Dr Gerard Albaigés, head of R&D at the Foetal Medicine Division of the Obstetrics Unit of Dexeus Mujer is part of the team of researchers participating in the prospective, multicentre study TRUFFLE 2 (Trial of Randomised Umbilical and Foetal Flow in Europe). The aim of this study is to address monitoring and optimal thresholds for delivery in late-onset foetal growth restriction, from 32-36 weeks of pregnancy. This study builds on the work of the team that implemented TRUFFLE 1 between 2005 and 2010.

Until the TRUFFLE study, the optimal time to deliver growth-restricted foetuses depended on the experience of the individual clinician and/or institution. The clinician considered and weighed the risks of stillbirth, obstetric intervention, prematurity, neonatal death, and long-term neurodevelopmental impairment. The study sought to determine whether an optimal monitoring modality and delivery threshold could be established.

To date, no intervention other than delivery has been reported to have an impact on late-onset foetal growth restriction. However, increasing the prevalence of preterm births through intervention in pregnancies considered to be at risk is associated with increased morbidity for the mother (due to caesarean section, induction of labour) and her baby (increased risk of poor birth outcomes and the consequences of neonatal admissions), and even with a small but significant increase in the risk of the child having special needs at school.

TRUFFLE 2 involves leading perinatal centres in the UK, Europe, and Scandinavia, with excellent foetal, obstetric, and neonatal medicine services. This group now has over 30 members committed to prospective research in high-risk perinatology and foetal growth restriction. Dexeus Mujer is currently the only centre in Spain that participates in this study.