Pregnancy outcomes in late-onset fetal growth restriction: a Delphi consensus-based approach

Objectives: To assess pregnancy outcomes of late-onset fetal growth restriction based on Delphi consensus. Materials and methods: A prospective study in 133 pregnant women with fetal growth restriction according to the Delphi consensus were investigated at the Obstetrics and Gynecology Center - Hue Central Hospital from May 2022 to June 2023. Results: Late-onset fetal growth restriction rate as classified by the Delphi-consensus was 87.2%. Baseline characteristics included: average maternal age was 27.4 ± 5.5 (years); unemployment rate was 28.4%; underweight BMI was 41.4%; smoking (active/passive) was 31%; history of previous late-onset fetal growth restriction was 10.3%; hypertensive disorders of pregnancy was 24.1%; primigravida was 69.8%; abnormal amniotic fluid index was 31.9%; Doppler spectrum of umbilical artery with increased resistance was 13.8%, absent/reversed end-diastolic flow 6.9%; abnormal Doppler of the middle cerebral artery, abnormal ductus venosus, and abnormal cerebroplacental ratio in about 25% of cases. The abnormal non-stress CTG was 41.4%. Regarding pregnancy outcomes, average gestational age was 37.6 ± 1.9 (weeks); average weight was 2155.2 ± 321.8 (grams); cesarean section rate was 68.1%, particularly 43.0% due to late-onset fetal growth restriction; adverse perinatal outcomes were 40.5%. The value of ultrasound and non-stress CTG in predicting cesarean delivery and adverse perinatal outcomes had low sensitivity but high specificity. Conclusion: Late-onset fetal growth restriction based on the Delphi consensus occurred at remarkably high rate. Although changes in arterial Doppler values have low sensitivity, the specificity is very high. The rate of adverse perinatal outcomes is notably high, emphasizing the need for early diagnosis for monitoring and determining the optimal intervention timing.