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a Second Department of Obstetrics and Gynecology, University of Athens Medical School, Aretaieion Hospital, Athens, Greece
Key Words: symmetric • small for gestational age (SGA) • intrauterine growth restriction (IUGR) • screening • ultrasonography • diagnosis • delivery
Address for correspondence: Dr. N. Vrachnis, Second Department of Obstetrics and Gynecology, University of Athens Medical School, Aretaieion Hospital, 124B Vas. Sofias Av., 115-26, Athens, Greece. Voice: 00302107777442; fax: 00302107777390. e-mail: nvrachnis{at}med.uoa.gr
The symmetric small for gestational age (SGA) fetus presents a complex management problem for the obstetrician, but the growth restriction affects morbidity and mortality at all stages of life. The differential diagnosis in symmetric growth aberration includes the constitutionally small fetus, the fetus with pathology, and the cases with incorrect dating of pregnancy. The ultrasonographic examination focuses in the detection of anomalies, signs of intrauterine infection, and serial assessment of fetal growth. Accuracy of fetal biometry may be improved by using individualized fetal growth curves. From the available surveillance tools, the uterine artery Doppler has a value in predicting poor perinatal outcome. Magnetic resonance imaging is also useful in the evaluation of anomalies. Cesarean section is not justified for all symmetric SGA fetuses that may carry a guarded prognosis.
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