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Abstract：
OBJECTIVE: To determine, by expert consensus, a definition for early and late fetal growth restriction (FGR) through a Delphi procedure.
METHODS: A Delphi survey was conducted among an international panel of experts on FGR. Panel members were provided with 18 literature-based parameters for defining FGR and were asked to rate the importance of these parameters for the diagnosis of both early and late FGR on a 5-point Likert scale. Parameters were described as solitary parameters (parameters that are sufficient to diagnose FGR, even if all other parameters are normal) and contributory parameters (parameters that require other abnormal parameter(s) to be present for the diagnosis of FGR). Consensus was sought to determine the cut-off values for accepted parameters.
RESULTS: A total of 106 experts were approached, of whom 56 agreed to participate and entered the first round, and 45 (80%) completed all four rounds. For early FGR (< 32 weeks), three solitary parameters (abdominal circumference (AC) < 3(rd) centile, estimated fetal weight (EFW) < 3(rd) centile and absent end-diastolic flow in the umbilical artery (UA)) and four contributory parameters (AC or EFW < 10(th) centile combined with a pulsatility index (PI) > 95(th) centile in either the UA or uterine artery) were agreed upon. For late FGR (≥ 32 weeks), two solitary parameters (AC or EFW < 3(rd) centile) and four contributory parameters (EFW or AC < 10(th) centile, AC or EFW crossing centiles by > two quartiles on growth charts and cerebroplacental ratio < 5(th) centile or UA-PI > 95(th) centile) were defined.
CONCLUSIONS: Consensus-based definitions for early and late FGR, as well as cut-off values for parameters involved, were agreed upon by a panel of experts. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
METHODS: A Delphi survey was conducted among an international panel of experts on FGR. Panel members were provided with 18 literature-based parameters for defining FGR and were asked to rate the importance of these parameters for the diagnosis of both early and late FGR on a 5-point Likert scale. Parameters were described as solitary parameters (parameters that are sufficient to diagnose FGR, even if all other parameters are normal) and contributory parameters (parameters that require other abnormal parameter(s) to be present for the diagnosis of FGR). Consensus was sought to determine the cut-off values for accepted parameters.
RESULTS: A total of 106 experts were approached, of whom 56 agreed to participate and entered the first round, and 45 (80%) completed all four rounds. For early FGR (< 32 weeks), three solitary parameters (abdominal circumference (AC) < 3(rd) centile, estimated fetal weight (EFW) < 3(rd) centile and absent end-diastolic flow in the umbilical artery (UA)) and four contributory parameters (AC or EFW < 10(th) centile combined with a pulsatility index (PI) > 95(th) centile in either the UA or uterine artery) were agreed upon. For late FGR (≥ 32 weeks), two solitary parameters (AC or EFW < 3(rd) centile) and four contributory parameters (EFW or AC < 10(th) centile, AC or EFW crossing centiles by > two quartiles on growth charts and cerebroplacental ratio < 5(th) centile or UA-PI > 95(th) centile) were defined.
CONCLUSIONS: Consensus-based definitions for early and late FGR, as well as cut-off values for parameters involved, were agreed upon by a panel of experts. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
摘要：
目的：确定，专家共识,通过Delphi程序定义早期和晚期胎儿生长受限（FGR）。
方法：在FGR的国际专家小组中进行了Delphi调查。小组成员获得了18个基于文献的参数来定义FGR，并被要求以5点Likert量表对这些参数对早期和晚期FGR诊断的重要性进行评分。参数被描述为孤立参数(足以诊断FGR的参数，即使所有其他参数都是正常的）和辅助参数（需要其他异常参数来诊断FGR的参数）。寻求共识以确定公认参数的截止值。
结果：共接触了106名专家，其中56人同意参加并进入第一轮，45（80％）完成了所有四轮比赛。对于早期FGR（<32周），三个孤立参数(腹围(AC)<3(rd)百分位数，估计胎儿体重（EFW）<3（rd）百分位数和脐动脉（UA）舒张末期血流缺失）和四个相关参数（AC或EFW<10（th）百分位数结合搏动指数（PI）>95（th）UA或子宫动脉百分位数）达成一致。对于晚期FGR（≥32周），两个孤立参数（AC或EFW<3（rd）百分位数）和四个贡献参数（EFW或AC<10（th）百分位数，确定了AC或EFW在生长图上的交叉百分位数>两个四分位数，以及脑胎盘比率<5（th）百分位数或UA-PI>95（th）百分位数。
结论：基于共识的早期和晚期FGR定义，以及相关参数的截止值，由专家小组同意。版权所有©2016ISUOG。由JohnWiley&SonsLtd.发布.
方法：在FGR的国际专家小组中进行了Delphi调查。小组成员获得了18个基于文献的参数来定义FGR，并被要求以5点Likert量表对这些参数对早期和晚期FGR诊断的重要性进行评分。参数被描述为孤立参数(足以诊断FGR的参数，即使所有其他参数都是正常的）和辅助参数（需要其他异常参数来诊断FGR的参数）。寻求共识以确定公认参数的截止值。
结果：共接触了106名专家，其中56人同意参加并进入第一轮，45（80％）完成了所有四轮比赛。对于早期FGR（<32周），三个孤立参数(腹围(AC)<3(rd)百分位数，估计胎儿体重（EFW）<3（rd）百分位数和脐动脉（UA）舒张末期血流缺失）和四个相关参数（AC或EFW<10（th）百分位数结合搏动指数（PI）>95（th）UA或子宫动脉百分位数）达成一致。对于晚期FGR（≥32周），两个孤立参数（AC或EFW<3（rd）百分位数）和四个贡献参数（EFW或AC<10（th）百分位数，确定了AC或EFW在生长图上的交叉百分位数>两个四分位数，以及脑胎盘比率<5（th）百分位数或UA-PI>95（th）百分位数。
结论：基于共识的早期和晚期FGR定义，以及相关参数的截止值，由专家小组同意。版权所有©2016ISUOG。由JohnWiley&SonsLtd.发布.
