Faculty Publish New FIGO Clinical Practice Guideline on Fetal Growth Restriction

This month saw the publication of a comprehensive clinical practice guideline on fetal growth restriction from the International Federation of Gynecology and Obstetrics (FIGO) and led by Dr. Nir Melamed (Associate Professor), who currently holds the Waugh Family Chair in Twin Pregnancy Research at the Sunnybrook Health Sciences Centre. The guideline contains many new pertinent updates that are based on research led by Dr. Melamed in partnership with Dr. John Kingdom (Chair) based at Mount Sinai Hospital. Many of their joint publications inform the content of this guideline, affirming UofT ObGyn as a major centre for research to improve clinical outcomes for pregnancies at risk of fetal growth restriction.

One of the most practical examples, formally adopted by all of our partners within the Southern Ontario Network of Obstetrics and Gynaecology (SOON-ObGyn), is the standardization of the method for estimation of fetal weight and the adoption of an ultrasound-derived fetal growth standard, published by Hadlock in 1991, to interpret fetal growth. The new guideline states that physicians should no longer use a birthweight standard graph to plot estimated fetal weight. Research by Dr. Melamed and Dr. Kingdom, summarized in this FIGO guideline, demonstrates the importance and clinical benefits of adopting these new ultrasound-based standards.

"Worldwide, fetal growth restriction is a leading cause of stillbirth, neonatal mortality, and short- and long-term morbidity," said Dr. Melamed. "This new supplement is a FIGO initiative that is a unique, up-to-date document that provides a comprehensive practical guidance regarding the best practice on the diagnosis and management of fetal growth restriction in both low- and high-income countries."

The existing SOGC guideline on fetal growth restriction, written by Dr. Andrea Lausman (Assistant Professor) and Dr. Kingdom in 2013, will now be revised with input by Dr. Melamed and regional representatives within maternal-fetal medicine across Canada. Congratulations to Dr. Melamed and his team on this very substantial achievement!

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