Coutinho, CM; Melchiorre, K; Thilaganathan, B
(2020)
Stillbirth at term: Does size really matter?
Int J Gynaecol Obstet, 150 (3).
pp. 299-305.
ISSN 1879-3479
https://doi.org/10.1002/ijgo.13229
SGUL Authors: Thilaganathan, Baskaran
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Abstract
Placental dysfunction has a deleterious influence on fetal size and is associated with higher rates of perinatal morbidity and mortality. This association underpins the strategy of fetal size evaluation as a mechanism to identify placental dysfunction and prevent stillbirth. The optimal method of routine detection of small for gestational age (SGA) remains to be clarified with choices between estimation of symphyseal-fundal height versus routine third-trimester ultrasound, various formulae for fetal weight estimation by ultrasound, and the variable use of national, customized, or international fetal growth references. In addition to these controversies, the strategy for detecting SGA is further undermined by data demonstrating that the relationship between fetal size and adverse outcome weakens significantly with advancing gestation such that near term, the majority of stillbirths and adverse perinatal outcomes occur in normally sized fetuses. The use of maternal serum biochemical and Doppler parameters near term appears to be superior to fetal size in the identification of fetuses compromised by placental dysfunction and at increased risk of damage or demise. Multiparameter models and predictive algorithms using maternal risk factors, and biochemical and Doppler parameters have been developed, but need to be prospectively validated to demonstrate their effectiveness.
Item Type: |
Article
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Additional Information: |
This is the peer reviewed version of the following article: Coutinho, C.M., Melchiorre, K. and Thilaganathan, B. (2020), Stillbirth at term: Does size really matter?. Int J Gynecol Obstet, 150: 299-305, which has been published in final form at https://doi.org/10.1002/ijgo.13229. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited. |
Keywords: |
Customized fetal growth, Estimated fetal weight, Fetal growth charts, Fetal growth reference standards, Fetal growth restriction, Placental dysfunction, Small for gestational age, Stillbirth, Female, Fetal Development, Fetal Growth Retardation, Fetal Weight, Fetus, Humans, Infant, Newborn, Infant, Small for Gestational Age, Pregnancy, Pregnancy Trimester, Third, Stillbirth, Ultrasonography, Doppler, Ultrasonography, Prenatal, Fetus, Humans, Fetal Growth Retardation, Fetal Weight, Ultrasonography, Doppler, Ultrasonography, Prenatal, Fetal Development, Pregnancy, Pregnancy Trimester, Third, Infant, Newborn, Infant, Small for Gestational Age, Female, Stillbirth, 1114 Paediatrics and Reproductive Medicine, Obstetrics & Reproductive Medicine |
SGUL Research Institute / Research Centre: |
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) |
Journal or Publication Title: |
Int J Gynaecol Obstet |
ISSN: |
1879-3479 |
Language: |
eng |
Dates: |
Date | Event |
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7 August 2020 | Published | 16 June 2020 | Published Online | 14 May 2020 | Accepted |
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Publisher License: |
Publisher's own licence |
Projects: |
Project ID | Funder | Funder ID |
---|
UNSPECIFIED | Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) | UNSPECIFIED |
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PubMed ID: |
32438457 |
![](http://static.pubmed.gov/portal/portal3rc.fcgi/2745237/img/27842) |
Go to PubMed abstract |
URI: |
https://openaccess.sgul.ac.uk/id/eprint/113625 |
Publisher's version: |
https://doi.org/10.1002/ijgo.13229 |
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