Placental causes of fetal growth restriction and treatment methods

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Abstract

Intrauterine growth restriction (IUGR) is one of the most common pregnancy complications and a leading cause of iatrogenic preterm birth.

AIM: To examine the potential causes of fetal growth restriction and available treatment options, based on a comprehensive literature review from the past decade utilizing search databases such as PubMed and Elibrary.

The most common etiology of intrauterine growth restriction is abnormal placentation, frequently associated with impaired placental blood flow. Fetuses with growth restriction and significant abnormalities in umbilical artery blood flow are at increased risk of adverse outcomes, including intrauterine fetal demise, neonatal death, and neonatal morbidity such as hypoglycemia, hyperbilirubinemia, hypothermia, intraventricular hemorrhage, necrotizing enterocolitis, and seizure syndrome. Additionally, epidemiological studies indicate that fetuses with IUGR are predisposed to cognitive delays during childhood and conditions such as obesity, type 2 diabetes, and ischemic heart disease in adulthood. Various pharmacological interventions are being explored as potential adjuncts to improve fetal outcomes.

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About the authors

Alexandra A. Blazhenko

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Author for correspondence.
Email: alexandrablazhenko@gmail.com
ORCID iD: 0000-0002-8079-0991
SPIN-code: 8762-3604

MD, Cand. Sci. (Medicine)

Russian Federation, 199034, Saint Petersburg, Mendeleyevskaya Liniya, 3

Olga V. Pachuliya

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: opachuliya@mail.ru
ORCID iD: 0000-0003-4116-0222
SPIN-code: 1204-3160

MD, Cand. Sci. (Medicine)

Russian Federation, 199034, Saint Petersburg, Mendeleyevskaya Liniya, 3

Olesya N. Bespalova

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: shiggerra@mail.ru
ORCID iD: 0000-0002-6542-5953
SPIN-code: 4732-8089

MD, Dr. Sci. (Medicine)

Russian Federation, 199034, Saint Petersburg, Mendeleyevskaya Liniya, 3

Igor Yu. Kogan

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: ikogan@mail.ru
ORCID iD: 0000-0002-7351-6900
SPIN-code: 6572-6450

corresponding member of the Russian Academy of Sciences, MD, Dr. Sci. (Medicine), professor

Russian Federation, 199034, Saint Petersburg, Mendeleyevskaya Liniya, 3

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2. Fig. 1. Possible interventions for the treatment of IUGR by site of action affecting vascular smooth muscle and endothelial metabolism. GMP — guanosine monophosphate; cGMP — cyclic guanosine monophosphate; GTP — guanosine triphosphate; HO-1 — heme oxygenase-1; NO — nitric oxide; NOS — nitric oxide synthase; PDE5 — phosphodiesterase type 5 inhibitor; sGC — soluble guanylate cyclase; TX-A2 — thromboxane A2 [55]

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