Fetal growth surveillance needs to be tailored according to the risk of FGR. A thorough risk assessment should be carried out in early pregnancy and needs to take into account of the mother’s medical and obstetric history and the risk factors in the current pregnancy.
The GAP care pathway 17 seeks to balance the need to identify, investigate and appropriately manage at risk pregnancies with the aim to avoid unnecessary intervention. It continues the emphasis on surveillance according to risk assessment, by standardised fundal height (SFH) and estimated fetal weight (EFW) measurements, serially plotted on customised charts to improve the distinction between constitutional and pathological smallness.
The care pathway can be implemented in two phases, according to health service capacity. In particular, in the UK sonographic services will need to acquire additional training and resources to be able to deliver Phase II.
17. GAP Guidance. Perinatal Institute 2020. https://www.perinatal.org.uk/GAPguidance.pdf