What is the best way of helping women with very early fetal growth restriction?

Babies who stop growing very early in pregnancy are at high risk of being stillborn. Tommy’s are trying to find out how we can help women who are affected.

Fetal growth restriction is when a baby is growing less than it should do in the womb. Babies whose growth slows or stops early on in pregnancy are at a much higher risk of stillbirth. In very early cases – before 28 weeks of pregnancy, when the baby weighs less than 600g – there is a very low chance of survival. This is extreme early onset fetal growth restriction, or eFGR.

At the moment, there is almost no research on how to help women who have eFGR babies. We don’t know how many people it affects, and different doctors respond to it in different ways. Most importantly, we don’t know the best way that we can help parents affected by eFGR. Going through an eFGR pregnancy can be very upsetting, as it is unclear how best to help the baby survive.

Tommy’s want to change this. We are about to start research that will help us to understand the challenges we face when helping women with eFGR babies.

First, we want to find out how many women suffer from eFGR pregnancies, and how doctors usually manage them. Second, we want to find out how we could tell which babies are at the most risk. One way of doing this is to see how accurately we can tell what a baby’s weight in the womb is. With very small babies, it is vital that we know exactly how much they weigh – this can tell us whether they stand a chance of life outside the womb.

Finally, we want to hear from parents of eFGR babies. Parents can be faced with tough decisions if their baby is very small. It may be a choice between delivering the baby when there is a very slim chance of survival, or not intervening, in which case stillbirth is almost certain.

This is not a choice any parent should have to make. We hope that our research will help us understand the best ways of helping women with eFGR pregnancies so that their babies have the best possible chance at life. 

Researchers

Dr Ed Johnstone, Dr Alexander Heazell, Dr Lynne Warrander

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Funding

This study is fully funded by Tommy's and takes place in a Tommy's centre

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