STUDY OF CEREBROPLACENTAL RATIO IN FETAL GROWTH RESTRICTED CASES AND ITS RELATION TO ADVERSE PERINATAL OUTCOMES.

Abstract

DEFINITION: As per ISUOG (International Society of Ultrasound in Obstetrics and Gynecology)
Practice Guidelines 2020, Fetal growth restriction (FGR) is described as
a) Sonographic estimated fetal weight or abdominal circumference of less than 3rd percentile of the
average for gestational age.
b) EFW or AC < 10th percentile with abnormal doppler (maternal or fetal)

c) A drop of > 2 quartiles in AC or EFW centile in serial USG.
Graph showing estimated fetal weight (EFW) as per gestational age.
Fetal Growth Restriction (FGR) is a serious obstetric complication affecting 5–10% of
pregnancies worldwide 1. Fetal Growth Restriction (FGR), otherwise known as Intrauterine Growth
Restriction (IUGR) is defined as a pathologic decrease in the rate of fetal growth. Here the fetus does
not achieve its inherent growth potential, thereby increasing perinatal morbidity and mortality.
It is associated with an increased risk of adverse perinatal outcome, such as premature birth,
fetal hypoxia, neonatal acidosis, low APGAR score or intrauterine death 2,3 . There are multiple
causes for FGR—they can be of fetal, placental or maternal origin such as preeclampsia. Ultimately,
they lead to the same endpoint: insufficient uteroplacental perfusion and restricted fetal nutrition
which is reflected by abnormal Doppler parameters 4.
FGR incidence is between 3% and 7% of the total population with round figure of 5.13% with a
progressively higher incidence during the last decade 5. In India, the prevalence of LBW has been
reported as 26% while the proportion of FGR has been found to be 54% 6 .