{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T23:38:06Z","timestamp":1792625886531,"version":"4.5.0"},"reference-count":11,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ultraschall Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Fetal growth restriction (FGR) is associated with increased perinatal morbidity and mortality. Its recognition requires differentiation from a constitutionally small-for-gestational-age (SGA) fetus. Based on the current AWMF S2k guideline, this CME review summarizes the ultrasound assessment and clinical management of suspected FGR. Accurate first-trimester dating, standardized fetal biometry, assessment of amniotic fluid volume, and detailed anatomical evaluation form the basis of diagnosis. Consensus-based criteria distinguish early FGR before 32\u200a+\u200a0 weeks\u2019 gestation from late FGR at or beyond 32\u200a+\u200a0 weeks\u2019 gestation. Multivessel Doppler assessment of the umbilical artery, middle cerebral artery, cerebroplacental ratio, and ductus venosus provides complementary information on placental resistance, fetal redistribution, and cardiovascular decompensation. Cardiotocography, including computerized analysis of short-term variation in early FGR, is used as part of multimodal surveillance and should not be interpreted in isolation. The review discusses appropriate monitoring intervals, indications for inpatient care, antenatal corticosteroids and fetal neuroprotection when preterm birth is anticipated, as well as gestational-age- and finding-dependent timing and mode of delivery. A practical clinical case illustrates the diagnostic pathway from abnormal fetal biometry to delivery planning.<\/jats:p>","DOI":"10.1055\/a-2965-4867","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T22:46:39Z","timestamp":1792622799000},"source":"Crossref","is-referenced-by-count":0,"title":["Ultrasound in fetal growth restriction"],"prefix":"10.1055","author":[{"given":"Sven","family":"Kehl","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, LMU University Hospital, LMU Medizin, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,10,21]]},"reference":[{"key":"ref2","doi-asserted-by":"crossref","first-page":"S869","DOI":"10.1016\/j.ajog.2017.12.012","article-title":"Long-term cardiovascular consequences of fetal growth restriction: biology, clinical implications, and opportunities for prevention of adult disease","volume":"218","author":"F Crispi","year":"2018","journal-title":"Am J Obstet Gynecol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"f108","DOI":"10.1136\/bmj.f108","article-title":"Maternal and fetal risk factors for stillbirth: population based study","volume":"346","author":"J Gardosi","year":"2013","journal-title":"Bmj"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1055\/a-2280-4756","article-title":"Firsttrimester Diagnosis and Therapy @ 11\u201313+6 Weeks of Gestation \u2013 Part 1","volume":"46","author":"C Kaisenberg von","year":"2025","journal-title":"Ultraschall in Med"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1002\/uog.20272","article-title":"ISUOG Practice Guidelines: ultrasound assessment of fetal biometry and growth","volume":"53","author":"L J Salomon","year":"2019","journal-title":"Ultrasound Obstet Gynecol"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/0002-9378(85)90298-4","article-title":"Estimation of fetal weight with the use of head, body, and femur measurements--a prospective study","volume":"151","author":"F P Hadlock","year":"1985","journal-title":"Am J Obstet Gynecol"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1002\/uog.14924","article-title":"Single deepest vertical pocket or amniotic fluid index as evaluation test for predicting adverse pregnancy outcome (SAFE trial): a multicenter, open-label, randomized controlled trial","volume":"47","author":"S Kehl","year":"2016","journal-title":"Ultrasound Obstet Gynecol"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1002\/uog.15884","article-title":"Consensus definition of fetal growth restriction: a Delphi procedure","volume":"48","author":"S J Gordijn","year":"2016","journal-title":"Ultrasound in obstetrics & gynecology: the official journal of the International Society of Ultrasound in Obstetrics and Gynecology"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1002\/uog.23698","article-title":"ISUOG Practice Guidelines (updated): use of Doppler velocimetry in obstetrics","volume":"58","author":"A Bhide","year":"2021","journal-title":"Ultrasound Obstet Gynecol"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"288 e1\u20135","DOI":"10.1016\/j.ajog.2014.05.008","article-title":"The role of brain sparing in the prediction of adverse outcomes in intrauterine growth restriction: results of the multicenter PORTO Study","volume":"211","author":"K Flood","year":"2014","journal-title":"American journal of obstetrics and gynecology"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"2162","DOI":"10.1016\/S0140-6736(14)62049-3","article-title":"2 year neurodevelopmental and intermediate perinatal outcomes in infants with very preterm fetal growth restriction (TRUFFLE): a randomised trial","volume":"385","author":"C C Lees","year":"2015","journal-title":"Lancet"},{"issue":"S 01","key":"ref12","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1002\/ijgo.13522","article-title":"FIGO (international Federation of Gynecology and obstetrics) initiative on fetal growth: best practice advice for screening, diagnosis, and management of fetal growth restriction","volume":"152","author":"N Melamed","year":"2021","journal-title":"Int J Gynaecol Obstet"}],"container-title":["Ultraschall in der Medizin - European Journal of Ultrasound"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2965-4867.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T22:46:40Z","timestamp":1792622800000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2965-4867"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,21]]},"references-count":11,"URL":"https:\/\/doi.org\/10.1055\/a-2965-4867","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0172-4614","1438-8782"],"issn-type":[{"value":"0172-4614","type":"print"},{"value":"1438-8782","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,21]]}}}