ABSTRACT
Fetal Growth Restriction (FGR) is defined as the inability of the fetus to achieve its growth potential. FGR is a complex and multifactorial disorder resulting from maternal, fetal and placental conditions. Some studies have shown that the use of customized growth standards (adjusted to factors that are known to affect birthweight such as maternal height, weight in early pregnancy, parity and ethnic group), improve the ability to distinguish growth-restricted fetuses from those that are constitutionally small when compared to population-based references. Interactions between the trophoblast and the immune system, in particular the natural killer cells, is necessary to assure an adequate remodeling as they are part of differentiation and loss of the smooth muscle cells within the arterial walls. A meta-analysis of multicenter trial data does not demonstrate any positive preventative effect of low-molecular-weight heparin on a primary composite outcome of placenta-mediated complications including fetal growth restriction.
