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True FGR relates to a pathological restriction of fetal growth resulting from complex interactions between maternal, placental, fetal, and environmental factors. Early\u2010onset FGR (onset &lt;32\u00a0weeks' gestation) is often first suspected at routine mid\u2010trimester sonographic assessment of fetal morphology, or identified as\u00a0part of the placental syndrome, commonly maternal pre\u2010eclampsia. Prenatal investigations may identify the cause of FGR. Timing of delivery is guided by serial sonographic surveillance of fetal growth and well\u2010being and maternal condition, balancing the risk of stillbirth with the benefits of advancing gestation. This is particularly pertinent to severe early\u2010onset FGR, a leading iatrogenic cause of very preterm birth. Prognosis is largely determined by the severity of FGR and its causes, gestation at birth, and birthweight. Pregnancy termination may be considered. Antenatal care\u00a0and delivery in a tertiary center, provided by a multi\u2010disciplinary team with expertise in managing high\u2010risk pregnancies, are imperative to optimizing outcomes.<\/jats:p>","DOI":"10.1002\/pd.6030","type":"journal-article","created":{"date-parts":[[2021,8,14]],"date-time":"2021-08-14T08:05:52Z","timestamp":1628928352000},"page":"1363-1371","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Severe early\u2010onset fetal growth restriction: What do we tell the prospective parents?"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1799-9191","authenticated-orcid":false,"given":"Julia","family":"Unterscheider","sequence":"first","affiliation":[{"name":"Department of Maternal Fetal Medicine The Royal Women's Hospital  Melbourne Victoria Australia"},{"name":"Department of Obstetrics and Gynecology The University of Melbourne  Melbourne Victoria 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