The suspicion of small for gestational age fetus before 37 weeks of gestation implies to discriminate those who are physiologically small from those who have an underlying pathology leading to growth retardation. A labor induction can be needed if the risks associated to the prolongation of the pregnancy are estimated to be higher than those of prematurity and cesarean. In this case, labor induction can be discussed if the fetal vitality is normal. A continuous fetal heart monitoring during induction and labor is, in this case, strongly recommended. However, even in these optimal conditions, the risk of cesarean in case of labor induction for small for gestational age fetus before 37 weeks of gestation is of about 50 % in the rare published studies.
Copyright 2010. Published by Elsevier SAS.