Full Description
This book is based on the 20th Study Group of the Royal College of Obstetricians and Gynaecologists, which concerned the important topic of fetal growth. Basic scientific, and both obstetric and paediatric aspects of the subject were addressed in contributions from many different disciplines, and we are greatly indebted to all the international experts who took part in this workshop at the RCOG in London in November 1988. The deliberations covered the broad topics of normal fetal growth, fetal over growth and undergrowth. Clinical implications of these entities, especially fetal undergrowth, played a large part in the proceedings as dictated by c.1inical con cerns. Definitions, epidemiology, aetiology and screening were covered, as were technological developments, with special reference to blood flow and volume flow measurements, both fetal and placental. Other aspects of clinical fetal monitoring, including fetal activity measurement, and biophysical evaluation were rationalised and placed in context, and the important newly emerging areas of cordocentesis and therapy in IUGR addressed. Finally, neonatal management of the SGA baby, mortality and long-term morbidity were considered.
Contents
Section 1 — Normal Fetal Growth.- Effect of genome on size at birth.- Fetal growth curves.- Discussion.- Placental control of fetal metabolism.- The placenta as an endocrine regulator.- Discussion.- Section 2 — Normal Fetal Growth (Continued).- Genetic mechanisms of regulation of fetal growth.- Control of cellular multiplication and differentiation.- Discussion.- Maternal diet and fetal substrate provision.- Environmental influences on fetal growth: effects and consequences.- Discussion.- Section 3 — Fetal Overgrowth.- Fetal growth: an overview.- Mechanisms of overgrowth.- Discussion.- Obstetric problems of fetal macrosomia.- Discussion.- Section 4 — Fetal Undergrowth.- Epidemiology.- Aetiology of fetal undergrowth.- Discussion.- Effects of changes in maternal energy and protein intake during pregnancy, with special reference to fetal growth.- Discussion.- Utero-placental blood flow and retal growth.- Discussion.- Section 5 — Clinical Implications of Fetal Undergrowth.- The detection of intrauterine growth retardation.- Detection of fetal growth retardation by biochemical tests.- Discussion.- Technical basis for Doppler blood flow measurement.- Volume flow calculation in the human fetus using pulsed Doppler ultrasound: basic problems.- Fetal and placental blood flow.- Discussion.- Clinical dating and assessment.- Discussion.- Section 6 — Clinical Implications of Fetal Undergrowth (Continued).- Treatment of fetal growth retardation.- Fetal activity and biophysical evaluation in IUGR.- Discussion.- Intrapartum monitoring in IUGR.- Discussion.- Neonatal management of the SGA infant.- Fetal growth: mortality and morbidity.- Discussion.- Conclusions.- Conclusions.
