{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T20:13:54Z","timestamp":1776024834823,"version":"3.50.1"},"reference-count":58,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,1,3]],"date-time":"2015-01-03T00:00:00Z","timestamp":1420243200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:p>Fetal growth restriction (<jats:styled-content style=\"fixed-case\">FGR<\/jats:styled-content>) is the single biggest risk factor for stillbirth. In the absence of any effective treatment for fetal growth restriction, the mainstay of management is close surveillance and timely delivery. While such statements are almost self\u2010evident, the daily clinical challenge of late\u2010onset fetal growth restriction remains; the competing priorities of minimising stillbirth risk, while avoiding excessive obstetric intervention and the neonatal sequelae of iatrogenic preterm birth. This dilemma is made harder because the tools for late\u2010onset <jats:styled-content style=\"fixed-case\">FGR<\/jats:styled-content> diagnosis and surveillance compare poorly to those used in early\u2010onset <jats:styled-content style=\"fixed-case\">FGR<\/jats:styled-content>; screening tests in early pregnancy have limited predictive value; most cases escape clinical detection, a phenomenon set to worsen given the obesity epidemic; there is a failure of consensus on the definition of small for gestational age, and ancillary tools, such as umbilical artery Doppler \u2013 of value in identification of preterm <jats:styled-content style=\"fixed-case\">FGR<\/jats:styled-content> \u2013 are less useful in the late\u2010preterm period and at term. Most importantly, the problem is common; 96% of all births occur after 32\u00a0weeks. This means a poor noise\/signal ratio of any test or management algorithm will inevitably have large clinical consequences. Into such a dark corner, we cast some light; a summary on diagnostic criteria, new developments to improve the diagnosis of late\u2010onset <jats:styled-content style=\"fixed-case\">FGR<\/jats:styled-content> and a suggested approach to management.<\/jats:p>","DOI":"10.1111\/ajo.12264","type":"journal-article","created":{"date-parts":[[2015,1,3]],"date-time":"2015-01-03T05:35:40Z","timestamp":1420263340000},"page":"3-10","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Shining light in dark corners: Diagnosis and management of late\u2010onset fetal growth restriction"],"prefix":"10.1111","volume":"55","author":[{"given":"Teresa M.","family":"MacDonald","sequence":"first","affiliation":[{"name":"The Northern Hospital Melbourne Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology University of Melbourne Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth A.","family":"McCarthy","sequence":"additional","affiliation":[{"name":"The Northern Hospital Melbourne Victoria Australia"},{"name":"Department of Perinatal Medicine Mercy Hospital for Women Melbourne Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology University of Melbourne Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan P.","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Perinatal Medicine Mercy Hospital for Women Melbourne Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology University of Melbourne Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,1,3]]},"reference":[{"key":"e_1_2_3_2_1","doi-asserted-by":"publisher","DOI":"10.1159\/000355525"},{"key":"e_1_2_3_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.11.014"},{"key":"e_1_2_3_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.298.6673.564"},{"key":"e_1_2_3_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f108"},{"key":"e_1_2_3_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2007.00742.x"},{"key":"e_1_2_3_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31820b0884"},{"key":"e_1_2_3_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-8-33"},{"key":"e_1_2_3_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12172"},{"key":"e_1_2_3_10_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.070430"},{"key":"e_1_2_3_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000321694"},{"key":"e_1_2_3_12_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2010.516285"},{"key":"e_1_2_3_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)62233-7"},{"key":"e_1_2_3_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2011.01408.x"},{"key":"e_1_2_3_15_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767051003728229"},{"key":"e_1_2_3_16_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2007.26.9.1167"},{"issue":"1","key":"e_1_2_3_17_1","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/S1701-2163(16)35129-5","article-title":"Screening, Diagnosis, and Management of Intrauterine Growth Restriction","volume":"34","author":"Lausman A","year":"2012","journal-title":"J Obstet Gynecol Can"},{"key":"e_1_2_3_18_1","unstructured":"Royal College of Obstetricians and Gynaecologists.Green\u2010top Guideline No. 31. The Investigation and Management of the Small\u2010for\u2010Gestational\u2010Age Fetus. Revised January 2014."},{"key":"e_1_2_3_19_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja11.11331"},{"key":"e_1_2_3_20_1","unstructured":"Australasian Society for Ultrasound in Medicine Policies and Statements. Guidelines for the Performance of the Third Trimester Ultrasound (D12). Revised July 2008."},{"key":"e_1_2_3_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.06.038"},{"key":"e_1_2_3_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1994.tb13007.x"},{"key":"e_1_2_3_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1994.tb13077.x"},{"key":"e_1_2_3_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1994.tb13078.x"},{"key":"e_1_2_3_25_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.181.1.1887021"},{"key":"e_1_2_3_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003081-199712000-00005"},{"key":"e_1_2_3_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2007.01273.x"},{"key":"e_1_2_3_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60364-4"},{"key":"e_1_2_3_29_1","first-page":"e1","article-title":"Adverse pregnancy outcome and association with small for gestational age birthweight by customized and population\u2010based percentiles","volume":"28","author":"Gardosi J","year":"2009","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_3_30_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2010.506566"},{"key":"e_1_2_3_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31823dc56e"},{"key":"e_1_2_3_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2010.01155.x"},{"key":"e_1_2_3_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2010.02642.x"},{"key":"e_1_2_3_34_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja12.10125"},{"key":"e_1_2_3_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(14)70121-4"},{"key":"e_1_2_3_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2009.02245.x"},{"key":"e_1_2_3_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12205"},{"key":"e_1_2_3_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13319"},{"key":"e_1_2_3_39_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199904223401603"},{"key":"e_1_2_3_40_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2231010876"},{"key":"e_1_2_3_41_1","doi-asserted-by":"publisher","DOI":"10.1515\/JPM.2008.100"},{"key":"e_1_2_3_42_1","doi-asserted-by":"publisher","DOI":"10.1515\/JPM.2009.003"},{"key":"e_1_2_3_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31818bdc7e"},{"issue":"1","key":"e_1_2_3_44_1","article-title":"Decline in growth trajectory between 28 and 36\u00a0weeks gestation is associated with ultrasound evidence of placental insufficiency: a prospective cohort study","volume":"48","author":"Bardien N","year":"2012","journal-title":"J Paediatr Child Health"},{"key":"e_1_2_3_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1985.tb01045.x"},{"key":"e_1_2_3_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/0301-5629(90)90167-B"},{"key":"e_1_2_3_47_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpm.2010.041"},{"key":"e_1_2_3_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2013.09.018"},{"key":"e_1_2_3_49_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7738"},{"key":"e_1_2_3_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.05.008"},{"key":"e_1_2_3_51_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.2002.00652.x"},{"key":"e_1_2_3_52_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2002.127137"},{"key":"e_1_2_3_53_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.8976"},{"key":"e_1_2_3_54_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12380"},{"key":"e_1_2_3_55_1","doi-asserted-by":"publisher","DOI":"10.1159\/000357592"},{"key":"e_1_2_3_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.02.007"},{"key":"e_1_2_3_57_1","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-11-256"},{"key":"e_1_2_3_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.04.011"},{"key":"e_1_2_3_59_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c7087"}],"container-title":["Australian and New Zealand Journal of Obstetrics and Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fajo.12264","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.12264","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T10:51:43Z","timestamp":1695552703000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/ajo.12264"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,1,3]]},"references-count":58,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2015,2]]}},"alternative-id":["10.1111\/ajo.12264"],"URL":"https:\/\/doi.org\/10.1111\/ajo.12264","archive":["Portico"],"relation":{},"ISSN":["0004-8666","1479-828X"],"issn-type":[{"value":"0004-8666","type":"print"},{"value":"1479-828X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,1,3]]},"assertion":[{"value":"2014-05-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-08-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-01-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}