When should delivery occur in uncomplicated cases of FGR when EFW is less than 3%?

In uncomplicated cases of fetal growth restriction (FGR) where the estimated fetal weight (EFW) is less than the 3rd percentile, the recommendation is to plan for delivery around 37 weeks of gestation. This timing is crucial because while some pregnancies can continue longer, the risk of adverse outcomes increases as gestation advances beyond this point in cases of FGR. Delivering at 37 weeks allows for the benefits of fetal maturation to be maximized while also addressing the risks associated with prolonged pregnancy in the presence of FGR.

The rationale is grounded in the understanding that the placental insufficiency, which typically causes FGR, may lead to increased risks for fetal distress, stillbirth, and other complications if the pregnancy extends too far into the third trimester. By 37 weeks, most infants demonstrate sufficient development to handle the stresses of extrauterine life, making this a clinically sound choice.

Timely delivery helps ensure better neonatal outcomes while balancing the necessary maturation of the fetus. Therefore, planning for delivery at 37 weeks provides a clinical strategy that aligns with current guidelines for managing cases of FGR without complications.