Severe fetal growth restriction at 26–32 weeks : key messages from the TRUFFLE study

What was the TRUFFLE study? The Trial of Randomized Umbilical and Fetal Flow in Europe (TRUFFLE) was a prospective, multicenter, unblinded, randomized trial that ran between 1 January 2005 and 1 October 2010 in 20 European centers 1 . It studied singleton pregnancies at 26–32 weeks of gestation with a diagnosis of fetal growth restriction (FGR), defined as abdominal circumference < 10th percentile and high umbilical artery Doppler pulsatility index (PI) (> 95th percentile). In order to assess whether changes in the fetal ductus venosus (DV) Doppler waveform or short-term variation (STV) on cardiotocography (CTG) should be used as a trigger for delivery in these pregnancies, the 503 included women were randomly allocated to one of three ‘timing-of-delivery’ plans (with 1 : 1 : 1 randomization).