Pregnancy management after diagnosis of type 2 and type 3 sFGR

Type 2 sFGR is characterized by fixed absent or fixed reversed UA end-diastolic velocity without variation of the waveform in the smaller twin; type 3 sFGR is characterized by variable flow pattern that cycles between forward, absent, and reversed flow over a short interval (ie, intermittent absent/reversed end-diastolic flow).

sFGR: selective fetal growth restriction; UV: umbilical vein; DV: ductus venosus; MCA: middle cerebral artery; BPP: biophysical profile; UA: umbilical artery; PI: pulsatility index; NST: nonstress test.
* Signs of worsening disease include progression from type 2 to type 3 sFGR, DV PI >95^th percentile, development of absent or reversed a-wave in the DV waveform, and oligohydramnios in the sac of the smaller twin.
¶ Consider admission for daily NSTs if delivery for fetal indications would be considered.

Graphic 122836 Version 2.0

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Pregnancy management after diagnosis of type 2 and type 3 sFGR