MODERN APPROACHES TO EARLY DIAGNOSIS OF FETAL GROWTH RESTRICTION

Abstract

Background: Fetal Growth Restriction (FGR) is a major cause of perinatal mortality and morbidity, often linked to placental insufficiency. Differentiating pathological growth restriction from constitutionally small-for-gestational-age (SGA) fetuses remains a clinical challenge. This study aims to evaluate the efficacy of a multi-modal screening approach combining biometry, Doppler velocimetry, and biochemical markers for the early diagnosis of FGR. Methods: A prospective cohort study involving 300 pregnant women was conducted. Participants underwent screening at 11-13 weeks and 20-24 weeks. The protocol included: assessment of maternal risk factors, Uterine Artery Pulsatility Index (UtA-PI) measurement, Cerebroplacental Ratio (CPR) calculation, and serum PlGF levels. Diagnosis accuracy was compared against postnatal birth weight centiles and neonatal outcomes. Results: Traditional biometry alone had a sensitivity of 45% for predicting FGR. The combined model (Biometry + UtA-PI + CPR + PlGF) significantly increased sensitivity to 88% (p < 0.001) with a false-positive rate of 8%. Low PlGF levels (<5th percentile) and abnormal CPR were strong independent predictors of adverse perinatal outcomes, even in fetuses with estimated weight >10th percentile. Conclusion: A combined screening strategy significantly improves the early detection of FGR compared to biometry alone. Integrating hemodynamic (Doppler) and metabolic (PlGF) markers allows for the identification of "at-risk" fetuses before growth lag becomes anatomically apparent.