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Fetal growth restriction is a heterogeneous condition, and diagnosis based only on a single estimated fetal weight can miss important patterns of placental insufficiency. Studies of umbilical-artery and cerebroplacental Doppler show that abnormal placental resistance and redistribution can identify fetuses at higher risk of adverse outcomes even when estimated fetal weight alone is not profoundly low. For maternal-fetal medicine, the practical lesson is to integrate serial growth, amniotic-fluid assessment and Doppler findings with gestational age and maternal risk factors. Surveillance should then be individualized according to severity and trajectory. An abnormal Doppler does not by itself dictate immediate delivery; the decision depends on gestational age, fetal testing, maternal status and local protocol. This approach helps avoid both delayed delivery of compromised fetuses and unnecessary intervention in constitutionally small but healthy pregnancies.
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Fetal growth restriction is a heterogeneous condition, and diagnosis based only on a single estimated fetal weight can miss important patterns of placental insufficiency. Studies of umbilical-artery and cerebroplacental Doppler show that abnormal placental resistance and redistribution can identify fetuses at higher risk of adverse outcomes even when estimated fetal weight alone is not profoundly low. For maternal-fetal medicine, the practical lesson is to integrate serial growth, amniotic-fluid assessment and Doppler findings with gestational age and maternal risk factors. Surveillance should then be individualized according to severity and trajectory. An abnormal Doppler does not by itself dictate immediate delivery; the decision depends on gestational age, fetal testing, maternal status and local protocol. This approach helps avoid both delayed delivery of compromised fetuses and unnecessary intervention in constitutionally small but healthy pregnancies.
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