The DOI matches its Crossref record; 208 of the 208 references it cites were found in a registry or an index; 60 of the 155 sources its claims cite were checked for support.
Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction
Open accessAbstract
Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction. Fetal growth restriction is associated with perinatal morbidity and mortality.
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Claims the paper makes
45 No full text of the sources · 25 Partly supported · 17 Sources not found · 13 Supported · 6 Supported so far · 6 Own interpretation · 2 Couldn’t confirm · 2 Not checked yet · 1 Mixed support · 1 Not supported · 1 No basis given · accuracy not yet measured
Some cited sources support this claim and some don’t — read each source’s verdict below.
In the paper
“However, this finding was not confirmed in the Aspirin for Evidence-Based Preeclampsia Prevention (ASPRE) trial, which was primarily designed for preterm preeclampsia prevention.74,75”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > General considerations
What the sources say
- Disputedcites [74] Rolnik, 2017, Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia, N Engl J Med sourceExperimental — accuracy not yet measured
The Primary Outcome section reports significantly less preterm preeclampsia with aspirin than placebo (1.6% versus 4.3%; P = 0.004), contrary to the claim that the trial did not confirm an aspirin benefit. The Discussion confirms that preterm preeclampsia was the trial’s primary outcome; it notes no significant differences for other outcomes, but says the trial was not adequately powered for them. (LLM, conf=0.89)
Checked by a reasoning model — may be wrong.
- Supportedcites [75] Groom, 2018, The role of aspirin, heparin, and other interventions in the prevention and treatment of fetal growth restriction, Am J Obstet Gynecol source
In “Prevention of FGR: Aspirin and other antiplatelet agents,” the review reports that meta-analyses found a modest aspirin benefit for FGR and SGA. It then says the ASPRE trial was designed to prevent preterm preeclampsia and found unchanged SGA rates despite a reduction in preterm preeclampsia. Thus, the claim is supported when the finding refers to fetal growth outcomes, not preeclampsia. (LLM, conf=0.93)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Disputed
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“The available evidence does not indicate improved accuracy of CPR over umbilical artery Doppler, and clinical trials are needed to evaluate the effectiveness of CPR in guiding clinical management, especially in late-onset FGR, before its use in routine surveillance of pregnancies with FGR can be recommended.139”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Middle cerebral artery Doppler
What the sources say
- Disputedcites [139] Vollgraff Heidweiller-Schreurs, 2018, Prognostic accuracy of cerebroplacental ratio and middle cerebral artery Doppler for adverse perinatal outcome: systematic review and meta-analysis, Ultrasound Obstet Gynecol sourceExperimental — accuracy not yet measured
The Results (Direct comparisons) and Discussion (Summary of main results) report that CPR was significantly more accurate than umbilical artery Doppler for composite adverse outcome and emergency delivery for fetal distress, though accuracy was similar for other outcomes. The Conclusion also says CPR can improve accuracy. The paper does call for clinical trials before using CPR to guide management, but that does not support the claim that the available evidence indicates no accuracy improvement. (LLM, conf=0.89)
Checked by a reasoning model — may be wrong.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Disputed
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“It also can contribute to cardiac remodeling, leading to cardiovascular dysfunction that can persist into childhood and adolescence.13,14”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Introduction
What the sources say
- Partly supportedcites [13] Cruz-Lemini, 2016, Fetal cardiovascular remodeling persists at 6 months in infants with intrauterine growth restriction, Ultrasound Obstet Gynecol sourceExperimental — accuracy not yet measured
The Introduction and Discussion report that intrauterine growth restriction is associated with fetal cardiovascular remodeling and dysfunction, and the study found that the pattern persisted at six months. The Introduction also discusses cardiovascular changes in children and young adults, but the Strengths and limitations section says persistence of this study’s findings in the long term remains to be established. It therefore does not establish that the cardiac dysfunction persists into adolescence. (LLM, conf=0.86)
- Not checked — no full text of the sourcecites [14] Crispi, 2010, Fetal growth restriction results in remodeled and less efficient hearts in children, Circulation source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Perinatal outcomes are largely dependent on the severity of FGR, with the worst outcomes noted in fetuses with estimated fetal weights (EFWs) at less than the third percentile or in association with fetal Doppler abnormalities.5,10”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Introduction
What the sources say
- Supportedcites [5] Unterscheider, 2014, Fetal growth restriction and the risk of perinatal mortality-case studies from the multicentre PORTO study, BMC Pregnancy Childbirth source
The Background states that outcomes in growth-restricted fetuses depend largely on severity, with those below the 3rd centile and/or with abnormal umbilical artery Doppler measurements at greatest risk. The Discussion likewise identifies EFW below the 3rd centile and/or abnormal umbilical artery Doppler as markers of greater risk of poor perinatal outcome. (LLM, conf=0.94)
- Not checked — no full text of the sourcecites [10] Savchev, 2012, Estimated weight centile as a predictor of perinatal outcome in small-for-gestational-age pregnancies with normal fetal and maternal Doppler indices, Ultrasound Obstet Gynecol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Fetal growth restriction (FGR) can result from a variety of maternal, fetal, and placental conditions. 1”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Introduction
What the sources say
- Supportedcites [1] Swanson, 2015, Animal models of fetal growth restriction: Considerations for translational medicine, Placenta source
The Tables 1–6 passage (page not provided) identifies fetal structural or genetic defects and placental insufficiency as causes of FGR. It also describes maternal and fetal blood-flow changes and placental changes that can contribute to insufficiency, supporting the paraphrase. (LLM, conf=0.92)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“It has been associated with metabolic programming that increases the risk of future development of metabolic syndrome and consequent cardiovascular and endocrine diseases.11,12”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Introduction
What the sources say
- Not checked — no full text of the sourcecites [11] Crispi, 2012, Cardiovascular programming in children born small for gestational age and relationship with prenatal signs of severity, Am J Obstet Gynecol source
- Partly supportedcites [12] Crispi, 2018, Long-term cardiovascular consequences of fetal growth restriction: biology, clinical implications, and opportunities for prevention of adult disease, Am J Obstet Gynecol sourceExperimental — accuracy not yet measured
The Abstract states that fetal growth restriction causes metabolic programming that may increase the risk of metabolic syndrome and, consequently, adult cardiovascular morbidity. The Fetal Programming of Adult Cardiovascular Disease section also discusses diabetes as a metabolic disease, but does not say that metabolic syndrome leads to endocrine diseases. The claim therefore adds an unsupported consequence and is more certain than the paper’s qualified statement. (LLM, conf=0.88)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“However, this approach requires multiple ultrasound examinations, and prospective studies fail to demonstrate the superiority of this approach in improving clinical outcomes.35”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Terminology and diagnostic criteria
What the sources say
- Partly supportedcites [35] Grantz, 2018, Fetal growth standards: the NICHD fetal growth study approach in context with INTERGROWTH-21st and the World Health Organization Multicentre Growth Reference Study, Am J Obstet Gynecol sourceExperimental — accuracy not yet measured
The Conclusion (page unavailable) says that estimating a fetal growth trajectory requires at least two measurements and that one-time measurement remains standard clinical practice. It does not report that prospective studies tested the trajectory approach against another approach or failed to show superior clinical outcomes. (LLM, conf=0.82)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Although the primary underlying mechanisms for FGR are varied, they often share the same final common pathway of suboptimal fetal nutrition and uteroplacental perfusion.1,2”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Introduction
What the sources say
- Supportedcites [1] Swanson, 2015, Animal models of fetal growth restriction: Considerations for translational medicine, Placenta source
The Tables 1–6 section describes placental insufficiency as the primary cause of FGR apart from fetal structural or genetic defects. It defines this as inadequate fetal acquisition of nutrients and oxygen, arising through varied factors that include altered blood flow and reduced nutrient transport, consistent with the citing sentence’s broad paraphrase. (LLM, conf=0.85)
- Partly supportedcites [2] Bamfo, 2011, Diagnosis and management of fetal growth restriction, J Pregnancy sourceExperimental — accuracy not yet measured
Section 2.1 (Causes) describes varied fetal, maternal, environmental, and placental causes of FGR and says uteroplacental hypoperfusion can impair fetal growth. Section 2.2 (Placental Dysfunction) links inadequate placentation to FGR and describes the placenta’s role in nutrient absorption. The paper does not establish that these varied causes often converge on a shared final pathway involving both suboptimal fetal nutrition and uteroplacental perfusion. (LLM, conf=0.78)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Of fetuses diagnosed with FGR, approximately 18%e22% will be constitutionally small but healthy at birth with a normal outcome.24”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Terminology and diagnostic criteria
What the sources say
- Partly supportedcites [24] McCowan, 2018, Evidence-based national guidelines for the management of suspected fetal growth restriction: comparison, consensus, and controversy, Am J Obstet Gynecol sourceExperimental — accuracy not yet measured
The Introduction says 18–22% of babies classified as small for gestational age (SGA) are constitutionally small but healthy. The Expert Reviews section says reclassified babies have perinatal mortality similar to normally grown babies. The figure applies to SGA infants, not fetuses diagnosed with FGR, and similar mortality does not establish a normal outcome in every respect. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“A review of national guidelines for the diagnostic criteria for FGR from 6 countries (United States, United Kingdom, France, Ireland, Canada, and New Zealand) reveals a broad consensus on this definition of FGR.24”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Terminology and diagnostic criteria
What the sources say
- Supportedcites [24] McCowan, 2018, Evidence-based national guidelines for the management of suspected fetal growth restriction: comparison, consensus, and controversy, Am J Obstet Gynecol source
The Results identify national guidelines from the six named countries. The Comment states that all guidelines recommended estimated fetal weight below the 10th centile as an appropriate definition of FGR, while noting that some require additional parameters to confirm pathological growth restriction. (LLM, conf=0.91)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
- It may state two separate claims as one. 32
- Probably not a substantial claim. 5
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Suboptimal perfusion of the maternal placental circulation is the most common cause of FGR and accounts for 25e30% of all cases.2,3”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Introduction
What the sources say
- Partly supportedcites [2] Bamfo, 2011, Diagnosis and management of fetal growth restriction, J Pregnancy sourceExperimental — accuracy not yet measured
Section 2.1 (Causes; page unavailable) says maternal vascular disease and thrombophilia can cause uteroplacental hypoperfusion that impairs fetal growth. Section 2.2 also discusses inadequate placentation in pregnancies with FGR. Neither section establishes that suboptimal maternal placental perfusion is the most common cause or accounts for 25–30% of all FGR cases; the 20–30% figure in section 2.1 concerns dichorionic twin pregnancies. (LLM, conf=0.88)
- Not checked — no full text of the sourcecites [3] Resnik, 2002, Intrauterine growth restriction, Obstet Gynecol source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Chromosomal disorders and congenital malformations are responsible for approximately 20% of FGR cases.2,3”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Introduction
What the sources say
- Partly supportedcites [2] Bamfo, 2011, Diagnosis and management of fetal growth restriction, J Pregnancy sourceExperimental — accuracy not yet measured
Section 2.1 (Causes; page unavailable) identifies aneuploidy and fetal malformations as less-common fetal causes of FGR. It does not say they account for approximately 20% of cases. Its figure of over 20% refers instead to confined placental mosaicism among fetuses with idiopathic FGR. (LLM, conf=0.87)
- Not checked — no full text of the sourcecites [3] Resnik, 2002, Intrauterine growth restriction, Obstet Gynecol source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Maternal hypertensive disease is common in early-onset FGR and plays an important role in pregnancy outcomes.”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > General considerations
What the sources say
- Supportedcites [80] Lees, 2013, Perinatal morbidity and mortality in early-onset fetal growth restriction: cohort outcomes of the trial of randomized umbilical and fetal flow in Europe (TRUFFLE), Ultrasound Obstet Gynecol source
The Results report that 368 of 503 women (73%) had a hypertensive condition at delivery. The Results also identify gestational hypertensive morbidity at study entry as an independent determinant of death or severe morbidity, while the Discussion says maternal hypertension shortened the interval to delivery and negatively influenced neonatal outcome. (LLM, conf=0.94)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In contrast, cardiovascular adaptation of late-onset FGR is typically limited to the cerebral circulation and is commonly associated with normal Doppler of the umbilical arteries.57,60,61”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Timing of diagnosis
What the sources say
- Not checked — no full text of the sourcecites [57] Parra-Saavedra, 2014, Neurodevelopmental outcomes of near-term small-for-gestational-age infants with and without signs of placental underperfusion, Placenta source
- Not checked — no full text of the sourcecites [60] Figueras, 2008, Small-for-gestational-age fetuses with normal umbilical artery Doppler have suboptimal perinatal and neurodevelopmental outcome, Eur J Obstet Gynecol Reprod Biol source
- Partly supportedcites [61] Severi, 2002, Uterine and fetal cerebral Doppler predict the outcome of third-trimester small-for-gestational age fetuses with normal umbilical artery Doppler, Ultrasound Obstet Gynecol sourceExperimental — accuracy not yet measured
The Introduction (page unavailable) describes cerebral blood-flow redistribution as a fetal response to mild hypoxemia, and the Discussion (page unavailable) examines abnormal middle cerebral artery Doppler in third-trimester small-for-gestational-age fetuses with normal umbilical artery Doppler. But normal umbilical Doppler was an inclusion criterion, so the study does not establish that it is common across late-onset growth restriction or that cardiovascular adaptation is typically limited to the cerebral circulation. (LLM, conf=0.86)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Late-onset FGR represents approximately 70%e80% of FGR cases and is typically milder in presentation.55,56”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Timing of diagnosis
What the sources say
- Supportedcites [55] Dall'Asta, 2017, Early onset fetal growth restriction, Matern Health Neonatol Perinatol source
The Definition and diagnosis section states that late-onset FGR accounts for approximately 70–80% of FGR cases. The Role of fetal Doppler in FGR section explicitly describes late-onset FGR as more common but less severe. (LLM, conf=0.94)
- Not checked — no full text of the sourcecites [56] Figueras, 2018, Diagnosis and surveillance of late-onset fetal growth restriction, Am J Obstet Gynecol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Pregnant women with hypertension had a significantly shorter median interval from study enrollment to delivery, and newborns of mothers with hypertension were delivered at an earlier gestational age and had lower birthweights.80”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > General considerations
What the sources say
- Supportedcites [80] Lees, 2013, Perinatal morbidity and mortality in early-onset fetal growth restriction: cohort outcomes of the trial of randomized umbilical and fetal flow in Europe (TRUFFLE), Ultrasound Obstet Gynecol source
The Results report that women with gestational hypertensive morbidity at study inclusion had a significantly shorter median interval to delivery than women without it (5 vs 13 days). Their babies were delivered at an earlier gestational age (30 + 1 vs 31 + 4 weeks) and had lower birthweights (979 vs 1063 g). (LLM, conf=0.95)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“In a large retrospective cohort of more than 3 million singleton pregnancies, the risk of stillbirth at birthweights of less than the 3rd percentile was increased approximately 3-fold over the 3rd to 5th percentile group at nearly all gestational ages, and there was an increased risk of 4-fold to 7-fold over the 5th to 10th percentile group.63”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Severity of fetal growth restriction
What the sources say
- Supportedcites [63] Pilliod, 2012, The risk of intrauterine fetal death in the small-for-gestational-age fetus, Am J Obstet Gynecol source
Split into 2 atoms — 2 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In TRUFFLE, maternal hypertension was present in 50% of pregnancies during the study and 70% of pregnancies at the time of delivery.”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > General considerations
What the sources say
- Partly supportedcites [80] Lees, 2013, Perinatal morbidity and mortality in early-onset fetal growth restriction: cohort outcomes of the trial of randomized umbilical and fetal flow in Europe (TRUFFLE), Ultrasound Obstet Gynecol sourceExperimental — accuracy not yet measured
The Results (page unavailable in our copy) report that 368 women (73%) had a hypertensive condition at delivery, supporting the claim's approximate 70%. They do not report 50% during the study; instead, they say the proportion with a gestational hypertensive condition increased by 13% between study entry and delivery. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The pulsatility index (PI), resistance index (RI), or systolicto-diastolic (S/D) ratio can be used for quantification of the Doppler waveform in the umbilical artery, although recent studies have generally used either the PI or RI.5,16,28,30,80,83”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Umbilical artery Doppler
What the sources say
- Partly supportedcites [5] Unterscheider, 2014, Fetal growth restriction and the risk of perinatal mortality-case studies from the multicentre PORTO study, BMC Pregnancy Childbirth sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
- Not checked — no full text of the sourcecites [16] Lees, 2015, 2 year neurodevelopmental and intermediate perinatal outcomes in infants with very preterm fetal growth restriction (TRUFFLE): a randomised trial, Lancet source
- Not checked — no full text of the sourcecites [28] Gordijn, 2016, Consensus definition of fetal growth restriction: a Delphi procedure, Ultrasound Obstet Gynecol source
- Not checked — no full text of the sourcecites [30] Unterscheider, 2013, Optimizing the definition of intrauterine growth restriction: the multicenter prospective PORTO Study, Am J Obstet Gynecol source
- Partly supportedcites [80] Lees, 2013, Perinatal morbidity and mortality in early-onset fetal growth restriction: cohort outcomes of the trial of randomized umbilical and fetal flow in Europe (TRUFFLE), Ultrasound Obstet Gynecol sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
- Could not verifycites [83] Baschat, 2007, Predictors of neonatal outcome in early-onset placental dysfunction, Obstet Gynecol sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 2 unverifiable. Expand the claim to see per-atom verdicts.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Incorporation of umbilical artery Doppler evaluation in the management of high-risk pregnancies has been shown to significantly reduce the risk of perinatal death, induction of labor, and cesarean delivery.”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > FIGURE 1
What the sources say
- Not checked — no full text of the sourcecites [96] McCowan, 2000, A pilot randomized controlled trial of two regimens of fetal surveillance for small-for-gestational-age fetuses with normal results of umbilical artery doppler velocimetry, Am J Obstet Gynecol source
- Supportedcites [97] Alfirevic, 2017, Fetal and umbilical Doppler ultrasound in high-risk pregnancies, Cochrane Database Syst Rev source
The Discussion (Summary of main results; page unavailable) reports fewer perinatal deaths, inductions of labour, and caesarean sections with Doppler ultrasound in high-risk pregnancies. The Main results and Data and Analyses give pooled estimates below one with 95% confidence intervals excluding one for these outcomes. The review notes that trials comparing Doppler specifically with cardiotocography did not establish the same differences. (LLM, conf=0.92)
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: An abnormal umbilical artery Doppler waveform reflects the presence of placental insufficiency and can help differentiate the growth-restricted fetus from the constitutionally small fetus.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Protocols vary from weekly umbilical artery Doppler to a 2-to 4-week interval.24,108”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > FIGURE 1
What the sources say
- Partly supportedcites [24] McCowan, 2018, Evidence-based national guidelines for the management of suspected fetal growth restriction: comparison, consensus, and controversy, Am J Obstet Gynecol sourceExperimental — accuracy not yet measured
Table 4 (Conclusions; page not supplied) shows that recommended umbilical artery Doppler intervals vary, including weekly and every two weeks, depending on the guideline and Doppler findings. The Results section gives a 2–4-week interval for ongoing growth scans, not umbilical artery Doppler, so the claimed four-week Doppler interval is unsupported. (LLM, conf=0.88)
- Partly supportedcites [108] Turan, 2008, Progression of Doppler abnormalities in intrauterine growth restriction, Ultrasound Obstet Gynecol sourceExperimental — accuracy not yet measured
The Discussion recommends weekly umbilical artery Doppler examinations after IUGR is diagnosed. It does not recommend a 2-to-4-week Doppler interval; its reference to the next two weeks concerns whether abnormalities develop, not how often to test. (LLM, conf=0.87)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“However, a large systematic review and metaanalysis on the prognostic accuracy of CPR and middle cerebral artery Doppler for adverse perinatal outcomes in FGR revealed few high-quality studies and reported large variations in sensitivity and specificity.139”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Middle cerebral artery Doppler
What the sources say
- Supportedcites [139] Vollgraff Heidweiller-Schreurs, 2018, Prognostic accuracy of cerebroplacental ratio and middle cerebral artery Doppler for adverse perinatal outcome: systematic review and meta-analysis, Ultrasound Obstet Gynecol source
Split into 2 atoms — 2 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Intact survival was 0% at 24 weeks, 13% at 25 weeks, and 6%e31% at 26 weeks of gestation.159”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Neonatal outcomes and delivery timing
What the sources say
- Supportedcites [159] Visser, 2014, Fetal growth restriction at the limits of viability, Fetal Diagn Ther source
The ‘Prognosis of IUGR Infants Born before 31 Weeks of Gestation’ section reports intact neonatal survival of 0% at 24 weeks, 13% at 25 weeks, and 6–31% at 26 weeks. Table 1 gives the same values for IUGR fetuses with abnormal umbilical-artery Doppler findings. (LLM, conf=0.95)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Although FGR detection rates >90% have been reported in firstand second-trimester prediction models that combine maternal factors, biochemical markers, and uterine artery Doppler, lack of external validation or demonstration of improved pregnancy outcomes limits their clinical applicability.145,150,151”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Uterine artery Doppler
What the sources say
- Partly supportedcites [145] Poon, 2015, Prediction of small-for-gestational-age neonates: screening by biophysical and biochemical markers at 19-24 weeks, Ultrasound Obstet Gynecol sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.
- Not checked — no full text of the sourcecites [150] Karagiannis, 2011, Prediction of small-for-gestation neonates from biophysical and biochemical markers at 11-13 weeks, Fetal Diagn Ther source
- Could not verifycites [151] Cruz-Martinez, 2015, Clinical utility of third-trimester uterine artery Doppler in the prediction of brain hemodynamic deterioration and adverse perinatal outcome in small-for-gestational-age fetuses, Ultrasound Obstet Gynecol sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 2 unverifiable. Expand the claim to see per-atom verdicts.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
In the paper
“Another systematic review and meta-analysis reported that AC and EFW performed similarly, and for a 10% fixed false-positive rate, AC had higher sensitivity.33”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Terminology and diagnostic criteria
What the sources say
- Not checked — no full text of the sourcecites [33] Caradeux, 2019, Diagnostic performance of third-trimester ultrasound for the prediction of late-onset fetal growth restriction: a systematic review and meta-analysis, Am J Obstet Gynecol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“FGR remains a complex obstetrical problem with disparate published diagnostic criteria, relatively low detection rates, and limited preventative and treatment options.22e25”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Introduction
What the sources say
- Not matchedcites 22e25
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“Compared with other cutoffs, an AC of less than the fifth percentile has significantly lower sensitivity but higher specificity in predicting SGA.32”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Terminology and diagnostic criteria
What the sources say
- Not checked — no full text of the sourcecites [32] Blue, 2017, Abdominal Circumference Alone versus Estimated Fetal Weight after 24 Weeks to Predict Small or Large for Gestational Age at Birth: A Meta-Analysis, Am J Perinatol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Fetuses with FGR are not always SGA at birth, and SGA neonates have often not been diagnosed as growth restricted on prenatal ultrasound.27”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Terminology and diagnostic criteria
What the sources say
- Not checked — no full text of the sourcecites [27] Monier, 2017, Fetal and neonatal outcomes of preterm infants born before 32 weeks of gestation according to antenatal vs postnatal assessments of restricted growth, Am J Obstet Gynecol source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In addition, studies have shown an association between FGR and long-term neurologic impairment, 15e20 with rates of cognitive and learning disabilities as high as 20%e40% by school age.21”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Introduction
What the sources say
- Not matchedcites 15e20
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [21] Leitner, 2007, Neurodevelopmental outcome of children with intrauterine growth retardation: a longitudinal, 10-year prospective study, J Child Neurol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“The Hadlock formula classified more infants within 10% of actual birthweight and was more accurate than the INTERGROWTH-21st in the overall estimation of weight for fetuses delivered between 22 and 34 weeks of gestation.53”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Ultrasonographic estimation of fetal weight
What the sources say
- Not checked — no full text of the sourcecites [53] Monier, 2018, Comparison of the Hadlock and INTERGROWTH formulas for calculating estimated fetal weight in a preterm population in France, Am J Obstet Gynecol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The clinical spectrum of early-and late-onset FGR also differs; early-onset FGR is typically more severe, tends to follow an established Doppler pattern of fetal deterioration, is more commonly associated with maternal hypertensive disorders of pregnancy, and shows more significant placental dysfunction than late-onset FGR.23,28,54e56”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Timing of diagnosis
What the sources say
- Not matchedcites 23,28,54e56
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“The Hadlock formula better predicted SGA and composite neonatal morbidity at birth and had a lower ultrasound-to-birthweight percentile discrepancy than the NICHD growth standard.”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Ultrasonographic estimation of fetal weight
What the sources say
- Not checked — no full text of the sourcecites [51] Blue, 2018, Comparing the Hadlock fetal growth standard to the Eunice Kennedy Shriver National Institute of Child Health and Human Development racial/ethnic standard for the prediction of neonatal morbidity and small for gestational age, Am J Obstet Gynecol source
plaincorrelationaln = 1,514- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Unlike early-onset FGR, late-onset FGR is less likely to be associated with maternal hypertensive disorders and typically has less extensive placental histopathologic findings of underperfusion.57e59”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Timing of diagnosis
What the sources say
- Not matchedcites 57e59
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“There is no consistent evidence that nutritional and dietary supplements or bed rest prevents FGR or reduces the incidence of SGA births.68e71”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > General considerations
What the sources say
- Not matchedcites 68e71
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“The association of maternal infections with FGR was recently evaluated in a study that included 319 pregnancies.No cases of maternal or congenital infection with toxoplasma, rubella, or herpes were found, whereas 6 (1.8%) fetuses were diagnosed as having congenital cytomegalovirus (CMV).”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Initial diagnosis
What the sources say
- Not checked — no full text of the sourcecites [91] Yamamoto, 2013, Significance of maternal screening for toxoplasmosis, rubella, cytomegalovirus and herpes simplex virus infection in cases of fetal growth restriction, J Obstet Gynaecol Res source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Waveforms obtained near the placental end of the cord reflect downstream impedance and show higher end-diastolic blood flow velocity than waveforms obtained near the fetal cord insertion.95”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Umbilical artery Doppler
What the sources say
- Not matchedcites [95] Trudinger, 1992, Doppler ultrasonography and fetal well-being
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“In a meta-analysis of 35 studies, abnormal middle cerebral artery Doppler had a low likelihood ratio (LR) for prediction of perinatal mortality (LR 1.36 [1.10e1.67])and adverse perinatal outcome (LR 2.77 [1.93e3.96]).130”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Middle cerebral artery Doppler
What the sources say
- Not checked — no full text of the sourcecites [130] Morris, 2012, Systematic review and meta-analysis of middle cerebral artery Doppler to predict perinatal wellbeing, Eur J Obstet Gynecol Reprod Biol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Longitudinal studies have shown that Doppler abnormalities of the ductus venosus in FGR reflect an advanced stage of fetal compromise, associated with increased perinatal morbidity and mortality.2,23,55,110e117”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Ductus venosus Doppler
What the sources say
- Not matchedcites 2,23,55,110e117
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“The middle cerebral artery is the largest vessel of the fetal cerebral circulation and carries about 80% of cerebral blood flow.122”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Middle cerebral artery Doppler
What the sources say
- Not checked — no full text of the sourcecites [122] Veille, 1993, Longitudinal quantitation of middle cerebral artery blood flow in normal human fetuses, Am J Obstet Gynecol source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“AEDV/REDV in the umbilical artery reflects the presence of significant placental deterioration and is associated with high perinatal mortality.”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > FIGURE 1
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Doppler abnormalities of the ductus venosus in the setting of a normal umbilical artery Doppler indicate an alternative pathophysiological etiology, possibly related to the presence of fetal cardiac, vascular, or genetic abnormalities, and thus are most often not reflective of significant placental disease.”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Ductus venosus Doppler
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Furthermore, absent or reversed A-wave of the ductus venosus represents an advanced stage of fetal compromise and is uncommon.”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Ductus venosus Doppler
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A meta-analysis of FGR at <34 weeks of gestation reported odds ratios for stillbirth of 11.16 (95% CI, 6.31e19.73)for absent or reversed A-wave of the ductus venosus and a frequency of stillbirth of 20%; the risk of stillbirth with a reversed A-wave was 46%. 100”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Ductus venosus Doppler
What the sources say
- Not checked — no full text of the sourcecites [100] Caradeux, 2018, Risk of fetal death in growth-restricted fetuses with umbilical and/or ductus venosus absent or reversed end-diastolic velocities before 34 weeks of gestation: a systematic review and meta-analysis, Am J Obstet Gynecol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Growth-restricted fetuses, particularly those with AEDV/REDV, are at an increased risk for decelerations in labor, emergency cesarean delivery, and metabolic acidemia at delivery.170,171”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Neonatal outcomes and delivery timing
What the sources say
- Not checked — no full text of the sourcecites [170] Lin, 1980, Acid-base characteristics of fetuses with intrauterine growth retardation during labor and delivery, Am J Obstet Gynecol source
- Not checked — no full text of the sourcecites [171] Baschat, 2000, Umbilical artery doppler screening for detection of the small fetus in need of antepartum surveillance, Am J Obstet Gynecol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: The decision for delivery in FGR is driven by fetal and maternal factors.
In the paper
“fetal deterioration has been reported to be independently reflected by Doppler and BPP testing”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Biophysical profile
What the sources say
- Not checked — no full text of the sourcecites [155] Figueras, 2011, Intrauterine growth restriction: new concepts in antenatal surveillance, diagnosis, and management, Am J Obstet Gynecol source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper relies on this without support.
CTG is currently accepted as the primary method for fetal surveillance in high-risk pregnancies in the United States.
“CTG is currently accepted as the primary method for fetal surveillance in high-risk pregnancies in the United States.”
The paper relies on this without support.
The decision for delivery in FGR is driven by fetal and maternal factors.
“The decision for delivery in FGR is driven by fetal and maternal factors.”
The paper relies on this without support.
An abnormal umbilical artery Doppler waveform reflects the presence of placental insufficiency and can help differentiate the growth-restricted fetus from the constitutionally small fetus.
“An abnormal umbilical artery Doppler waveform reflects the presence of placental insufficiency and can help differentiate the growth-restricted fetus from the constitutionally small fetus.”
The paper relies on this without support.
Fetal hypoxemia associated with growth restriction results in cerebral vasodilation, an early adaptive mechanism termed the brain-sparing effect.
“Fetal hypoxemia associated with growth restriction results in cerebral vasodilation, an early adaptive mechanism termed the brain-sparing effect.”
The paper relies on this without support.
Measurement of flow through the middle cerebral artery using Doppler can identify cerebral vasodilation, which can be quantified using PI or the cerebroplacental ratio (CPR).
“Measurement of flow through the middle cerebral artery using Doppler can identify cerebral vasodilation, which can be quantified using PI or the cerebroplacental ratio (CPR).”
The paper relies on this without support.
Uterine artery Doppler assesses the maternal component of placental blood flow and is a marker of remodeling of the spiral arteries by trophoblastic cellular invasion.
“Uterine artery Doppler assesses the maternal component of placental blood flow and is a marker of remodeling of the spiral arteries by trophoblastic cellular invasion.”
The paper relies on this without support.
This pregnancy adaptation optimizes the intervillous placental blood flow and delivery of oxygen and nutrients to the fetus.
“This pregnancy adaptation optimizes the intervillous placental blood flow and delivery of oxygen and nutrients to the fetus.”
The paper relies on this without support.
There are limited data to inform recommendations regarding the mode of delivery in pregnancies complicated by FGR.
“There are limited data to inform recommendations regarding the mode of delivery in pregnancies complicated by FGR.”
The paper relies on this without support.
More recent studies have questioned the value of BPP in fetal surveillance of high-risk pregnancies, including early-onset severe FGR, because of a high prevalence of false-positive and false-negative results.
“More recent studies have questioned the value of BPP in fetal surveillance of high-risk pregnancies, including early-onset severe FGR, because of a high prevalence of false-positive and false-negative results.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“The association of maternal infections with FGR was recently evaluated in a study that included 319 pregnancies.No cases of maternal or congenital infection with toxoplasma, rubella, or herpes were found, whereas 6 (1.8%) fetuses were diagnosed as having congenital cytomegalovirus (CMV).”
§ Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction > Initial diagnosis
Reported 1.8 · recomputed 1.880878
Citations
Cites
GRADE: an emerging consensus on rating quality of evidence and strength of recommendations
Guyatt, G. H., Oxman, A. D., Vist, G. E., Kunz, R., Falck-Ytter, Y., Alonso-Coello, P., & Schünemann, H. J. (2008) · BMJ · doi:10.1136/bmj.39489.470347.ad · Cited by 23,305
Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia
Rolnik, D. L., Wright, D., Poon, L. C., O’Gorman, N., Syngelaki, A., de Paco Matallana, C., Akolekar, R., Cicero, S., Janga, D., Singh, M., et al. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1704559 · Cited by 2,287
Consensus definition of fetal growth restriction: a Delphi procedure: Consensus definition of FGR
Gordijn, S. J., Beune, I. M., Thilaganathan, B., Papageorghiou, A., Baschat, A. A., Baker, P. N., Silver, R. M., Wynia, K., & Ganzevoort, W. (2016) · Ultrasound in Obstetrics & Gynecology · doi:10.1002/uog.15884 · Cited by 1,638
In utero analysis of fetal growth: a sonographic weight standard
Hadlock, F. P., Harrist, R. B., & Martinez-Poyer, J. (1991) · Radiology · doi:10.1148/radiology.181.1.1887021 · Cited by 1,281
Birth weight in relation to morbidity and mortality among newborn infants
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Pathophysiology of placental-derived fetal growth restriction
Burton, G. J., & Jauniaux, E. (2018) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2017.11.577 · Cited by 1,070
Intrauterine growth restriction
Resnik, R. (2002) · Obstetrics & Gynecology · doi:10.1016/s0029-7844(01)01780-x · Cited by 1,022
Papageorghiou, A. T., Ohuma, E. O., Altman, D. G., Todros, T., Ismail, L. C., Lambert, A., Jaffer, Y. A., Bertino, E., Gravett, M. G., Purwar, M., et al. (2014) · The Lancet · doi:10.1016/s0140-6736(14)61490-2 · Cited by 870
Morbidity and mortality among very-low-birth-weight neonates with intrauterine growth restriction
Bernstein, I. M., Horbar, J. D., Badger, G. J., Ohlsson, A., & Golan, A. (2000) · American Journal of Obstetrics and Gynecology · doi:10.1016/s0002-9378(00)70513-8 · Cited by 840
Antenatal Betamethasone for Women at Risk for Late Preterm Delivery
Gyamfi-Bannerman, C., Thom, E. A., Blackwell, S. C., Tita, A. T. N., Reddy, U. M., Saade, G. R., Rouse, D. J., McKenna, D. S., Clark, E. A. S., Thorp, J. M., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1516783 · Cited by 814
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ACOG Committee Opinion No. 743: Low-Dose Aspirin Use During Pregnancy
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Committee Opinion No. 700: Methods for estimating the due date
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Antenatal Corticosteroids for Women at Risk of Late Preterm Delivery
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Daily oral iron supplementation during pregnancy
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Timing of Indicated Late-Preterm and Early-Term Birth
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Daily oral iron supplementation during pregnancy
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Racial/ethnic standards for fetal growth: the NICHD Fetal Growth Studies
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“…growth standards translates to improved pregnancy outcomes was the subject of several recent studies: the INTERGROWTH-21st standard, 44 the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) standards, 48 and the World Health Organization (WHO) standard.”
The cerebroplacental Doppler ratio revisited
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“108 With decreased end-diastolic velocity (ie, flow ratios greater than the 95th percentile) or in pregnancies with severe FGR (EFW less than the 3rd percentile), we suggest weekly umbilical artery Doppler evaluation 24,95 (GRADE 2C).”
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Intrauterine growth restriction
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Non-placental causes of intrauterine growth restriction
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“It has been associated with metabolic programming that increases the risk of future development of metabolic syndrome and consequent cardiovascular and endocrine diseases.(11,12) It also can contribute to cardiac remodeling, leading to cardiovascular dysfunction that can persist into childhood and adolescence.”
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Placental Pathology of Idiopathic Intrauterine Growth Retardation at Term
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Middle Cerebral Artery Peak Systolic Velocity
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“It also can contribute to cardiac remodeling, leading to cardiovascular dysfunction that can persist into childhood and adolescence.(13,14) In addition, studies have shown an association between FGR and long-term neurologic impairment, with rates of cognitive and learning disabilities as high as 20%e40% by school age.”
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Metadata
- Authors
- Martins, J. G., Biggio, J. R., & Abuhamad, A.
- Affiliations
- Society for Maternal-Fetal Medicine (US)
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 2020-10
- Volume
- 223
- Issue
- 4
- Pages
- B2-B17
- ISSN
- 0002-9378 (ISSN-L)
- OpenAlex
- W3025237121
- Cited by
- 584
- References
- 194
- Citations by year
- 2026: 132 · 2025: 109 · 2024: 96 · 2023: 103 · 2022: 74 · 2021: 62 · 2020: 8
- FWCI
- 36.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- 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
- fetal growth restriction, prenatal diagnosis, low molecular weight heparin, sildenafil, activity limitation, chromosomal microarray analysis, prenatal diagnostic testing, umbilical artery Doppler, end-diastolic velocity, fetal monitoring, amniocentesis, toxoplasmosis screening, rubella screening
- MeSH terms
- Adrenal Cortex Hormones, Cesarean Section, Chromosome Aberrations, Female, Fetal Growth Retardation, Gestational Age, Hospitalization, Humans, Magnesium Sulfate, Pregnancy, Severity of Illness Index, Umbilical Arteries, Cardiotocography, Ultrasonography, Prenatal, Risk Assessment, Ultrasonography, Doppler, Disease Management, Fetal Weight, Delivery, Obstetric, Microarray Analysis
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