Fetal growth restriction: features of anamnesis, outcomes of pregnancy and childbirth

Background. Fetal growth restriction (FGR) is a serious medical and social problem, which is associated with high perinatal morbidity and mortality, as well as long-term consequences for offspring. To date, there are no absolute instrumental tests for accurately predicting the condition of the fetus, which justifies the relevance of this study.

Objective. To study the features of the anamnesis, the course of pregnancy, and the outcome of childbirth in women with fetal growth restriction.

Materials and methods. A retrospective cohort study was conducted using a continuous sample of 200 women who were delivered at the Clinic of the South Ural State Medical University (Chelyabinsk) in 2022. All the women were divided into two groups: group 1 - 30 women with FGR, group 2  - 170 women without FGR. The outcomes of pregnancy and childbirth were studied (the results were obtained by means of a questionnaire, analysis of medical documentation: the book of a pregnant woman, the history of childbirth).

Results. There was a low effectiveness of the prognosis of FGR both according to the results of the analysis of anamnestic risk factors and according to laboratory and instrumental screening programs at 11-13,6 weeks of gestation. A low percentage of coverage with drug prevention was registered in the high-risk group of FGR (55%). We found that FGR is associated with other placental disorders, which more often began in the second trimester with changes in uterine and fetal blood flow and progressed as the gestation period increased. Fetal growth restriction is associated with severe preeclampsia, high incidence of premature birth, cesarean section, hypotrophy and severe asphyxia of newborns.

Conclusion. The absence of significant anamnestic risk factors, the low effectiveness of predicting fetal growth retardation based on the results of programmatic screening at 11-13,6 weeks require the development of new modern methods for predicting pathology. Research should focus on the development of new fetal diagnostic tools that can improve the accuracy of predicting critical fetal conditions, as well as on the introduction of innovative therapeutic measures aimed at improving placental hemodynamics, which will further optimize the timing of delivery.

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