Universal screening for foetal growth restriction.
Best practice & research. Clinical obstetrics & gynaecology
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Smith, G. (2018). Universal screening for foetal growth restriction.. Best practice & research. Clinical obstetrics & gynaecology, 49 16-28. https://doi.org/10.1016/j.bpobgyn.2018.02.008
Fetal growth restriction (FGR) is a major cause of morbidity and mortality. Clinical methods for identifying women whose pregnancies are affected by FGR do not perform well. Despite this, the current approach to screening remains clinical assessment of risk and targeted use of ultrasound. Universal screening of women using ultrasound has not been shown to improve outcomes in randomised controlled trials and, when implemented nationally in France, appeared mostly to change outcomes for the worse through the effect of iatrogenic prematurity on false positives. Research is currently focused on trying to develop screening tests with higher sensitivity and specificity, for example by combining ultrasound with placental biomarkers. The diagnostic tests employed should be identified through high-quality research investigating the diagnostic accuracy of the tests, and this will usually involve blinding of the results. Therefore, future trials of screening and intervention will require careful planning. Moreover, if trials are to be powered for perinatal death large sample sizes will be required.
Placenta, Humans, Fetal Growth Retardation, Ultrasonography, Prenatal, Mass Screening, Prenatal Care, Risk Factors, Predictive Value of Tests, Biometry, Gestational Age, Pregnancy, Research Design, Infant, Newborn, Female, Randomized Controlled Trials as Topic, Biomarkers
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
External DOI: https://doi.org/10.1016/j.bpobgyn.2018.02.008
This record's URL: https://www.repository.cam.ac.uk/handle/1810/276442