Assessment of Decidual Natural Killer Cells CD56+ Population in Placental Bed in Fetal Growth Restriction

Abstract

The most commonly adopted definition to describe a fetus that has not reached its target weight based on sonographic estimated fetal weight (EFW) for a certain gestation is an abdominal circumference (AC) or EFW measurement <10th centile. The American Congress of Obstetricians and Gynecologists (ACOG) and Royal College of Obstetricians and Gynecologists (RCOG) agree that at this cutoff the risk of perinatal morbidity and mortality increases (Unterscheider et al., 2013). The causes of IUGR are broadly described under three main categories: maternal, fetal, and placental (Hendrix et al., 2008). Since no treatment has been demonstrated to be of benefit in growth restriction, assessment of fetal wellbeing and timing of delivery remain as the main management strategy. The aim behind a clinical protocol for managing IUGR is to combine existing evidence on various methods for monitoring fetal well-being in order to establish the risks of fetal injury or death, and to balance them against the risks of prematurity if the fetus is delivered. Added into the equation is the awareness that leaving pregnancies with FGR to deliver at term may also lead to perinatal morbidity and delayed effects such as cerebral palsy (Jacobsson et al., 2008).