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Fetal growth restriction is an important part of monitoring a pregnancy. Because guidelines or diagnostic criteria for either minor or major thrombophilia are scarce, this systematic review aims to summarize the present knowledge in the field. We performed the CRD42022376006 protocol in Prospero with a systematic literature search in PubMed and Web of Science databases and included original full-text articles (randomized control trials and clinical trials) from the last 10 years, published in English, and with the "thrombophilia AND (pregnancy OR diagnostic criteria) AND fetal growth restriction" criteria. After two researchers extracted the articles of interest, they were assessed using the Newcastle–Ottawa Scale and eight articles were included. The elements from the thrombophilia diagnostic predict IUGR, factor V Leiden mutation, MTHFR C667T mutation, protein S deficiency, antithrombin deficiency, factor VII polymorphism, and antiphospholipid antibodies, while the association of protein C, PAI-1 and certain combinations of mutations are still under debate and require the collection of more data. The present systematic review provides an extensive picture of the actual knowledge about thrombophilia diagnosis and its links with pregnancy complications, such as intrauterine growth restriction, despite its limitation in the inclusion of other actually debated disorders such as PAI-1 mutation, protein C deficiency and other thrombophilia types. [ABSTRACT FROM AUTHOR]

Intrauterine growth restriction or fetal growth restriction represents a fetal incapacity of achieving its entire growth potential in intrauterine life, as a result of maternal, fetal and/or placental causes, from hypertension, autoimmune diseases, drug consumption, hereditary thrombophilia to genetic syndromes, intrauterine infections, umbilical cord anomalies or placental insufficiency. The ultrasonographic evaluation of the fetus with intrauterine growth restriction identifies an estimated fetal weight or a fetal abdominal circumference below the 10 th percentile for gestational age; a severe fetal growth restriction is defined as an estimated fetal weight below the 3rd percentile. The Delphi consensus managed to classify fetal growth restriction as early, being diagnosed under 32 weeks of gestation, respectively late, after 32 weeks of gestation. Up to 10% of pregnancies are complicated by fetal growth restriction, which are then considered high-risk pregnancies for the morbidity and mortality risk carried for the fetus, requiring an accurate diagnosis of the cause, intensifying the fetal monitoring and timing the birth, in order to deliver the fetus in safe conditions. This paper proposes an algorithm for an initial evaluation of fetal growth restriction, with the aim of simplifying the medical approach when encountering a fetus with intrauterine growth restriction, in order to improve morbidity and mortality rates among pregnancies complicated by fetal growth restriction. [ABSTRACT FROM AUTHOR]

The increase in the number of microorganisms that cause maternal-fetal infections has led to the need to update the acronym TORCH (Toxoplasma, Others, Rubella, Cytomegalovirus, Herpes) to SCRATVHEZ (Syphilis, Cytomegalovirus, Rubella, AIDS, Tuberculosis, Varicella, Herpes, Enterovirus, Zika). The multiple routes of transmission (transplacental, intrapartum, breast milk or posttransfusion), the multitude of microorganisms generating various and complex complications – from quasi-asymptomatic diseases to intrauterine growth restriction, neurological sequelae and to fetal death, the treatment that varies from case to case, between symptomatic and etiological and the possibility of preventing infections, outline their complexity and importance. A complete and correct early diagnosis involves clinical, biological and serological evaluation from the prenatal period, in order to prevent the evolution of infections, especially in the case of those in which there is an etiological treatment. The importance of knowing these infections and the effort to prevent their transmission, in order to limit the development of the consequences they can cause, are key elements in the optimal management of a pregnancy. [ABSTRACT FROM AUTHOR]

The increase in the number of microorganisms that cause maternal-fetal infections has led to the need to update the acronym TORCH (Toxoplasma, Others, Rubella, Cytomegalovirus, Herpes) to SCRATVHEZ (Syphilis, Cytomegalovirus, Rubella, AIDS, Tuberculosis, Varicella, Herpes, Enterovirus, Zika). The multiple routes of transmission (transplacental, intrapartum, breast milk or posttransfusion), the multitude of microorganisms generating various and complex complications – from quasi-asymptomatic diseases to intrauterine growth restriction, neurological sequelae and to fetal death, the treatment that varies from case to case, between symptomatic and etiological and the possibility of preventing infections, outline their complexity and importance. A complete and correct early diagnosis involves clinical, biological and serological evaluation from the prenatal period, in order to prevent the evolution of infections, especially in the case of those in which there is an etiological treatment. The importance of knowing these infections and the effort to prevent their transmission, in order to limit the development of the consequences they can cause, are key elements in the optimal management of a pregnancy [ABSTRACT FROM AUTHOR]