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Главная / Архив / 2026 год / MEDICUS № 6 (84), June / LATE FETAL GROWTH RESTRICTION: DIAGNOSTIC CHALLENGES AND CONTEMPORARY INDUCTION STRATEGIES

LATE FETAL GROWTH RESTRICTION: DIAGNOSTIC CHALLENGES AND CONTEMPORARY INDUCTION STRATEGIES

Дата публикации: 16.06.2026

UDC 61

 

LATE FETAL GROWTH RESTRICTION: DIAGNOSTIC CHALLENGES

AND CONTEMPORARY INDUCTION STRATEGIES

 

Capros Hristiana, PhD, Associate Professor, Obstetrics, Gynecology Department

State Medical University of Medicine and Pharmacy “Nicolae Testemitanu”

(MD 2001, Republic of Moldova, Chişinău, bd. Ştefan cel Mare, 165)

E-mail: hristiana.capros@usmf.md

 

Surguci Mihai, PhD, Associate Professor, Obstetrics, Gynecology Department

State Medical University of Medicine and Pharmacy “Nicolae Testemitanu”

(MD 2001, Republic of Moldova, Chişinău, bd. Ştefan cel Mare, 165)

E-mail: surguci.mihail@usmf.md

 

Burac Mihaela, Assistant Professor, Obstetrics, Gynecology Department

State Medical University of Medicine and Pharmacy “Nicolae Testemitanu”

(MD 2001, Republic of Moldova, Chişinău, bd. Ştefan cel Mare, 165)

E-mail: burac.mihaela@usmf.md

 

Bologan Ion, PhD, Associate Professor, Obstetrics, Gynecology Department

State Medical University of Medicine and Pharmacy “Nicolae Testemitanu”

(MD 2001, Republic of Moldova, Chişinău, bd. Ştefan cel Mare, 165)

E-mail: ion.bologan@usmf.md

Abstract. Background. Fetal growth restriction (FGR) remains one of the major challenges of modern obstetrics. Late-onset FGR, diagnosed after 32 weeks of gestation, is the most frequent clinical form and is characterized by subtle Doppler abnormalities and preserved fetal compensatory mechanisms, making obstetrical management particularly complex. Objective. To analyze current diagnostic criteria for late fetal growth restriction and to evaluate recent evidence regarding induction of labour methods in pregnancies complicated by this pathology. Material and methods. A narrative review of recent literature was performed, focusing on modern diagnostic standards established after the Delphi consensus and comparative clinical studies evaluating mechanical and pharmacological induction methods in late FGR pregnancies. Results. The Delphi consensus improved diagnostic standardization by integrating biometric and Doppler criteria. Recent studies demonstrate that mechanical induction methods, particularly Foley balloon and extra-amniotic balloon, are associated with lower rates of uterine tachysystole, cesarean delivery for fetal distress, and neonatal intensive care admission compared with dinoprostone.  Conclusions. Late fetal growth restriction requires precise prenatal diagnosis and individualized obstetrical management. Mechanical cervical ripening methods currently appear to offer better maternal and fetal tolerance in many clinical situations.

Keywords: late fetal growth restriction, induction of labour, Foley balloon, placental insufficiency, Doppler velocimetry.

 

Introduction

Fetal growth restriction remains one of the most important and intensively studied problems of contemporary obstetrics because of its direct association with increased perinatal morbidity and mortality. Failure of the fetus to achieve its genetically determined growth potential is associated with placental insufficiency, chronic intrauterine hypoxia, fetal distress, iatrogenic prematurity, and long-term neonatal complications. Correct and timely diagnosis of fetal growth restriction allows optimal obstetrical management and significantly improves perinatal outcomes.

Materials and Methods

This paper represents a narrative review of contemporary literature focused on late fetal growth restriction, diagnostic criteria, fetal adaptive mechanisms to chronic intrauterine hypoxia, and current induction strategies in pregnancies complicated by placental insufficiency.

Results and discussions.

Intrauterine fetal growth restriction (FGR) remains one of the most important and intensively studied problems in modern obstetrics [4]. FGR is defined as the inability of the fetus to achieve its genetically determined growth potential. In clinical practice, late-onset FGR, occurring after 32 weeks of gestation, differs considerably from early-onset disease in terms of placental pathology, Doppler abnormalities, and clinical progression [10]. Recent studies have increasingly highlighted the role of immunological and inflammatory mechanisms in placental development and fetal growth. Altered maternal immune response and impaired endometrial immune balance may contribute to abnormal placentation and reduced uteroplacental perfusion, processes frequently associated with fetal growth restriction [3]. Because fetal hypoxia represents a central mechanism in the pathophysiology of FGR, increasing attention has been directed toward understanding fetal cardiovascular adaptation during intrauterine life [8]. In this regard, fetal circulation differs substantially from neonatal circulation due to the presence of the feto-placental circulation and specific vascular shunts that ensure oxygen redistribution during hypoxic stress [5]. To improve diagnostic uniformity, the International Federation of Gynecology and Obstetrics adopted the Delphi consensus criteria for the definition of FGR. Through this procedure, nine standardized diagnostic criteria were proposed and classified into solitary and contributive criteria [6]. Solitary criteria include estimated fetal weight below the 3rd percentile, abdominal circumference below the 3rd percentile on static growth charts, and absent or reversed end-diastolic flow in the umbilical artery. Contributive criteria include estimated fetal weight below the 10th percentile, abdominal circumference below the 10th percentile, pathological Doppler findings in the uterine arteries or umbilical artery, and an abnormal cerebroplacental ratio [7]. Therefore, the Delphi criteria not only facilitate the diagnosis of FGR, but also provide important insight into the ongoing fetal adaptive processes in a hypoxic intrauterine environment [8]. Nevertheless, despite the major contribution of the Delphi consensus to the standardization of FGR diagnosis, significant challenges persist in differentiating true pathological growth restriction from constitutionally small but otherwise healthy fetuses. This distinction is clinically crucial, as an inaccurate diagnosis may lead to unnecessary obstetrical interventions and modifications in perinatal management. Furthermore, recent studies suggest that false-positive prenatal diagnosis may influence not only the timing of delivery, but also long-term neonatal outcomes [14]. Consequently, a deeper understanding of fetal adaptive mechanisms to hypoxia is essential for the correct interpretation of Doppler parameters and of the cardiotocography in pregnancies complicated by fetal growth restriction [9]. Recent evidence suggests that false-positive prenatal diagnosis of fetal growth restriction may influence long-term neonatal outcomes. The reported increased respiratory morbidity in children prenatally misclassified as FGR despite being appropriate for gestational age at birth, highlighted the potential consequences of unnecessary obstetrical interventions and early delivery [19]. Recent advances in intrapartum ultrasound also improve the objective assessment of labor progression in pregnancies complicated by fetal growth restriction, providing reproducible information that may support safer intrapartum decision-making [20]. Villalain C. et al. compared cervical ripening with vaginal dinoprostone versus Foley balloon in pregnancies complicated by late-onset fetal growth restriction. The study demonstrated that Foley balloon induction was associated with lower rates of uterine tachysystole, fetal distress, and cesarean delivery, resulting in a higher rate of vaginal birth, while both methods showed favorable perinatal safety profiles [21]. Al-Hafez L. et al. evaluated labor induction methods in pregnancies complicated by fetal growth restriction and reported that prostaglandin use was associated with higher rates of cesarean delivery, particularly for nonreassuring fetal heart tracings, compared to other induction methods. However, no significant differences in adverse neonatal outcomes were observed between the groups [1]. Di Mascio D. et al. compared vaginal dinoprostone with mechanical methods for labor induction in pregnancies complicated by late fetal growth restriction. The authors reported significantly lower rates of uterine tachysystole, operative delivery for nonreassuring fetal status, adverse neonatal outcomes, and neonatal intensive care unit admission in the mechanical induction group, suggesting a more favorable safety profile compared to dinoprostone [13]. Hochberg A. et al. compared extra-amniotic balloon and prostaglandin E2 for labor induction in pregnancies complicated by fetal growth restriction. Although lower crude rates of cesarean delivery and adverse maternal outcomes were observed in the extra-amniotic balloon group, overall maternal and neonatal outcomes were considered comparable between the two induction methods [16]. Al-Hafez L. et al. compared oxytocin plus Cook balloon with misoprostol plus Cook balloon for labor induction in high-risk pregnancies, including cases complicated by fetal growth restriction. The study demonstrated similar rates of cesarean delivery and comparable maternal and neonatal outcomes between the two induction methods [2]. Sayuri Iwai et al. evaluated labor induction in pregnancies with suspected fetal growth restriction and reported a low overall cesarean delivery rate. The authors also observed lower rates of uterine tachysystole and cesarean delivery when oxytocin was discontinued during the active phase of labor, suggesting that this approach may be safely used without increasing adverse maternal or neonatal outcomes [17]. Marieke D. T. de Vaan et al. evaluated different labor induction methods in pregnancies complicated by small-for-gestational-age neonates and reported lower rates of adverse neonatal outcomes with Foley catheter compared to oral misoprostol, particularly regarding low 5-minute Apgar scores and neonatal intensive care unit admissions. These findings suggest a more favorable neonatal safety profile for mechanical induction methods in this population [12].

Conclusions

Late fetal growth restriction remains a significant obstetrical challenge requiring accurate diagnosis and careful intrapartum monitoring. Current evidence suggests that mechanical methods of labor induction may provide a safer profile compared with pharmacological cervical ripening in pregnancies complicated by late FGR.

 

REFERENCES

  1. Al-Hafez, L., Bicocca, M.J., Chauhan, S.P., Berghella, V. Prostaglandins for induction in pregnancies with fetal growth restriction. American Journal of Obstetrics & Gynecology MFM. 2022;4(2):100538. DOI: 10.1016/j.ajogmf.2021.100538.
  2. Al-Hafez, L., Khanuja, K., Mendez-Figueroa, H., Al-Kouatly, H.B., Mascio, D.D., Chauhan, S.P., Berghella, V. Misoprostol with balloon vs oxytocin with balloon in high-risk pregnancy induction: a randomized controlled trial. Am J Obstet Gynecol MFM. 2023;5(12):101175.
  3. Burac, M., Friptu, V., Corolcova, N., Profire, L., Mihalcean, L., Cotelea, V., Caproș, H. The Cytokine Profile of the Endometrial Fluid in Women with Primary Infertility. Medicus. 2026;1(79):6-12.
  4. Burdeniuc, I., Capros, H., Bologan, I., Darii, C., Bologan, I. Dinamica ratei operației cezariene în Spitalul Clinic Municipal „Gheorghe Paladi”. În: Cercetarea în biomedicină și sănătate: calitate, excelență și performanță, Ed. 4, 16-18 octombrie 2024, Chișinău. Chișinău, Republica Moldova, 2024, p. 676.
  5. Capros, H. Restriction de la croissance foetale: les signes echographiques et seriques entre 11-14 semaines d’amenorrhee. Archives of the Balkan Medical Union Supplement. 2016;51(Suppl. 1):38-40.
  6. Capros, H., Scoricova, I., Mihalceanu, L. Intrauterine growth restriction: contemporary issues in diagnosis and management. Moldovan Medical Journal. 2017;2(60):26-30.
  7. Capros, H., Mihalcean, L., Surguci, M. Fetal growth restriction. New terminology and classification. Obstetrics and Gynaecology of Saint-Petersburg. 2020;1(2):6-10.
  8. Capros, H. Restricția de creștere fetală. Actualități de diagnostic. Buletin de Perinatologie. 2020;1(86):74-80.
  9. Capros, H., Codreanu, N., Surguci, M., Mitriuc, D., Voloceai, V., Cotelea, V. Interpretation of cardiotocography in labor through understanding the pathophysiological mechanisms of intrauterine hypoxia. Medicus. 2024;1(55):8-13.
  10. Capros, H., Grejdian-Voloceai, V., Cotelea, V., Mitryuk, D., Marian-Pavlenco, A. Fetal growth restriction-clinical manifestations through the perspective of pathophysiological changes. Journal of Clinical Medicine of Kazakhstan. 2024;21:21-25. DOI: 10.23950/jcmk/14130.
  11. Coliban, N., Capros, H., Codreanu, N., Ivanova, E., Capros, H. Cauze genetice ale restricției de creștere fetală. În: Cercetarea în biomedicină și sănătate: calitate, excelență și performanță, Ed. 4, 16-18 octombrie 2024, Chișinău. Chișinău, Republica Moldova, 2024, p. 677.
  12. de Vaan, M.D.T., Croll, D.M.R., Verhoeven, C.J.M., de Boer, M.A., Jozwiak, M., Ten Eikelder, M.L.G., Mol, B.W., Bloemenkamp, K.W.M., de Heus, R. The influence of various induction methods on adverse outcomes in small for gestational age neonates: A secondary analysis of the PROBAAT 1 and 2 trials. Eur J Obstet Gynecol Reprod Biol. 2023;282:89-93. DOI: 10.1016/j.ejogrb.2023.01.003.
  13. Di Mascio, D., Villalain, C., Rizzo, G., Morales-Rosello, J., Sileo, F.G., Maruotti, G.M., Prefumo, F., Galindo, A., D'Antonio, F. Maternal and neonatal outcomes of pregnancies complicated by late fetal growth restriction undergoing induction of labor with dinoprostone compared with cervical balloon: A retrospective, international study. Acta Obstet Gynecol Scand. 2021;100(7):1313-1321. DOI: 10.1111/aogs.14135.
  14. Dondiuc, I., Alsatou, A., Capros, H. Impact of umbilical cord pathology on perinatal outcomes: risk factors and clinical implications. Revista de Ştiinţe ale Sănătăţii din Moldova. 2024;11(4):10-14. DOI: 10.52645/MJHS.2024.4.02.
  15. Friptu, V., AlDiabat, M., Cardaniuc, C., Surguci, M. Acidul folic: influenţa asupra sarcinii şi lactaţiei. În: Buletin de Perinatologie, 2008, nr. 1, p. 57–59.
  16. Hochberg, A., Amikam, U., Krispin, E., Wiznitzer, A., Hadar, E., Salman, L. Maternal and neonatal outcomes following induction of labor for fetal growth restriction: Extra-amniotic balloon versus prostaglandins. Int J Gynaecol Obstet. 2023;160(2):678-684. DOI: 10.1002/ijgo.14338.
  17. Iwai, S., Mimura, K., Endo, M., Kawanishi, Y., Miyake, T., Hiramatsu, K., Kimura, T., Tomimatsu, T., Kimura, T. Outcome of Inducing Labor in Pregnancies with Suspected Fetal Growth Restriction: Oxytocin Discontinuation during the Active Phase of Labor versus Conventional Management. Am J Perinatol. 2024;41(Suppl. 1):e739-e746. DOI: 10.1055/a-1933-7340.
  18. Jora, A., Bologan, I., Capros, H., Friptu, V., Capros, H. Diagnosticul restricției de creștere fetală în sarcina gemelară. În: Cercetarea în biomedicină și sănătate: calitate, excelență și performanță, Ed. 4, 16-18 octombrie 2024, Chișinău. Chișinău, Republica Moldova, 2024, p. 692.
  19. Mitta, K., Tsakiridis, I., Virgiliou, A., Mamopoulos, A., Caproș, H., Athanasiadis, A., Dagklis, T.I. Ultrasonographic Evaluation of Labor Patterns: A Prospective Cohort Study in Greece. Journal of Clinical Medicine. 2025;14(15):5283. DOI: 10.3390/jcm14155283.
  20. Sprincean, M., Halabudenco, E., Strătilă, R., Secrieru, V. et al. The role of medical-genetic counseling and of prenatal diagnosis in the process of identification of congenital malformations. În: Archives of the Balkan Medical Union. The official journal of the Balkan Medical Union. Republica Moldova, 2013, p. 58.
  21. Villalain, C., Herraiz, I., Quezada, M.S., Gómez Arriaga, P., Simón, E., Gómez-Montes, E., Galindo, A. Labor Induction in Late-Onset Fetal Growth Restriction: Foley Balloon versus Vaginal Dinoprostone. Fetal Diagn Ther. 2019;46(1):67-74. DOI: 10.1159/000491784.

 

REFERENCES

1.   Al-Hafez L., Bicocca M.J., Chauhan S.P., Berghella V. Prostaglandins for induction in pregnancies with fetal growth restriction. American Journal of Obstetrics & Gynecology MFM. 2022;4(2):100538. DOI: 10.1016/j.ajogmf.2021.100538.

2.   Al-Hafez L., Khanuja K., Mendez-Figueroa H., Al-Kouatly H.B., Mascio D.D., Chauhan S.P., Berghella V. Misoprostol with balloon vs oxytocin with balloon in high-risk pregnancy induction: a randomized controlled trial. Am J Obstet Gynecol MFM. 2023;5(12):101175.

3.   Burac M., Friptu V., Corolcova N., Profire L., Mihalcean L., Cotelea V., Caproș H. The Cytokine Profile of the Endometrial Fluid in Women with Primary Infertility. Medicus. 2026;1(79):6-12.

4.   Burdeniuc I., Capros H., Bologan I., Darii C., Bologan I. Dinamica ratei operației cezariene în Spitalul Clinic Municipal „Gheorghe Paladi”. În: Cercetarea în biomedicină și sănătate: calitate, excelență și performanță, Ed. 4, 16-18 octombrie 2024, Chișinău. Chișinău, Republica Moldova, 2024, p. 676.

5.   Capros H. Restriction de la croissance foetale: les signes echographiques et seriques entre 11-14 semaines d’amenorrhee. Archives of the Balkan Medical Union Supplement. 2016;51(Suppl. 1):38-40.

6.   Capros H., Scoricova I., Mihalceanu L. Intrauterine growth restriction: contemporary issues in diagnosis and management. Moldovan Medical Journal. 2017;2(60):26-30.

7.   Capros H., Mihalcean L., Surguci M. Fetal growth restriction. New terminology and classification. Obstetrics and Gynaecology of Saint-Petersburg. 2020;1(2):6-10.

8.   Capros H. Restricția de creștere fetală. Actualități de diagnostic. Buletin de Perinatologie. 2020;1(86):74-80.

9.   Capros H., Codreanu N., Surguci M., Mitriuc D., Voloceai V., Cotelea V. Interpretation of cardiotocography in labor through understanding the pathophysiological mechanisms of intrauterine hypoxia. Medicus. 2024;1(55):8-13.

10. Capros H., Grejdian-Voloceai V., Cotelea V., Mitryuk D., Marian-Pavlenco A. Fetal growth restriction-clinical manifestations through the perspective of pathophysiological changes. Journal of Clinical Medicine of Kazakhstan. 2024;21:21-25. DOI: 10.23950/jcmk/14130.

11. Coliban N., Capros H., Codreanu N., Ivanova E., Capros H. Cauze genetice ale restricției de creștere fetală. În: Cercetarea în biomedicină și sănătate: calitate, excelență și performanță, Ed. 4, 16-18 octombrie 2024, Chișinău. Chișinău, Republica Moldova, 2024, p. 677.

12. de Vaan M.D.T., Croll D.M.R., Verhoeven C.J.M., de Boer M.A., Jozwiak M., Ten Eikelder M.L.G., Mol B.W., Bloemenkamp K.W.M., de Heus R. The influence of various induction methods on adverse outcomes in small for gestational age neonates: A secondary analysis of the PROBAAT 1 and 2 trials. Eur J Obstet Gynecol Reprod Biol. 2023;282:89-93. DOI: 10.1016/j.ejogrb.2023.01.003.

13. Di Mascio D., Villalain C., Rizzo G., Morales-Rosello J., Sileo F.G., Maruotti G.M., Prefumo F., Galindo A., D'Antonio F. Maternal and neonatal outcomes of pregnancies complicated by late fetal growth restriction undergoing induction of labor with dinoprostone compared with cervical balloon: A retrospective, international study. Acta Obstet Gynecol Scand. 2021;100(7):1313-1321. DOI: 10.1111/aogs.14135.

14. Dondiuc I., Alsatou A., Capros H. Impact of umbilical cord pathology on perinatal outcomes: risk factors and clinical implications. Revista de Ştiinţe ale Sănătăţii din Moldova. 2024;11(4):10-14. DOI: 10.52645/MJHS.2024.4.02.

15. Friptu V., AlDiabat M., Cardaniuc C., Surguci M. Acidul folic: influenţa asupra sarcinii şi lactaţiei. În: Buletin de Perinatologie, 2008, nr. 1, p. 57–59.

16. Hochberg A., Amikam U., Krispin E., Wiznitzer A., Hadar E., Salman L. Maternal and neonatal outcomes following induction of labor for fetal growth restriction: Extra-amniotic balloon versus prostaglandins. Int J Gynaecol Obstet. 2023;160(2):678-684. DOI: 10.1002/ijgo.14338.

17. Iwai S., Mimura K., Endo M., Kawanishi Y., Miyake T., Hiramatsu K., Kimura T., Tomimatsu T., Kimura T. Outcome of Inducing Labor in Pregnancies with Suspected Fetal Growth Restriction: Oxytocin Discontinuation during the Active Phase of Labor versus Conventional Management. Am J Perinatol. 2024;41(Suppl. 1):e739-e746. DOI: 10.1055/a-1933-7340.

18. Jora A., Bologan I., Capros H., Friptu V., Capros H. Diagnosticul restricției de creștere fetală în sarcina gemelară. În: Cercetarea în biomedicină și sănătate: calitate, excelență și performanță, Ed. 4, 16-18 octombrie 2024, Chișinău. Chișinău, Republica Moldova, 2024, p. 692.

19. Mitta K., Tsakiridis I., Virgiliou A., Mamopoulos A., Caproș H., Athanasiadis A., Dagklis T.I. Ultrasonographic Evaluation of Labor Patterns: A Prospective Cohort Study in Greece. Journal of Clinical Medicine. 2025;14(15):5283. DOI: 10.3390/jcm14155283.

20. Sprincean M., Halabudenco E., Strătilă R., Secrieru V. et al. The role of medical-genetic counseling and of prenatal diagnosis in the process of identification of congenital malformations. În: Archives of the Balkan Medical Union. The official journal of the Balkan Medical Union. Republica Moldova, 2013, p. 58.

21. Villalain C., Herraiz I., Quezada M.S., Gómez Arriaga P., Simón E., Gómez-Montes E., Galindo A. Labor Induction in Late-Onset Fetal Growth Restriction: Foley Balloon versus Vaginal Dinoprostone. Fetal Diagn Ther. 2019;46(1):67-74. DOI: 10.1159/000491784.

 

Материал поступил в редакцию 13.05.26

 

 

ПОЗДНЯЯ ЗАДЕРЖКА РОСТА ПЛОДА: ДИАГНОСТИЧЕСКИЕ ПРОБЛЕМЫ

И СОВРЕМЕННЫЕ СТРАТЕГИИ ИНДУКЦИИ

 

Капрош Христиана, доцент кафедры акушерства и гинекологии

Государственный медицинский медико-фармацевтический университет им. Николае Тестемицану

(MD 2001, Республика Молдова, г. Кишинев, бд. Штефан чел Маре, 165)

E-mail: hristiana.capros@usmf.md

 

Сургуч Михай, доцент кафедры акушерства и гинекологии

Государственный медицинский медико-фармацевтический университет им. Николае Тестемицану

(MD 2001, Республика Молдова, г. Кишинев, бд. Штефан чел Маре, 165)

E-mail: surguci.mihail@usmf.md

 

Бурак Михаэла, ассистент кафедры акушерства и гинекологии

Государственный медицинский медико-фармацевтический университет им. Николае Тестемицану

(MD 2001, Республика Молдова, г. Кишинев, бд. Штефан чел Маре, 165)

E-mail: burac.mihaela@usmf.md

 

Ион Бологан, доцент кафедры акушерства и гинекологии

Государственный медицинский медико-фармацевтический университет им. Николае Тестемицану

(MD 2001, Республика Молдова, г. Кишинев, бд. Штефан чел Маре, 165)

E-mail: ion.bologan@usmf.md

 

Аннотация. Актуальность. Задержка роста плода остаётся одной из актуальных проблем современной акушерской практики в связи с высокой частотой перинатальной заболеваемости, смертности и возможными отдалёнными неонатальными осложнениями. Поздняя форма задержки роста плода, диагностируемая после 32 недель беременности, является наиболее распространённой клинической формой и характеризуется менее выраженными допплерометрическими изменениями и сохранёнными компенсаторными механизмами плода. Цель исследования. Проанализировать современные диагностические критерии поздней задержки роста плода и оценить современные данные о методах индукции родов при данной патологии. Материал и методы. Проведён обзор современной литературы, посвящённой диагностическим критериям согласно Delphi-консенсусу и сравнительным исследованиям механических и фармакологических методов индукции родов при поздней задержке роста плода. Результаты. Delphi-консенсус позволил стандартизировать диагностику за счёт объединения биометрических и допплерометрических критериев. Современные исследования показывают, что механические методы подготовки шейки матки, в частности катетер Фолея и экстраамниотический баллон, сопровождаются меньшей частотой тахисистолии, кесарева сечения по поводу дистресса плода и госпитализации новорождённых в отделение интенсивной терапии по сравнению с динопростоном. Выводы. Поздняя задержка роста плода требует точной пренатальной диагностики и индивидуализированного выбора акушерской тактики. Механические методы подготовки шейки матки в ряде случаев демонстрируют лучшие показатели материнской и перинатальной переносимости.

Ключевые слова: поздняя задержка роста плода, индукция родов, катетер Фолея, плацентарная недостаточность, измерение скорости потока с помощью эффекта Доплера.