Early-onset fetal growth restriction with severe preeclampsia: our experience of a challenging topic

Abstract

Background. Early-onset foetal growth restriction is a critical condition of the pregnancy and the follow up and the best timing for the delivery could be challenging. Case presentation. We present the case of a 38-year older woman, pregnant at 27 weeks+3 days of gestation, admitted to Obstetrics and Gynecology Unit complaining of lower limb oedema and hypertensive peak; after ultrasound assessment, we diagnosed early-onset foetal growth restriction with preeclampsia. We commenced a follow up with ultrasound doppler evaluation and computerized cardiotocography. At the 31+5 of gestation, the maternal conditions worsened suddenly, and a caesarean section was carried out. The female newborn needed primary resuscitation, but she breathed ambient air spontaneously from the second day of life. Conclusions. The present study revealed that an optimal monitoring and timing of delivery remain crucial in the management of early-onset foetal growth restriction, to find the best balance between prolonging pregnancy and preventing mortality/morbidity.