(1) General Management: Bed rest, balanced diet, oxygen therapy, and left-side lying position to improve uteroplacental blood circulation.
(2) Nutritional supplementation: Oral administration of 1 tablet of compound amino acid tablets, 1-2 times daily; intravenous drip of 250-500ml fat emulsion injection, administered every 3 days for 1-2 consecutive weeks; 500ml of 10% glucose solution with vitamin C or energy compound, once daily for 10 consecutive days;Folic acid 5–10mg, 3 times daily for 15–30 days. Supplement appropriately with vitamin E, B vitamins, calcium, iron, and zinc.
(3) Pharmacological treatment: Beta-adrenergic agonists dilate blood vessels, relax the uterus, improve uteroplacental blood flow, and promote fetal growth. Magnesium sulfate restores normal placental perfusion.Danshen promotes cellular metabolism, improves microcirculation, and reduces capillary permeability, aiding in placental function maintenance. Administration: 40–500 mL dextran plus 4 mL compound Danshen injection via intravenous drip.
2. Indications for Continued Pregnancy
① Favorable intrauterine monitoring; ② Normal placental function;③ Pregnancy is not yet full-term, and the mother has no complications or comorbidities. Under close monitoring, pregnancy may be continued to term but should not exceed the estimated due date.
3. Indications for Terminating Pregnancy
① No improvement in FGR after treatment, poor response to electronic fetal monitoring, fetal biophysical profile score of 4–6 points—pregnancy should be terminated promptly; ② Signs of fetal intrauterine hypoxia, premature placental aging, fetal growth arrest lasting over 3 weeks;③ Worsening of pregnancy-related complications during treatment, where continued pregnancy jeopardizes maternal or fetal health/life; termination should be performed promptly. ④ For preterm fetuses, lung maturation should be actively induced before termination. Method: Administer dexamethasone 5 mg IM three times daily or intra-amniotic injection of 10 mg dexamethasone two days prior to termination to promote fetal lung maturation. Simultaneously, closely monitor fetal condition in utero.
4. Choice of Delivery Method
FGR fetuses exhibit poor tolerance to hypoxia and inadequate fetal-placental reserves, making them vulnerable to oxygen deprivation during uterine contractions. Indications for cesarean section should be appropriately expanded.
(1) Vaginal Delivery: Indicated when:amniotic fluid volume and fetal position are normal, and there are no other contraindications. Another scenario involves inducing labor when fetal survival is unlikely and there are no indications for cesarean section.
(2) Cesarean Section: Cesarean delivery should be performed to terminate pregnancy when the fetal condition is critical, the birth canal is unfavorable, or vaginal delivery poses risks to the fetus.