Abstract:
The pursuit of assessing fetal well-being in obstetrical practice remains a central tenet, propelling ongoing endeavors to explore innovative markers and diagnostic methodologies aimed at prognosing potential perinatal adversities. Deviations from standard patterns of intrauterine growth, whether exhibiting excessive or insufficient trajectories, stand as pivotal indices hinting at underlying pathophysiological processes or heightened concurrent medical conditions. Initiatives like the Delphi consensus and the INTERGROWTH-21st project strive to refine diagnostic criteria and establish international standards for fetal growth assessment. This article aims to present the current knowledge regarding the assessment of abnormal growth, including novel methods such as growth velocity. Integrating fetal growth velocity assessment into perinatal care protocols holds promise in enhancing diagnostic precision. Growth velocity, involving changes in fetal size over a given period, offers insights into distinguishing between constitutional and pathological growth abnormalities. Various methodologies and models have been proposed to evaluate growth velocity, with notable advancements in understanding fetal growth patterns across different trimesters. It is believed that accelerated and reduced growth velocity may be a sensible parameter in the detection of fetal growth restriction (FGR), small-for-gestational-age (SGA) fetuses, large-for-gestational-age (LGA) fetuses and macrosomic fetuses as well as appropriate-for-gestational age (AGA) fetuses that encounter problems with growth continuation. Recent studies found that changes in growth velocity reflect the risk of adverse perinatal outcomes (APOs). Future directions in fetal health research aim to elucidate the long-term consequences of abnormal fetal growth velocity on neurodevelopmental outcomes, highlighting the critical role of early assessment and intervention.
摘要:
在产科实践中追求评估胎儿健康状况仍然是一个中心原则,推动正在进行的努力,以探索旨在预测潜在的围产期逆境的创新标记和诊断方法。与子宫内生长的标准模式有偏差,无论是表现出过度或不足的轨迹,作为暗示潜在病理生理过程或并发医疗状况加剧的关键指标。诸如Delphi共识和INTERGROWTH-21st项目之类的倡议致力于完善诊断标准并建立胎儿生长评估的国际标准。本文旨在介绍有关异常增长评估的最新知识,包括生长速度等新方法。将胎儿生长速度评估纳入围产期护理方案有望提高诊断精度。生长速度,包括在给定时期内胎儿大小的变化,提供了区分体质和病理生长异常的见解。已经提出了各种方法和模型来评估生长速度,在理解不同孕期的胎儿生长模式方面取得了显著进展。据信,加速和降低的生长速度可能是检测胎儿生长受限(FGR)的明智参数。小于胎龄(SGA)胎儿,胎龄大(LGA)胎儿和大胎胎儿以及适合胎龄(AGA)胎儿遇到生长延续问题。最近的研究发现,生长速度的变化反映了不良围产期结局(APO)的风险。胎儿健康研究的未来方向旨在阐明胎儿生长速度异常对神经发育结局的长期影响。强调早期评估和干预的关键作用。