臨床婦人科産科74巻1号

2020年01月発行

合併増大号　今月の臨床 周産期超音波検査バイブル―エキスパートに学ぶ技術と知識のエッセンス 胎児疾患編

胎児発育不全

著者： 梅原永能¹ 粟野啓¹

所属機関： ¹国立成育医療研究センター周産期・母性診療センター産科

ページ範囲：P.103 - P.111

●FGRと診断された児のなかに，発育が障害されたgrowth restricted fetusと体質的に小さいconstitutionally small fetusが含まれるが，両者を正確に区別することは困難である．

●さまざまな胎児・胎盤血流評価の報告がされており，将来的には詳細な管理指針が作成されることが期待される．

参考文献

1）FCGO : Fetal growth restriction and intra-uterine growth restriction : guidelines for clinical practice from the French College of Gynecologists and Obstetricians. Eur J Obstet Gynecol Reprod Biol 193 : 10-18, 2015

2）Gardosi J, et al : Customized growth charts : rationale, validation and clinical benefits. Am J Obstet Gynecol 218 : S609-S618, 2018

3）Figueras F, et al : Update on the diagnosis and classification of fetal growth restriction and proposal of a stage-based management protocol. Fetal Diagn Ther 36 : 86-98, 2014

4）Alfirevic Z, et al : Fetal and umbilical Doppler ultrasound in high-risk pregnancies. Cochrane Database Syst Rev （1） : CD007529, 2010

5）Thornton JG, et al : Growth restriction intervention trial（GRIT）. Lancet 364 : 513-520, 2004

6）Eixarch E, et al : Neurodevelopmental outcome in 2-year-old infants who were small-for-gestational age term fetuses with cerebral blood flow redistribution. Ultrasound Obstet Gynecol 32 : 894-899, 2008

7）Gramellini D, et l : Cerebral-umbilical Doppler ratio as a predictor of adverse perinatal outcome. Obstet Gynecol 79 : 416-420, 1992

8）Arbeille P, et al : Assessment of the fetal PO2 changes by cerebral and umbilical Doppler on lamb fetuses during acute hypoxia. Ultrasound Med Biol 21 : 861-870, 1995

9）Nassr AA, et al : Fetal cerebro-placental ratio and adverse perinatal outcome : systematic review and meta-analysis of the association and diagnostic performance. J Perinat Med 44 : 249-256, 2016

10）Cruz-Lemini M, et al : Risk of perinatal death in early-onset intrauterine growth restriction according to gestational age and cardiovascular Doppler indices : a multicenter study. Fetal Diagn Ther 32 : 116-122, 2012

11）Schwarze A, et al : Qualitative venous Doppler flow waveform analysis in preterm intrauterine growth-restricted fetuses with ARED flow in the umbilical artery--correlation with short-term outcome. Ultrasound Obstet Gynecol 25 : 573-579, 2005

12）Baschat AA, et al : Qualitative venous Doppler waveform analysis improves prediction of critical perinatal outcomes in premature growth-restricted fetuses. Ultrasound Obstet Gynecol 22 : 240-245, 2003

13）Hecher K, et al : Monitoring of fetuses with intrauterine growth restriction : a longitudinal study. Ultrasound Obstet Gynecol 18 : 564-570, 2001

14）Baschat AA, et al : The sequence of changes in Doppler and biophysical parameters as severe fetal growth restriction worsens. Ultrasound Obstet Gynecol 18 : 571-577, 2001

15）Royal College of Obstetricians & Gynaecologists : The investigation and management of the small-for-gestational-age fetus （Green-top Guideline No.31）, 2013

16）American College of Obstetricians and Gynecologists : ACOG Practice bulletin : no.134 : fetal growth restriction. Obstet Gynecol 121 : 1122-1133, 2013

17）SOGC Clinical Practice Guideline. Intrauterine growth restriction : screening, diagnosis, and management. No.295, 2013

18）New Zealand Maternal Fetal Medicine Network : Guideline for the management of suspected small for gestational age singleton pregnancies and infants after 34weeks' gestation. 2014

19）Royal College of Physicians of Ireland : Fetal growth restriction-recognition, diagnosis, and management. Clinical practice guideline, No.28, 2014

20）Vayssiére C, et al : Fetal growth restriction and intra-uterine growth restriction : guidelines for clinical practice from the French College of Gynecologists and Obstetricians. Eur J Obstet Gynecol Reprod Biol 193 : 10-18, 2015