ISUOG Practice Guidelines: diagnosis and management of small‐for‐gestational‐age fetus and fetal growth restriction
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ISUOG Practice Guidelines: diagnosis and management of small-for-gestational-age fetus and fetal growth restriction Clinical Standards CommitteeThe International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) is a scientific organization that encourages sound clinical practice, and high-quality teaching and research related to diagnostic imaging in women's healthcare.The ISUOG Clinical Standards Committee (CSC) has a remit to develop Practice Guidelines and Consensus Statements as educational recommendations that provide healthcare practitioners with a consensus-based approach, from experts, for diagnostic imaging.They are intended to reflect what is considered by ISUOG to be the best practice at the time at which they are issued.Although ISUOG has made every effort to ensure that Guidelines are accurate when issued, neither the Society nor any of its employees or members accepts any liability for the consequences of any inaccurate or misleading data, opinions or statements issued by the CSC.The ISUOG CSC documents are not intended to establish a legal standard of care, because interpretation of the evidence that underpins the Guidelines may be influenced by individual circumstances, local protocol and available resources.Approved Guidelines can be distributed freely with the permission of ISUOG (info@isuog.org).
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Current screening methods have limited sensitivity, as subtle placental dysfunctions may not be apparent until late gestation when growth deviation or abnormal Doppler findings occur.
“However, current screening methods have limited sensitivity, as subtle placental dysfunctions may not be apparent until late gestation when growth deviation or abnormal Doppler findings occur.5,6,11”
From Early detection of severe fetal growth restriction using multimodal deep learning based on ultrasound and prenatal biomarkers (2026) · cites this paper as [5]
The ‘What is not known and implications for research’ section (page unavailable) describes a possible preclinical phase that Doppler measures may fail to detect. The ‘Late-onset fetal growth restriction’ section (page unavailable) says umbilical-artery Doppler abnormalities are rare and miss most late-FGR cases. These passages support limited detection of subtle dysfunction, but do not establish that it generally becomes apparent only in late gestation through growth deviation or abnormal Doppler findings. (LLM, conf=0.84)
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Self-citationOros, D., Figueras, F., Cruz‐Martinez, R., Padilla, N., Meler, E., Hernandez‐Andrade, E. A., & Gratacós, E. (2010) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.7588 · Cited by 93 · see citing works
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Self-citationScreening, Diagnosis, and Management of Intrauterine Growth Restriction
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Are fetuses that fail to achieve their growth potential at increased risk of intrapartum compromise?
Prior, T., Paramasivam, G., Bennett, P. R., & Kumar, S. (2014) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.14758 · Cited by 88 · see citing works
Groom, K., McCowan, L., Mackay, L., Lee, A., Gardener, G., Unterscheider, J., Sekar, R., Dickinson, J., Muller, P., Reid, R., et al. (2019) · BJOG: An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.15658 · Cited by 88 · see citing works
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Keating, S. J., Melamed, N., Walker, M., Sebire, N. J., Levytska, K., Higgins, M., & Kingdom, J. C. (2016) · American Journal of Perinatology · doi:10.1055/s-0036-1592347 · Cited by 85 · see citing works
Self-citationPredictors of outcome at 2 years of age after early intrauterine growth restriction
Torrance, H. L., Bloemen, M. C. T., Mulder, E. J. H., Nikkels, P. G. J., Derks, J. B., de Vries, L. S., & Visser, G. H. A. (2010) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.7627 · Cited by 84 · see citing works
Perinatal mortality by birthweight centile
Francis, J. H., Permezel, M., & Davey, M. (2014) · Australian and New Zealand Journal of Obstetrics and Gynaecology · doi:10.1111/ajo.12205 · Cited by 83 · see citing works
Wolf, H., Huusom, L. D., Henriksen, T. B., Hegaard, H. K., Brok, J. S., & Pinborg, A. B. (2020) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.16238 · Cited by 83 · see citing works
MacDonald, T. M., Hui, L., Tong, S. Y. C., Robinson, A. J., Dane, K. M., Middleton, A., & Walker, S. P. (2017) · BMC Medicine · doi:10.1186/s12916-017-0928-z · Cited by 81 · see citing works
Validation of Delphi procedure consensus criteria for defining fetal growth restriction
Molina, L. C. G., Odibo, L., Zientara, S., Običan, S. G., Rodriguez, A. R., Stout, M. J., & Odibo, A. O. (2019) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.20854 · Cited by 81 · see citing works
Deter, R. L., Lee, W., Yeo, L., Erez, O., Ramamurthy, U., Naik, M., & Romero, R. (2018) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2017.12.210 · Cited by 80 · see citing works
Boers, K. E., van Wyk, L., van der Post, J., Kwee, A., van Pampus, M. G., Spaanderdam, M. E. A., Duvekot, J. J., Bremer, H. A., Delemarre, F. M. C., Bloemenkamp, K. W. M., et al. (2012) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2012.01.015 · Cited by 78 · see citing works
Crimmins, S. D., Desai, A. N., Block‐Abraham, D., Berg, C., Gembruch, U., & Baschat, A. (2014) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2014.06.022 · Cited by 73 · see citing works
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Premature placental aging in term small‐for‐gestational‐age and growth‐restricted fetuses
Paulés, C., Dantas, A. P., Miranda, J., Crovetto, F., Eixarch, E., Rodríguez‐Sureda, V., Domı́nguez, C., Casu, G., Rovira, C., Nadal, A., et al. (2018) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.20103 · Cited by 71 · see citing works
Cruz‐Martinez, R., Savchev, S., Cruz‐Lemini, M., Mendez, A., Gratacos, E., & Figueras, F. (2015) · Ultrasound in Obstetrics & Gynecology · doi:10.1002/uog.14706 · Cited by 70 · see citing works
Self-citationHecher, K., Spernol, R., Stettner, H. M., & Szalay, S. M. (1992) · Ultrasound in Obstetrics and Gynecology · doi:10.1046/j.1469-0705.1992.02040266.x · Cited by 69 · see citing works
Self-citationParra-Saavedra, M. A., Crovetto, F., Triunfo, S., Savchev, S., Parra, G., Sanz, M., Gratacós, E., & Figueras, F. (2013) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.12380 · Cited by 65 · see citing works
Self-citationUse of antenatal corticosteroids in special circumstances: a comprehensive review
Magann, E. F., Haram, K., Ounpraseuth, S., Mortensen, J. H. S., Spencer, H. J., & Morrison, J. C. (2017) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/aogs.13104 · Cited by 64 · see citing works
Parra-Saavedra, M. A., Simeone, S., Triunfo, S., Crovetto, F., Botet, F., Nadal, A., Gratacós, E., & Figueras, F. (2014) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.13415 · Cited by 62 · see citing works
Self-citationKnight, H. E., Cromwell, D. A., Gurol‐Urganci, I., Harron, K. L., van der Meulen, J., & Smith, G. C. S. (2017) · PLoS Medicine · doi:10.1371/journal.pmed.1002425 · Cited by 58 · see citing works
Stampalija, T., Casati, D., Monasta, L., Sassi, R., Rivolta, M. W., Muggiasca, M. L., Bauer, A., & Ferrazzi, E. M. (2015) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.13607 · Cited by 57 · see citing works
Self-citationFerrazzi, E. M., Rigano, S., Padoan, A., Boito, S., Pennati, G., & Galan, H. L. (2011) · Placenta · doi:10.1016/j.placenta.2011.04.004 · Cited by 55 · see citing works
Self-citationPrenatal identification of small‐for‐gestational age and risk of neonatal morbidity and stillbirth
Nohuz, E., Rivière, O., Coste, K., & Vendittelli, F. (2019) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.20282 · Cited by 52 · see citing works
Roberts, L., Ling, H. Z., Poon, L. C., Nicolaides, K. H., & Kametas, N. A. (2018) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.19067 · Cited by 50 · see citing works
Self-citationCerebral blood flow studies in the diagnosis and management of intrauterine growth restriction
Hernandez‐Andrade, E. A., Stampalija, T., & Figueras, F. (2013) · Current Opinion in Obstetrics & Gynecology · doi:10.1097/gco.0b013e32835e0e9c · Cited by 47 · see citing works
Self-citationThe untapped potential of placenta-enriched molecules for diagnostic and therapeutic development
Whigham, C., MacDonald, T. M., Walker, S. P., Hannan, N. J., Tong, S., & Kaitu’u‐Lino, T. J. (2019) · Placenta · doi:10.1016/j.placenta.2019.02.002 · Cited by 40 · see citing works
Ting, J. Y., Kingdom, J. C., & Shah, P. S. (2018) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2017.12.227 · Cited by 39 · see citing works
Self-citationGriffin, M., Seed, P. T., Webster, L., Myers, J., Mackillop, L. H., Simpson, N., Anumba, D. O. C., Khalil, A. A., Denbow, M. L., Sau, A., et al. (2015) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.14860 · Cited by 38 · see citing works
Middle cerebral artery pulsatility index: reliability at different sampling sites
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Self-citationHabek, D., Salihagić, A., Jugović, D., & Herman, R. (2007) · Fetal Diagnosis and Therapy · doi:10.1159/000106354 · Cited by 31 · see citing works
Ruiz, S., Papageorghiou, A. T., Staines-Urias, E., Villar, J., de Agüero, R. G., & Oros, D. (2019) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.20380 · Cited by 30 · see citing works
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Leemhuis, A. G., Marlow, N., Lees, C., Wolf, H., & the TRUFFLE investigators (2017) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.14511 · Cited by 28 · see citing works
Self-citationThe controversial role of the ductus venosus in hypoxic human fetuses
Ferrazzi, E. M., Lees, C., & Acharya, G. (2019) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/aogs.13572 · Cited by 23 · see citing works
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Intrapartum magnesium sulfate is associated with neuroprotection in growth-restricted fetuses
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Self-citationCurrent use and performance of the different fetal growth charts in the Italian population
Stampalija, T., Ghi, T., Rosolen, V., Rizzo, G., Ferrazzi, E. M., Prefumo, F., Dall’Asta, A., Quadrifoglio, M., Todros, T., & Frusca, T. (2020) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2020.06.059 · Cited by 21 · see citing works
Self-citationSurvey on the Current Trends in Managing Intrauterine Growth Restriction
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Baschat, A., Kush, M. L., Berg, C., Gembruch, U., Nicolaides, K. H., Harman, C. R., & Turan, O. M. (2012) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.12322 · Cited by 17 · see citing works
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Salomon, L. J., Alfirevic, Z., Berghella, V., Bilardo, C. M., Chalouhi, G. E., Da Silva Costa, F., Hernandez‐Andrade, E., Malinger, G., Munoz, H., Paladini, D., et al. (2022) · Ultrasound in Obstetrics & Gynecology · doi:10.1002/uog.24888 · Cited by 436 · see citing works
Self-citationStepan, H., Galindo, A., Hund, M., Schlembach, D., Sillman, J., Surbek, D., & Vatish, M. (2023) · Ultrasound in Obstetrics & Gynecology · doi:10.1002/uog.26032 · Cited by 245 · see citing works
Roeckner, J. T., Pressman, K., Odibo, L., Duncan, J. R., & Odibo, A. O. (2021) · Ultrasound in Obstetrics & Gynecology · doi:10.1002/uog.23638 · Cited by 60 · see citing works
The role of the fetal biophysical profile in the management of fetal growth restriction
Baschat, A. A., Galan, H. L., Lee, W., DeVore, G. R., Mari, G., Hobbins, J., Vintzileos, A., Platt, L. D., & Manning, F. A. (2022) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2022.01.020 · Cited by 42 · see citing works
Self-citationSchreiber, V., Hurst, C., da Silva Costa, F., Stoke, R., Turner, J., & Kumar, S. (2023) · Ultrasound in Obstetrics & Gynecology · doi:10.1002/uog.26035 · Cited by 34 · see citing works
Hong, J., Crawford, K., Cavanagh, E., da Silva Costa, F., & Kumar, S. (2024) · Ultrasound in Obstetrics & Gynecology · doi:10.1002/uog.27513 · Cited by 21 · see citing works
Zheng, C., Ji, C., Wang, B., Zhang, J., He, Q., Ma, J., Yang, Z., Pan, Q., Sun, L., Sun, N., et al. (2024) · Ultrasound in Obstetrics & Gynecology · doi:10.1002/uog.27522 · Cited by 11 · see citing works
Sanchez-Martinez, S., Marti-Castellote, P. M., Hoodbhoy, Z., Bernardino, G., Prats-Valero, J., Aguado, A. M., Testa, L., Piella, G., Crovetto, F., Snyder, C., et al. (2024) · BMJ Global Health · doi:10.1136/bmjgh-2024-016088 · Cited by 9 · see citing works
Long-Term Neurologic Consequences following Fetal Growth Restriction: The Impact on Brain Reserve
Shah, D. K., Pereira, S., & Lodygensky, G. A. (2024) · Developmental Neuroscience · doi:10.1159/000539266 · Cited by 8 · see citing works
Wang, J., Chen, Z., Zhang, H., Li, W., Li, K., Deng, M., & Zou, Y. (2025) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-025-07450-1 · Cited by 9 · see citing works
Wang, J., Wang, J., Peng, Y., Hou, F., Zhang, X., & Jin, H. (2026) · Annals of Medicine · doi:10.1080/07853890.2026.2688297
“5,6,11 Therefore, there is a critical need for more accurate early prediction methods.”
- Authors
- Lees, C. C., Stampalija, T., Baschat, A. A., da Silva Costa, F., Ferrazzi, E., Figueras, F., Hecher, K., Kingdom, J., Poon, L. C., Salomon, L. J., & Unterscheider, J.
- Affiliations
- Imperial College Healthcare NHS Trust (GB)
- University of Trieste (IT)
- Johns Hopkins University (US)
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School University of São Paulo, Ribeirão Preto São Paulo Brazil
- University of Milan (IT)
- Hospital Sant Joan de Déu Barcelona (ES)
- University Medical Center Hamburg-Eppendorf (DE)
- Mount Sinai Hospital (CA)
- Chinese University of Hong Kong (HK)
- Hôpital Necker-Enfants Malades (FR)
- Royal Women's Hospital (AU)
- ORCID
- Venue
- Ultrasound in Obstetrics & Gynecology
- Publisher
- Wiley
- Published
- 2020-08
- Volume
- 56
- Issue
- 2
- Pages
- 298-312
- ISSN
- 0960-7692 (ISSN-L)
- 1469-0705
- OpenAlex
- W3046521213
- Cited by
- 886
- References
- 133
- Citations by year
- 2026: 192 · 2025: 169 · 2024: 134 · 2023: 138 · 2022: 156 · 2021: 86 · 2020: 9 · 2019: 1
- FWCI
- 59.96
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Ultrasound in Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- ArTS Archivio della ricerca di Trieste (University of Trieste https://www.units.it/) (submittedVersion, other-oa)
- Minerva Access (University of Melbourne) (submittedVersion)
- Griffith Research Online (submittedVersion)
- Funders
- Johns Hopkins University
- International Society of Ultrasound in Obstetrics and Gynecology
- Università degli Studi di Milano
- Imperial College London
- Imperial College Healthcare NHS Trust
- Monash University
- University of Toronto
- KU Leuven
- Chinese University of Hong Kong
- Universitat de Barcelona
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
- Université de Paris
- Universitätsklinikum Hamburg-Eppendorf
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Screening and Diagnostics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Keywords
- small-for-gestational-age fetuses, fetal growth restriction, prenatal diagnosis, prenatal ultrasound, antenatal management, fetal biometry
- MeSH terms
- Adult, Biometry, Female, Fetal Growth Retardation, Humans, Infant, Newborn, Infant, Small for Gestational Age, Obstetrics, Pregnancy, Prenatal Diagnosis, Fetal Development
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