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Standardization in fetal growth restriction

Progression by consensus
PhD ceremony:Ms I.M. (Irene) Beune
When:February 08, 2021
Supervisor:prof. dr. J.J.H.M. (Jan Jaap) Erwich
Co-supervisors:dr. S.J. Gordijn, dr. J.W. Ganzevoort
Where:Academy building RUG
Faculty:Medical Sciences / UMCG
Standardization in fetal growth restriction

For the development of study protocols, data analysis and comparisons of cohorts, and through this to determine the best fitting treatment for a patient, there has to be agreement on the basic principles of the condition concerned. This starts with consensus on the definition. Regarding fetal growth restriction, this consensus was missing. Fetal growth restriction is a frequently studied condition because of the major impact on perinatal morbidity and mortality. The diversity in currently used definitions was described in a systematic review, with 44 different definitions found in 2014. This heterogeneity makes it impossible to compare the results of these studies.

Expert consensus is the method of choice, in lack of a gold standard and when empirical evidence is impossible to obtain. A Delphi procedure is a systematic, interactive, group-communication process, to reach consensus in an expert panel. The existing consensus-methodology itself is also founded with little evidence and mainly based on expert-consensus.

This thesis aimed to develop consensus on the topic of fetal growth restriction. We succeeded in developing a consensus definition for fetal growth restriction diagnosed in singleton pregnancy (separate for early- and late-onset), in twin pregnancy (separate for monochorionic and dichorionic), the stillborn and the neonate. Additionally, some of the consensus methodology was tested to provide underlying evidence.