This trial is evaluating whether Treatment will improve 1 primary outcome and 1 secondary outcome in patients with Fetal Growth Retardation. Measurement will happen over the course of 6 weeks post pregnancy.
This trial requires 70 total participants across 1 different treatment groups
This trial involves a single treatment. Treatment is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are not being studied for commercial purposes.
A small proportion of birthweight standard deviations above and below the median are associated with a known identifiable cause. However, because a large number of such patients do not have a single identifiable cause, even such patients should not be regarded as "at risk" for adverse pregnancy outcomes.
There is no evidence in the published literature to support a change in prenatal screening guidelines to allow for the diagnosis of fetal intrauterine growth retardation and subsequent induction of termination.
Approximately 6,600 babies per year in the United States are born with FGR. This makes up about 1.1% of all babies in the United States. Fetal birth weight z-score greater than 3.3 at delivery is associated with long-term adverse outcomes for the children.
In some cases, intrauterine growth retarded fetuses will be delivered by cesarean section. In other cases, postnatal care will be prescribed. The latter includes feeding tube, intravenous nutrition, and total parenteral nutrition. Treatment for fetal growth retardation may be more effective for some fetuses than for others.
Birth weight is positively correlated with maternal weight. Therefore, the birth weight of mothers with normal prepregnancy weight might be related mainly to the fetal weight since it is easy to imagine that a mother with an obese pregnancy and heavy infant (birth weight ≥10 - 16 kg) may have an obese newborn because of her maternal obesity. Birth weight increases with the increasing number of pregnancies and the increasing numbers of babies. Therefore, even a normal weight maternal could also have an obese baby with bigger head circumference. In conclusion, we think that [heavier baby] with large or obese head circumference might not be a normal fetal growth retardation but [a normal fetal growth retardation].
Growth retardation has a variety of potential symptoms, and one of the first signs is prenatal growth. Most cases develop in the absence of known risk factors. The mainstay of management is a detailed antenatal examination, regular ultrasound scanning, and fetal monitoring by cardiotocography. Treatment is geared towards identifying the underlying cause. Often, treatment of the underlying abnormality will improve the fetal growth. Those women who have problems with their weight, or who have an abnormal vaginal bleeding, should be questioned about recent birth histories. It is suggested that a blood or amniotic fluid aspirate may be required. If ultrasound is positive, an ultrasound guided blood sample is recommended in some circumstances, to give a more definitive diagnosis.
Even in this limited study, women receiving growth hormone showed higher scores on all QOL instruments. These scores correlated with patient satisfaction scores and with growth rate at the time of referral.
The data from this meta-analysis supports the evidence for the effectiveness of conventional treatment in improving growth and growth velocity during the first six months of growth and in improving motor development at six and 12 months. There is insufficient evidence to suggest that early growth and motor development can be improved with the aim of preventing permanent neurological abnormalities.
As fetal growth retardation progresses, fetal death becomes almost certain, regardless of the underlying cause. The current recommendation is that fetuses should be delivered at gestational ages of 22 to 24 weeks in the absence of medical indications for labor induction or cesarean section. However, fetal death can occur after a gestational age of 16 weeks without a medical indication.
With low to moderate risk of fetal growth problem, the safety of the treatment for pregnant women is confirmed. Appropriate training and good-quality surveillance for fetal growth retardation would prevent the risks of poor pregnancy results and decrease the risk of miscarriage.
Current knowledge of potential problems with FGR does not allow clinicians with an interest in managing FGR to make clinical trial decisions as long as the patient is still actively undergoing pregnancy. Clinicians' expertise and interest in FGR is not the sole criterion for participation in clinical trials for FGR.
Treatment options are many; there's no short cuts. There's some research into prenatal gene therapy to treat certain conditions such as Duchenne muscular dystrophy and Friedreich's ataxia. There have been trials and results on prenatal treatment, but there have not been results yet of the gene therapy treatments on pregnant women or their newborns. This is a new field still being researched to help the pregnant mothers and newborn babies with these chronic disease. There's a new field in preimplantation genetic diagnosis to help a woman with an inherited disease to have her own child free of their inherited disease. Genetic testing to decide the best option to ensure future health, in the case of preimplantation genetic diagnosis.