Fetal growth

Effective monitoring of fetal growth is a key aspect of antenatal care. The short-term complications of fetal growth restriction (FGR) include stillbi rth, prematurity, perinatal morbidity and decreased fetal reserve during la bour. At the other end of the spectrum, macrosomia is associated with birth trauma and neonatal metabolic disturbances. Evidence also exists that thes e growth disturbances may have long-term complications for several organ sy stems extending well beyond childhood [1]. Therefore, any advance in the su rveillance and prevention of deranged fetal growth is likely to reap large social and economic benefits. The clinical performance of screening methods for FGR remains poor. Screeni ng policies for detecting the small for-gestational age (SGA) baby using cl inical methods succeed in only approximately a quarter of cases [2,3]. It h as also been questioned whether, with current methods, antenatal detection actually improves outcome [4]. A systematic review of randomized trials sug gests that, to date, most prenatal interventions do not show any significan t effects on Short-term perinatal outcome [5]. In this article we focus on recent developments in our understanding of fet al growth abnormalities and their clinical detection.