Healthy Fetal Growth

In healthy pregnancy, fetal growth follows distinct patterns. Initially, fetal weight increases mainly due to skeletal and muscle growth and is related to placental glucose and amino acid transport. After 20 weeks of gestation there is deposition of fetal adipose tissue, which occurs alongside increases in fatty acid transport; later, fetal growth and adipose tissue deposition coincide with increasing conversion of glucose into fat. Assessment of fetal size and fetal growth are key elements of pregnancy care. The overarching aim is to determine healthy fetal growth, newborn size, preterm postnatal growth and neurodevelopment in the first 1000 days of life in healthy mothers, under healthy conditions. In order to differentiate the normally growing fetus from the abnormal, this chapter discusses three things, namely: accurate gestational age; measurement of the fetus; and whether the measurements of size (or growth) are within the normal range compared to a standard or reference.