article, both human data and animal data pertinent to un derstanding causative factors, pathogenesis, clinical type, and pathop hysiology were included. To perform a meaningful comparison, the conce pt of investigators and their methods of investigation were critically compared between the two study periods: 1976-1985 and 1986-1997. Tabu lation, integration, and results: Older concepts involving basic princ iples of FGR based on animal models during the first study period were integrated with new research findings obtained from human FGR during the second study period. By comparative analysis of older animal data and new human data, current concepts of FGR were synthesized. Conclusi on: Fetal growth restriction affects a heterogenous group of infants. Despite development of new technology for investigation, many older ba sic concepts related to FGR are still fundamentally sound. However, ne w investigations directly performed on human fetuses are a useful expa nsion of the older concepts. (Obstet Gynecol 1998;92:1044-55. (C) 1998 by The American College of Obstetricians and Gynecologists.)