1. Executive summary	7
2. Target audience	11
3. Assessment of quality of evidence and grading of strength of recommendations	12
4. Fetal growth restriction: background, definition, etiology, and risks	13
4.1. Background	13
4.2. Terminology and definitions	13
4.2.1. Consensus‐based definition of placenta‐related fetal growth restriction	13
4.2.2. Early‐ versus late‐onset fetal growth restriction	13
4.3. Etiology of fetal growth restriction	16
4.4. Risks associated with fetal growth restriction	16
4.5. Recommendations	17
5. Early prediction and prevention of fetal growth restriction	18
5.1. History‐based risk factors	18
5.2. Biochemical markers	18
5.3. Ultrasound markers	19
5.4. Prediction models	19
5.5. Prevention of fetal growth restriction in high‐risk populations	20
5.5.1. Lifestyle modifications	20
5.5.2. Medical interventions	20
5.6. Recommendations	21
6. Detection of fetal growth restriction	22
6.1. Symphysis–fundal height	22
6.2. Sonographic fetal weight estimation	22
6.3. Is there a role for routine third‐trimester ultrasound to assess fetal growth?	22
6.4. Which growth chart should be used to determine fetal weight percentile?	23
6.4.1. Growth references versus growth standards	23
6.4.2. Charts based on birth weight versus sonographic fetal weight estimation	23
6.4.3. Universal versus customized charts	24
6.4.4. Description of commonly available charts	24
6.4.5. How to choose the best chart	25
6.5. How to assess fetal growth in twin gestations	26
6.6. Recommendations	27
7. What kind of investigations should be performed when fetal growth restriction is suspected?	28
7.1. Detailed history	28
7.2. Detailed anatomy scan	28
7.3. Doppler studies	28
7.4. Additional testing	28
7.5. Recommendations	29
8. Management of pregnancies with fetal growth restriction	30
8.1. Monitoring	30
8.1.1. Fetal movement counting	30
8.1.2. Fetal heart rate monitoring	30
8.1.3. Computerized fetal heart rate monitoring	32
8.1.4. Ultrasound measurement of amniotic fluid volume	33
8.1.5. Biophysical profile scoring	33
8.1.6. Umbilical artery Doppler	33
8.1.7. Cerebral artery Doppler	33
8.1.8. Ductus venosus Doppler	34
8.1.9. Surveillance strategy	34
8.2. Timing of delivery	35
8.2.1. Gestational age‐related risks in fetal growth restriction	35
8.2.2. Gestational age‐related management strategy	35
8.2.3. Absolute delivery criteria for fetal growth restriction (independent of gestational age)	35
8.2.4. Relative delivery criteria for fetal growth restriction (adjusted for gestational age)	36
8.3. Mode of delivery and intrapartum considerations	36
8.4. Medical interventions	37
8.4.1. Antenatal corticosteroids	37
8.4.2. Magnesium sulfate for neuroprotection	37
8.4.3. Treatments under investigation	37
8.5. Recommendations	38
9. Postpartum assessment and counselling for future pregnancies	40
9.1. Infant follow‐up	40
9.2. Maternal follow‐up	40
9.3. Counselling regarding future pregnancies	40
9.3.1. Risk of recurrence based on severity and onset	40
9.3.2. Risk of recurrence based on placental histopathology	41
9.3.3. Role of thrombophilia screening	41
9.3.4. Preconception counselling and management of future pregnancies	41
9.4. Recommendations	43
10. Summary and future research directions	44
11. References	45