{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T09:59:00Z","timestamp":1783072740600,"version":"3.54.6"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To explore the effect on perinatal outcome of different fetal monitoring strategies for early\u2010onset fetal growth restriction (FGR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a cohort analysis of individual participant data from two European multicenter trials of fetal monitoring methods for FGR: the Growth Restriction Intervention Study (GRIT) and the Trial of Umbilical and Fetal Flow in Europe (TRUFFLE).\nAll women from GRIT (<jats:italic>n<\/jats:italic>\u2009=\u2009238) and TRUFFLE (<jats:italic>n<\/jats:italic>\u2009=\u2009503) who were randomized between 26 and 32\u2009weeks' gestation were included. The women were grouped according to intervention and monitoring method: immediate delivery (GRIT) or delayed delivery with monitoring by conventional cardiotocography (CTG) (GRIT), computerized CTG (cCTG) only (GRIT and TRUFFLE) or cCTG and ductus venosus (DV) Doppler (TRUFFLE). The primary outcome was survival without neurodevelopmental impairment at 2\u2009years of age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Gestational age at delivery and birth weight were similar in both studies. Fetal death rate was similar between the GRIT and TRUFFLE groups, but neonatal and late death were more frequent in GRIT (18% <jats:italic>vs<\/jats:italic> 6%; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01). The rate of survival without impairment at 2\u2009years was lowest in pregnancies that underwent immediate delivery (70% (95%\u2009CI, 61\u201378%)) or delayed delivery with monitoring by CTG (69% (95%\u2009CI, 57\u201382%)),  increased in those monitored using cCTG only in both GRIT (80% (95%\u2009CI, 68\u201391%)) and TRUFFLE (77% (95%\u2009CI, 70\u201384%)), and was highest in pregnancies monitored using cCTG and DV Doppler (84% (95%\u2009CI, 80\u201389%)) (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01 for trend).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This analysis supports the hypothesis  that the optimal method for fetal monitoring in pregnancies complicated by early\u2010onset FGR is a combination of cCTG and DV Doppler assessment.<\/jats:p><jats:p><jats:bold>Trial Registration:<\/jats:bold> GRIT ISRCTN41358726 and TRUFFLE ISRCTN56204499. \u00a9 2019 The Authors. <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic> published by John Wiley &amp; Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.20354","type":"journal-article","created":{"date-parts":[[2019,5,24]],"date-time":"2019-05-24T16:07:26Z","timestamp":1558714046000},"page":"68-74","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Comparative analysis of 2\u2010year outcomes in GRIT and TRUFFLE trials"],"prefix":"10.1002","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7243-2115","authenticated-orcid":false,"given":"W.","family":"Ganzevoort","sequence":"first","affiliation":[{"name":"Department of Obstetrics Amsterdam University Medical Center  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. G.","family":"Thornton","sequence":"additional","affiliation":[{"name":"Division of Child Health, Obstetrics and Gynaecology, School of Medicine University of Nottingham, Nottingham City Hospital  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Marlow","sequence":"additional","affiliation":[{"name":"Department of Academic Neonatology UCL Institute for Women's Health  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5531-4301","authenticated-orcid":false,"given":"B.","family":"Thilaganathan","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit St George's University Hospitals NHS Foundation Trust, University of London  London UK"},{"name":"Vascular Biology and Research Centre, Molecular &amp; Clinical Sciences Research Institute St George's University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Arabin","sequence":"additional","affiliation":[{"name":"Center for Mother and Child of the Philipps University  Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7793-714X","authenticated-orcid":false,"given":"F.","family":"Prefumo","sequence":"additional","affiliation":[{"name":"Maternal\u2013Fetal Medicine Unit University of Brescia  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2104-5561","authenticated-orcid":false,"given":"C.","family":"Lees","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology Rosie Hospital  Cambridge UK"},{"name":"Department of Obstetrics and Gynecology KU Leuven  Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Wolf","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Amsterdam University Medical Center  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the GRIT Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the TRUFFLE Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,1]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.965"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7321"},{"key":"e_1_2_8_4_1","doi-asserted-by":"crossref","unstructured":"GRIT Study Group.A randomised trial of timed delivery for the compromised preterm fetus: short term outcomes and Bayesian interpretation.BJOG2003;110:27\u201332.","DOI":"10.1046\/j.1471-0528.2003.02014.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)62049-3"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16809-8"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13190"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.181.1.1887021"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.3758\/BF03206553"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.infbeh.2015.06.004"},{"key":"e_1_2_8_11_1","first-page":"673","article-title":"Short\u2010term fetal heart rate variation, decelerations, and umbilical flow velocity waveforms before labor","volume":"80","author":"Dawes GS","year":"1992","journal-title":"Obstet Gynecol"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0960-7692.2001.00590.x"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17361"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.4101"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7210715"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2016.1156670"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2019.01.005"}],"container-title":["Ultrasound in Obstetrics &amp; 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