目的:胎儿生长受限是一种常见的产科并发症,在一般人群中影响高达10%的妊娠,最常见的原因是潜在的胎盘疾病。本指南的目的是提供摘要声明和建议,以支持有效筛查的临床框架。诊断,以及有胎儿生长受限风险或受胎儿生长受限影响的妊娠管理。
方法:所有单胎妊娠的妊娠患者。
结果:实施本指南中的建议应提高临床医生检测胎儿生长受限和提供适当干预措施的能力。
方法:通过搜索PubMed或MEDLINE检索英文出版文献,CINAHL,和Cochrane图书馆通过MeSH术语(胎儿生长迟缓和小于胎龄)和关键词(胎儿生长,限制,生长迟缓,IUGR,FGR,低出生体重,小于胎龄,多普勒,胎盘,病理学)。结果仅限于系统评价,随机对照试验/对照临床试验,和观察性研究。通过搜索卫生技术评估和卫生技术相关机构的网站,确定了灰色文献,临床实践指南收集,临床试验登记处,以及国家和国际医学专业协会。
方法:作者使用建议分级评估对证据质量和建议强度进行了评估,开发和评估(等级)方法。见在线附录A(表A1的定义和表A2的强和有条件的[弱]建议的解释)。
■产科医生,家庭医生,护士,助产士,母胎医学专家,放射科医生,和其他照顾怀孕患者的医疗保健提供者。
结论:更新了筛查指南,诊断,以及对有FGR风险或受FGR影响的怀孕的管理。
结论:建议:FGR的预测FGR的预防FGR的检测在有可疑胎儿生长受限的孕妇中进行FGR的调查早期胎儿生长受限的管理晚期FGR的管理产后管理和孕前咨询。
Fetal growth restriction is a common obstetrical complication that affects up to 10% of pregnancies in the general population and is most commonly due to underlying placental diseases. The purpose of this
guideline is to provide summary statements and recommendations to support a clinical framework for effective screening, diagnosis, and management of pregnancies that are either at risk of or affected by fetal growth restriction.
All pregnant patients with a singleton pregnancy.
Implementation of the recommendations in this
guideline should increase clinician competency to detect fetal growth restriction and provide appropriate interventions.
Published literature in English was retrieved through searches of PubMed or MEDLINE, CINAHL, and The Cochrane Library through to September 2022 using appropriate controlled vocabulary via MeSH terms (fetal growth retardation and small for gestational age) and key words (fetal growth, restriction, growth retardation, IUGR, FGR, low birth weight, small for gestational age, Doppler, placenta, pathology). Results were restricted to systematic reviews, randomized controlled trials/controlled clinical trials, and observational studies. Grey literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice
guideline collections, clinical trial registries, and national and international medical specialty societies.
The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Table A1 for definitions and Table A2 for interpretations of strong and conditional [weak] recommendations).
Obstetricians, family physicians, nurses, midwives, maternal-fetal medicine specialists, radiologists, and other health care providers who care for pregnant patients.
Updated
guidelines on screening, diagnosis, and management of pregnancies at risk of or affected by FGR.
RECOMMENDATIONS: Prediction of FGR Prevention of FGR Detection of FGR Investigations in Pregnancies with Suspected Fetal Growth Restriction Management of Early-Onset Fetal Growth Restriction Management of Late-Onset FGR Postpartum management and preconception counselling.