Fetal growth restriction versus small for gestational age - diagnosis and controversies regarding the ultrasonographic algorithm.

Small-for-gestational-age fetuses are defined as fetuses with an estimated weight under the 10th percentile for the gestational age. Fetal growth restriction (FGR) is one of the most difficult and frequent situations in clinical practice. A true FGR is associated with abnormal Doppler and poorer perinatal outcome, instead of small-for-gestational-age fetuses who do not present abnormal feto-placental function, Doppler and have a normal perinatal outcome. Unfortunately, gestational age is not always easy to establish due to the lack of ultrasound examinations during the first trimester. On the other hand, in some cases, a small-forgestational- age fetus develops also intrauterine growth restriction and the differentiation between the two entities becomes more difficult. We analyzed a group of pregnant women who delivered in the "Filantropia" Hospital, Bucharest, in the last two years and divided them in four groups (small for gestational age, intrauterine growth restriction, mixed features, control group) and we separated a group of pregnant women without a proper pregnancy dating. This study evaluated the fetal and neonatal complications, the moment of onset, the degree of severity and the moment of delivery. We tried to identify the correct protocol in order to make a right decision of the optimal delivery of the fetus. The final step of this algorithm is to establish the way of delivery in order to reduce fetal injury and the risk of an iatrogenic preterm delivery. [ABSTRACT FROM AUTHOR]