Timing for the delivery of the growth-restricted fetus: a resolvable issue

IUGR pregnancies face the absence of effective fetal therapies, so, timing of delivery becomes the critical issue; the risk of intrauterine compromise has to be weighed against the potential risks from iatrogenic premature delivery, which are typically greatest before 32-34 weeks' gestation. The importance of assessing the optimum timing of delivery as accurately as possible is difficult to overemphasize. Between 23 and 26 weeks gestation, neonatal mortality is falling by 2 % per day14. Delivering babies when they are as mature as possible, but also as healthy as possible, could have a profound effect on neonatal mortality and short-and long-term morbidity. The objective of our study is to compare results of 46 IUGR pregnancies who underwent Doppler surveillance to those of other 46 IUGR pregnancies monitored with cardiotocographic tracing, in order to find the better way to decide when is the best moment to terminate an IUGR pregnancy. Both ways proved to be valuable, with similar results, but larger population study should be enrolled in order to obtain the best approach in the decision making. We certainly need an antenatal test which will better predict fetal morbidity and mortality, and, more than that, which should open numerous avenues for neonatal management protocols.