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Case 74 - A 40-Year-Old at 28 Weeks’ Gestation with a Well Dated Pregnancy and a Fundal Height Measuring 24 cm

from Section 8 - Fetal Complications

Published online by Cambridge University Press:  08 April 2025

By
Sarah Smithson
Edited by
Peter F. Schnatz ,
D. Yvette LaCoursiere ,
Christopher M. Morosky ,
Jonathan Schaffir ,
Vanessa Torbenson  and
David Chelmow
Peter F. Schnatz
Affiliation:
The Reading Hospital, Pennsylvania
D. Yvette LaCoursiere
Affiliation:
University of California, San Diego
Christopher M. Morosky
Affiliation:
University of Connecticut School of Medicine
Jonathan Schaffir
Affiliation:
The Ohio State University College of Medicine
Vanessa Torbenson
Affiliation:
Mayo Clinic Alix School of Medicine
David Chelmow
Affiliation:
Virginia Commonwealth School of Medicine
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Summary

This case describes a clinical case of fetal growth restriction (FGR) in a patient with advanced maternal age and provides a guide to management as well as a discussion of risk factors and etiologies. When FGR is suspected, close follow-up with serial ultrasound examination and antenatal testing is warranted. Management is determined by balancing the risk of deteriorating intrauterine fetal status with the risk of prematurity. Due to the increased risk of preeclampsia in patients with FGR, maternal status also requires close monitoring and may be an indication for early delivery.

Keywords

fetal growth restrictionsmall for gestational ageumbilical artery Dopplersantepartum testing
Type
Chapter
Information
Pregnancy Complications
A Case-Based Approach
 , pp. 229 - 231
Publisher: Cambridge University Press
Print publication year: 2025

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References

Fetal Growth Restriction: ACOG Practice Bulletin, Number 227. Obstet Gynecol. 2021;137:e16–e28.CrossRefGoogle Scholar
Martins, JG, Biggio, JR, Abuhamad, A. 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. 2020;223:B2–B17.CrossRefGoogle Scholar
American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice; Society for Maternal-Fetal Medicine. Medically Indicated Late-Preterm And Early-Term Deliveries: ACOG Committee Opinion, Number 831. Obstet Gynecol. 2021;138:e35–e39.CrossRefGoogle Scholar
Antepartum Fetal Surveillance: ACOG Practice Bulletin, Number 229. Obstet Gynecol. 2021;137(6):e116–e127.CrossRefGoogle Scholar
Society for Maternal-Fetal Medicine; Publications Committee. Society for Maternal-Fetal Medicine Statement: Antihypertensive Therapy for Mild Chronic Hypertension in Pregnancy–The Chronic Hypertension and Pregnancy Trial. Am J Obstet Gynecol. 2022;227(2):B24–B27.CrossRefGoogle Scholar
ACOG Committee Opinion No. 743: Low-Dose Aspirin Use during Pregnancy. Obstet Gynecol. 2018;132:e44–e52.CrossRefGoogle Scholar

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