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Fetal Growth Restriction risk assessment, pregnancies at risk of FGR (1004)

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(Based on Element 2 of the Saving Babies’ Lives Versions Two, Care Bundle for Reducing Perinatal Mortality)

There is strong evidence to suggest that Fetal growth restriction (FGR) is the biggest risk factor for stillbirth. Therefore antenatal detection of growth restricted babies is vital and has been shown to reduce stillbirth significantly because it gives the option to consider timely delivery of the baby at risk.

All staff looking after pregnant women must be aware however that

Small for Gestational Age (SGA) where the Estimated Fetal Weight (EFW) <10th centile  and

Fetal Growth Restriction (FGR) where a fetus fails to reach its growth potential 

are distinct entities.  Although SGA babies are at increased risk of FGR compared to appropriately grown fetuses, fetuses <3rdcentile are far more likely to be FGR than fetuses between the 3rd and 10th centile. This guideline aims to identify and focus on the higher risk FGR group whilst trying to limit unnecessary intervention in the lower risk SGA group. 

Decision making relies on balancing the risks of causing mild harm to a relatively large number of infants (admission to Neonatal unit) to prevent serious harm to a small number of infants (stillbirth).

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Editorial Information

Last reviewed: 08/11/2022

Next review date: 01/01/2025

Author(s): Dawn Kernaghan.

Version: 3

Approved By: Obstetrics Clinical Governance Group

Document Id: 1004