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: 0I 00357592 Update on the Diagnosis and Classification of Fetal Growth Restriction and Proposal of a Stage-Based Management Protocol Francesc Figueras Eduard Gratacós Barcelona Center of Maternal-Fetal Medicine and Neonatology (Hospital Clinic and Hospital Sant Joan de Deu), IDIBAPS, Abnormal levels of maternal serum analytes have been associated with fetal growth restriction (FGR) and preeclampsia secondary to placental vascular dysfunction. Society for Maternal-Fetal Medicine Consult Series #52: diagnosis and management of fetal growth restriction: (replaces clinical guideline number 3, April 2012). In utero analysis of fetal growth: a sonographic weight standard. The first step in diagnosing sIUGR is verifying a monochorionic twin pregnancy. Your doctor or midwife, and your maternal-fetal medicine consultant, will keep a watchful eye on your pregnancy to reduce the risk of stillbirth. It is associated with an increased risk of intrauterine demise, neo- ... nal-Fetal Medicine (SMFM) recommends that if *).. The estimated fetal weight is plotted on the reference range for gestational age derived from the formula reported by: Nicolaides KH, Wright D, Syngelaki A, Wright A, Akolekar R. Fetal Medicine Foundation fetal and neonatal population weight charts. aneuploidy, other genetic syndromes, infection), and placental (e.g. Intrauterine growth restriction (IUGR) refers to diminished fetal growth during intrauterine life and is defined as decreased fetal growth. • Antepartum fetal surveillance starting at 32 weeks of gestation or 1 to 2 weeks earlier than previous stillbirth • Growth ultrasound after 28 weeks to screen for fetal growth restriction • Timing of delivery • 39 weeks or or as dictated by other maternal or fetal comorbid conditions ... Malone F. Guidelines on Fetal Growth Restriction: A comparison of Recent National Publications. MFM Fellow Lecture Series: Fetal Growth Restriction-International perspective, TRUFFLE study and SMFM Updates to Fetal Growth Restriction Select the "View On-Demand Recording" button to begin. Fetal growth restriction (FGR)is a condition in which the fetus is much smaller than expected for the gestational age. ... Maternal-Fetal Medicine, Professional Memberships. Because of this, MSU Extension and the Michigan Soybean Committee are co-sponsoring a Soybean Research and Crop Management Field Day on … Register now. The guidelines are restricted to subscribers and members. MFM Fellow Lecture Series: Intrauterine Growth Restriction (IUGR) Select the "View On-Demand Recording" button to begin. ... chronic hypertension with suspected fetal growth restriction), antenatal fetal surveillance might begin at a gestational age when delivery would be considered for perinatal benefit. DEFINITION Fetal growth restriction (FGR) is a leading cause of perinatal morbidity and mortality. Early vs. late fetal growth restriction. Fetal Growth Restriction: Inadequate growth of the fetus during pregnancy. Fetal growth restriction is commonly defined as an estimated fetal weight (EFW) that is below the 10th percentile for gestational age. High-quality diet in pregnancy is associated with a lower risk of fetal growth restriction. Tune in to Henry Galan's lecture on developing an understanding of normal and abnormal doppler waveform … American Congress of Obstetricians and Gynecologists, Fellow. Fetal growth restriction, also known as intrauterine growth restriction, is a common complication of pregnancy that has been ... and the Society for Maternal Fetal Medicine (SMFM) have issued new guidelines replacing previous guidance on prenatal genetic screening. Maternal-fetal medicine: principles and practice. In cases of sIUGR, the estimated fetal weight of the smaller, growth-restricted twin usually falls below the 10th percentile. The Society for Maternal-Fetal Medicine (SMFM) defines IUGR or FGR as an estimated fetal weight that’s below the 10th percentile for gestational age. We sought to determine the impact Fetal growth restriction (FGR) is a condition in which an unborn baby (fetus) is smaller than expected for the number of weeks of pregnancy (gestational age). ... Poor nutrition or weight gain. Alcohol or drug use. Cigarette smoking. Factors in the baby that can cause FGR include: Being one of a twin or triplets. 1) with 60% of the fetal surface demonstrating evidence of infarction and fetal vascular malperfusion. This case is a dramatic presentation of arrested fetal growth related to placental vascular pathology. FGR can lead to health problems for the baby. The GW Medical Faculty Associates Center for Maternal Fetal Medicine and Genetics providers are experts in the diagnosis and treatment of pregnancy complications, and they'll be by your side to help you manage your pregnancy complications. Society for Maternal-Fetal Medicine (SMFM). ... Head of the Maternal-Fetal Medicine Department & Service at Hospital Clínic Barcelona and coordinator of Maternal and Obstetric Pathology at BCNatal. 9/29/21 njm FETAL GROWTH RESTRICTION 1. The Society for Maternal-Fetal Medicine recently expanded thedefinition offetal growth restriction (FGR) as fetuses with a fetal abdominal circumference (AC) <10th percentile in addition to the traditional definition as fetuses with an esti-mated fetal weight (EFW)<10th percentile. There is a lack of consensus regarding terminology, etiology, and diagnostic criteria for fetal growth restriction, with uncertainty surrounding the … ACOG Practice Bulletin #227, Fetal Growth Restriction. When ultrasound examination suggests fetal growth restriction (FGR), prenatal care involves accurately determining gestational age, confirming the suspected diagnosis, determining the cause and severity of FGR, counseling the parents, closely monitoring fetal growth and well-being, and determining the optimal time for and route of delivery. METHODS: Relevant documents were identified using PubMed (US National Library of Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction: (Replaces Clinical Guideline Number 3, April 2012). The recommendations of the Society for Maternal-Fetal Medicine are as follows: (1) we recommend that fetal growth restriction be defined as an ultrasonographic estimated fetal weight or abdominal circumference below the 10th percentile for gestational age (GRADE 1B); (2) we recommend the use of population-based fetal growth references (such as Hadlock) in … DEFINITION Fetal growth restriction (FGR) is a leading cause of perinatal morbidity and mortality. Contains 2 Component (s) Tune in to Drs. Fetal growth restriction, also known as intrauterine growth restriction, is a common complication of pregnancy that has been associated with a variety of adverse perinatal outcomes. vascular disease), fetal (e.g. C. Lees. In 2008, ACOG, NICHD, and the Society for Maternal-Fetal Medicine reviewed and updated the definitions for fetal heart rate (FHR) patterns, interpretation, and research recommendations. Gestational Diabetes: Diabetes that develops during pregnancy. Martins JG, Biggio JR, Abuhamad A. Am J Perinatol 2015 Mar;32(4):307-16. Fetal Diagn Ther 2014;36:86–98 D115 1O09/. We aimed to compare the ability of three definitions of FGR to predict small for gestational age (SGA) … Therefore, timely diagnosis and management is key to optimizing long term benefit. this lecture about fetal growth restriction includes the update on this topic especially the management follow chart Download Citation | Society for Maternal-Fetal Medicine (SMFM) Consult Series #52: Diagnosis and Management of Fetal Growth Restriction | Fetal growth restriction (FGR) is … Worldwide, FGR is a leading cause of stillbirth, neonatal mortality, and short‐ and long‐term morbidity. 1 According to the American College of Obstetricians and Gynecologists, IUGR is “one the most common and complex problems in modern obstetrics.” 2 This characterization is understandable considering the various published definitions, poor … Early vs. late fetal growth restriction. The diagnosis, surveillance, and time of delivery of fetuses with suspected fetal growth restriction (FGR) are major issues in obstetrical practice. insufficiency). Society for Maternal‐Fetal Medicine guidelines for diagnosing fetal growth restriction (FGR) have broadened the definition to include abdominal circumference (AC) <10 th percentile for gestational age (GA) regardless of estimated fetal weight (EFW). Monochorionic twins are twins that share a single placenta. Nowadays, early prediction of FGR is the primary goal in maternal-fetal medicine, followed by prevention strategies in the antenatal period. Growth restriction increases the risk of stillbirth, which is devastating. restriction. 1, 2 The Society for Maternal-Fetal Medicine (SMFM) 3 and the International Society for Ultrasound in Obstetrics and Gynecology (ISUOG) 4 have recently issued clinical guidelines concerning FGR management. Objective: We sought to provide evidence-based guidelines for utilization of Doppler studies for fetuses with intrauterine growth restriction (IUGR). Selective intrauterine growth restriction (sIUGR) occurs when there is unequal placental sharing which leads to suboptimal growth of one twin. This means that the baby weighs less than or has a belly … Intrauterine growth restriction (IUGR) is defined as sonographic estimated fetal weight <10th percentile for gestational age. Immediate Delivery Group Median time to delivery = 0.9d Perinatal death rate = 10% Acog Guidelines 2013 Fetal Growth Restriction The FGR guidelines from the Society for Maternal-Fetal Medicine suggest delivery if there is absent end-diastolic flow at or beyond 34 0/7 weeks and with reverse end diastolic flow delivery if gestational age is?32 0/7 weeks. The recent international guidelines by the Society for Maternal–Fetal Medicine (SMFM) and the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) differ in their definitions of fetal growth restriction (FGR). (1). THURSDAY, Feb. 10, 2022 (HealthDay News) — A high-quality diet in late pregnancy is associated with a lower risk for fetal growth restriction (FGR), according to a study presented at the annual meeting of the Society for Maternal-Fetal Medicine, held virtually from Jan. 31 to Feb. 5. THURSDAY, Feb. 10, 2022 (HealthDay News) -- A high-quality diet in late pregnancy is associated with a lower risk for fetal growth restriction (FGR), according to a study presented at the annual meeting of the Society for Maternal-Fetal Medicine, held virtually from Jan. 31 to Feb. 5. It is associated with an increased risk of intrauterine demise, neonatal morbidity, and neonatal death; therefore, antenatal detection and surveillance with the optimization of delivery timing are necessary to improve pregnancy … Nowadays, early prediction of FGR is the primary goal in maternal-fetal medicine, followed by prevention strategies in the antenatal period. 1 According to the American College of Obstetricians and Gynecologists, IUGR is “one the most common and complex problems in modern obstetrics.” 2 This characterization is understandable considering the various published definitions, poor … Home » Publications & Guidelines » Doppler assessment of the fetus with intrauterine growth restriction Doppler assessment of the fetus with intrauterine growth restriction Diagnosis/definition: IUGR is estimated fetal weight < 10% for gestational age. FETAL GROWTH RESTRICTION 1. Fetal growth restriction (FGR) is a condition in which an unborn baby (fetus) is smaller than expected for the number of weeks of pregnancy (gestational age). It's often described as an estimated weight less than the 10th percentile. This means that the baby weighs less than 9 out of 10 babies of the same gestational age. Fetal growth restriction- Practice Bulletin #134. Society for Maternal-Fetal Medicine. SMFM Consult Series #52: Diagnosis and Management of Fetal Growth Restriction. In cases of sIUGR, the estimated fetal weight of the smaller, growth-restricted twin usually falls below the 10th percentile. 3d ed. Kurt Hecher and Alirezea Shamshirsaz's lecture on Fetal Growth Restriction-International perspective, TRUFFLE study and SMFM Updates to Fetal Growth Restriction. Introduction. SMFM was established in 1977 to “give Maternal-Fetal Medicine (MFM) physicians and scientists a place to share knowledge, research and clinical best practices in order to improve care for moms and babies.” Introduction. 2021 Jun;57(6):880-883. doi: 10.1002/uog.23663. ABSTRACT: Fetal growth restriction, also known as intrauterine growth restriction, is a common complication of pregnancy that has been associated with a variety of adverse perinatal outcomes. This hybrid (in-person or virtual) SMFM's Annual Meeting will offer learning about cutting-edge science in obstetrics, and opportunity for connecting with leaders in maternal-fetal medicine. Conventionally, fetal growth restriction is defined as an estimate of fetal size at a specific gestational age that is below a predefined threshold, usually the bottom 10th percentile, based on a specific growth standard or population reference.1 By this definition, most fetuses … This complex obstetrical problem has disparate published diagnostic criteria, relatively low detection rates, and limited preventative and treatment options. Introduction. https://obgyn.onlinelibrary.wiley.com/doi/10.1002/uog.23663 David Miller, MD, Chief of Maternal Fetal Medicine, Children's Hospital Los Angeles, explains everything you need to know about a intrauterine growth restriction diagnosis ... aren't that big. Her clinical interests include fetal growth abnormalities in particular fetal growth restriction, autoimmune disorders, and caring for women hypertensive disorders, including preeclampsia. Glossary. Out of 10 fetuses at the same gestational age, a growth- restricted fetus weighs less than 9 of them. The Society for Maternal-Fetal Medicine recently expanded thedefinition offetal growth restriction (FGR) as fetuses with a fetal abdominal circumference (AC) <10th percentile in addition to the traditional definition as fetuses with an esti-mated fetal weight (EFW)<10th percentile. Diagnosis and management of fetal growth restriction: the SMFM guideline and comparison with the ISUOG guideline Ultrasound Obstet Gynecol. Society for Maternal-Fetal Medicine (SMFM). A. Abuhamad, Corresponding Author. From the Society for Maternal-Fetal Medicine Publications Committee, with the assistance of Eliza Berkley, Suneet P. Chauhan, and ... studies for fetuses with intrauterine growth restriction (IUGR). Fetal growth restriction occurs in up to 10% of pregnancies and is second to premature birth as a cause of infant morbidity and mortality. Fetal Growth Restriction (FGR) is defined as estimated fetal weight (EFW) <10 th percentile OR abdominal circumference <10 th percentile irrespective of EFW, in accordance with the 2020 SMFM Consult Series recommendations.1 2. Maternal Fetal Medicine Fellow, PGY5 Department of Obstetrics and Gynecology University of Florida College of Medicine. ACOG PB 204. Current strategies to identify fetuses with pathological fetal growth restriction are inadequate. ACOG and SMFM state that a sonographic estimated fetal weight less than the 10th percentile is the measurement definition of fetal growth restriction, though as Chris explains, there are a number of limitations to this definition. We sought to determine the impact Fetal growth restriction (FGR) is one of the major obstetric complications that has been associated with term consequences as poor postnatal outcomes, perinatal morbidity, and mortality. …occurs in up to 10% of pregnancies and is second to premature birth as a cause of infant morbidity and mortality. Fetal growth restriction is the second leading cause of perinatal morbidity and ... Resnik R, eds. 1, 2 The Society for Maternal-Fetal Medicine (SMFM) 3 and the International Society for Ultrasound in Obstetrics and Gynecology (ISUOG) 4 have recently issued clinical guidelines concerning FGR management. Risk factors/associations: Fetal growth restriction can be a result of several possible conditions, including maternal (e.g. University of Cincinnati for management of patients with fetal growth restriction. Fetal Growth Restriction (FGR) Fetal growth restriction (FGR) , also known as intrauterine growth restriction (IUGR), is a condition in which an unborn baby (fetus) has an estimated fetal weight (EFW) or abdominal circumference (AC) below the 10th percentile for an accurately assigned gestational age. FGR is defined as an ultrasound estimated fetal weight (EFW) of less than the 10th percentile or abdominal circumference <10% for gestational age. It is associated with an increased risk of intrauterine demise, neo- ... nal-Fetal Medicine (SMFM) recommends that if *).. Classification of fetal growth restriction . Am J Obstet Gynecol. Fetal Growth Restriction Contributor: Shelley Chapman, MD Date: June 2020 Fetal growth restriction (FGR) occurs in approximately 10% of pregnancies and represents the manifestation of a variety of maternal, fetal and placental conditions. The origin of the problem may be fetal, placental, or maternal, with significant overlap among these entities. However, what needs to be clarified is that IUGR does not refer to just small fetal size, but to smaller size than what this particular fetus was genetically programmed to be. Selective intrauterine growth restriction (sIUGR) occurs when there is unequal placental sharing which leads to suboptimal growth of one twin. Tune in to Drs. ... Maternal Fetal Medicine consult should be considered when the diagnosis is made, especially in the setting of early onset FGR before 32 weeks. Open in a separate window. Selective Intrauterine Growth Restriction Diagnosis. Fetal growth restriction (FGR) can result from a variety of maternal, fetal, and placental conditions. Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction: (Replaces Clinical Guideline Number 3, April 2012). A maternal-fetal medicine specialist can diagnose sIUGR by studying the results of a detailed ultrasound. Am J Obstet Gynecol. Deep Vein Thrombosis (DVT): A condition in which blood clots develop in the deep veins of the body, most commonly in the legs. Diagnosis and management of fetal growth restriction: the ISUOG guideline and comparison with the SMFM guideline. 2020 Oct;223(4):B2-B17. (1). It occurs in up to 10% of pregnancies and is a leading cause of infant morbidity and mortality. [email protected]; ... Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Fetal growth restriction occurs in up to 10% of pregnancies and is a cause of infant morbidity and mortality around the world . Fetal growth restriction (FGR) is the final manifestation of a variety of maternal, fetal, and placental conditions. Fetal growth restriction (FGR) can result from a variety of maternal, fetal, and placental conditions. There is a lack of consensus regarding terminology, etiology, and diagnostic criteria for fetal growth restriction, with uncertainty surrounding the optimal management and timing of delivery … Effective interventions for prevention of recurrent fetal growth restriction include the following: a reproductive plan because spacing of pregnancies impacts their outcome, optimization of maternal medical conditions, smoking cessation, accurate dating by first-trimester sonography and monitoring of fetal growth with serial sonograms, and low-dose aspirin (80–160 … Source Reference: Wang XY, et al "Diet quality in pregnancy and the risk of fetal growth restriction" SMFM 2022; Abstract 26. share to facebook. The diagnosis, surveillance, and time of delivery of fetuses with suspected fetal growth restriction (FGR) are major issues in obstetrical practice. Activity Restriction: A term used in medicine to describe the practice of limiting a patient’s activity. Fetal growth restriction is commonly defined as an estimated fetal weight (EFW) that is below the 10th percentile for gestational age. Depending on the cause of IUGR, there may be other issues to be concerned about. Fetal growth restriction is commonly defined as an estimated fetal weight (EFW) that is below the 10th percentile for gestational age. 1, 2 Chromosomal disorders and congenital malformations are responsible for … Identification of fetuses with growth restriction that are at risk for complications remains a challenge. Our objective was to compare the prediction of small for gestational age (SGA) and a composite neonatal … What Causes Fetal Growth Restriction Fetal growth restriction is most often caused by a problem with transport of nutrients and oxygen from the mother’s blood to the baby, via the placenta. Inadequate blood flow to the placenta in the uterine arteries is the underlying abnormality in many cases. Society for Maternal-Fetal Medicine (SMFM). Whereas a fetus with a weight that is less than the 10th percentile for its gestational age is considered to have fetal growth restriction (FGR), also known as intrauterine growth restriction (IUGR) [5, 7]. There is a lack of consensus regarding terminology, etiology, and diagnostic criteria for fetal growth restriction, with uncertainty surrounding the … In 2020, the Society for Maternal-Fetal Medicine recommended that the definition be expanded to include either an estimated fetal weight<10th percentile or a fetal abdominal circumference<10th percentile. Fetal growth restriction (FGR) is defined as the failure of the fetus to meet its growth potential due to a pathological factor, most commonly placental dysfunction. Electronic address: [email protected] Society for Maternal-Fetal Medicine Consult Series #52: diagnosis and management of fetal growth restriction: (Replaces Clinical Guideline Number 3, April 2012). Am J Obstet Gynecol. Radiology 1991; 181: 129-133 . While there is currently no clear consensus on the definition, evaluation, and management, FGR is associated with adverse perinatal outcomes. Fetal Growth Restriction - all you need to know. Fetal growth restriction, also known as intrauterine growth restriction, is a common complication of pregnancy that has been associated with a variety of adverse perinatal outcomes. 1. Fetal growth restriction has traditionally been defined as fetuses with an estimated fetal weight <10th percentile for gestational age. SMFM has released guidance on fetal growth restriction (FGR), an evidence-based document that provides a standardized approach to diagnosis and management. FGR: Estimated fetal weight (EFW) or abdominal circumference (AC) < 10th percentile for gestational age (GA) Suggests fetus is pathologically small but will include some some constitutionally small fetuses. Don’t do an inherited thrombophilia evaluation for women with histories of pregnancy loss, fetal growth restriction (FGR), preeclampsia and abruption. Philadelphia: Saunders, 1994:558–74. Hear from a fantastic line up of top international experts and join the Q&A. Then the fetal weight of each twin is assessed. Diagnosis/definition: Fetal growth restriction is an estimated fetal weight of less than the 10th percentile for gestational age. Fetal growth restriction (FGR) is one of the major obstetric complications that has been associated with term consequences as poor postnatal outcomes, perinatal morbidity, and mortality. Fetal growth and well-being should be monitored following SARS-CoV-2 infection. On the agenda: Cardio Obstetrics: A Practical Case-Based Approach; Help Us Help You: An Obstetric Anesthesiologist’s Perspective on High-Risk Deliveries Live webinar on September 9, 2021 - 10am (UK) for sonologists, sonographers, obstetricians, specialists in fetal medicine and radiologists focussing on the new and emerging themes in fetal growth restriction. Diagnosis and management of fetal growth restriction: the ISUOG guideline and comparison with the SMFM guideline Ultrasound Obstet Gynecol . These include preeclampsia, intrauterine growth restriction, preterm labor, maternal depression, diabetes, placenta accreta, fetal congenital heart defects, and many other conditions. Martins JG, Biggio JR, Abuhamad A. MFM Fellow Lecture Series: Fetal Growth Restriction-International perspective, TRUFFLE study and SMFM Updates to Fetal Growth Restriction. Severe FGR is defined as EFW <3rd Objective: Predicting fetal growth restriction (FGR) is a challenge and recent international guidelines by the Society of Maternal Fetal Medicine (SMFM) and the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) differ in their definitions of FGR. With IUGR, baby grows slower than would normally be expected during pregnancy. Objective. ... Fetal growth restriction, also known as intrauterine growth restriction, is a common complication of pregnancy that has been associated with a variety of adverse perinatal outcomes. It’s also now known as FGR, or fetal growth restriction. Fetal growth restriction can result from a variety of maternal, fetal, and placental conditions. Society for Maternal-Fetal Medicine View all recommendations from this society Released February 3, 2014 . C. Lees, Corresponding Author. Fetal growth restriction (FGR, also called intrauterine growth restriction [IUGR]) is the term used to describe a fetus that has not reached its growth potential because of environmental factors. Intrauterine growth restriction (IUGR) is defined as sonographic estimated fetal weight <10th percentile for gestational age. The document emphasizes the importance of FGR as a significant pregnancy complication that. Diagnosis and management of fetal growth restriction: the SMFM guideline and comparison with the ISUOG guideline. Objective. Electronic address: [email protected] Society for Maternal-Fetal Medicine Consult Series #52: diagnosis and management of fetal growth restriction: (Replaces Clinical Guideline Number 3, April 2012). The Maternal-Fetal Medicine Division is committed to training the future leaders in women’s health, playing key roles in educating students, residents, fellows and other students of the health sciences at the University of … Again, per SMFM consult series defined as onset <32 weeks (early) or late (at or after 32 weeks) Introduction. In addition to its significant perinatal impact, FGR also … A. Abuhamad. Adobe Stock. Committee on Practice Bulletins—Obstetrics and the Society for Maternal-Fetal Medicine. [email protected]; Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, VA, USA. The most common definition of Intrauterine Growth Restriction (IUGR) is a fetal weight that is below the 10th percentile for gestational age as determined through an ultrasound. Intrauterine Growth Restriction is also known as Small-for-Gestational-Age (SGA) or fetal growth restriction. Fetal Growth Restriction From detection and diagnosis, to follow-up and management Interactive masterclass November 12th, 2021. Fetal growth restriction is commonly defined using small for gestational age (SGA) birth (birthweight < 10th percentile) as a proxy, but this approach is problematic because most SGA infants are small but healthy. The Society of Maternal Fetal Medicine has made recommendations in their SMFM Consult Series #52: Diagnosis and Management of Fetal … 2020 Oct;223(4):B2-B17. 1 Although the primary underlying mechanisms for FGR are varied, they often share the same final common pathway of suboptimal fetal nutrition and uteroplacental perfusion. There is a lot of exciting and relevant soybean research being conducted at Michigan State University, and Michigan State University Extension specialists also have new crop and pest management recommendations to share. SUMMARY: ACOG / SMFM released a guidance update on fetal growth restriction (FGR). Society for Maternal-Fetal Medicine. 2021 Jun;57(6):884-887. doi: 10.1002/uog.23664. Course Description: Approximately 10 percent of pregnant patients will be diagnosed with Fetal Growth Restriction (FGR) and receive Doppler assessment. 3 ACOG Guidelines at a Glance: Antepartum fetal Page 9/17

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