Adverse Birth Outcomes in Relation to Prenatal Sonographic Measurements of Fetal Size

Abstract

Morbidity and mortality are significantly increased among fetuses with an estimated fetal weight in the 5th percentile or less for gestational age.

Microcephaly is associated with early adverse neurologic outcomes in hypoplastic left heart syndrome

“…Taken together, brain findings and anthropometrics may inform ongoing efforts to develop new neuroprotection strategies. Surprisingly, neither LBW nor SGA infants with HLHS demonstrated an increased frequency of adverse clinical outcomes, including mortality, at 1 y, which is contrary to previous reports (12,24,25). Although this may reflect an inadequate cohort size, a more compelling possibility is that by excluding prematurity and genetic syndromes (high-risk infants), two common causes of LBW, adverse outcomes are associated more strongly with gestational age rather than weight (26).…”

Value of third‐trimester cerebroplacental ratio and uterine artery Doppler indices as predictors of stillbirth and perinatal loss

“…The validity of using small fetal size, defined as small‐for‐gestational age (SGA), to identify pregnancies complicated by placental failure has been called into question by recent studies. It is relatively well accepted that a good proportion of small babies have been growing at a normal rate along their own centile lines and that the majority of term stillbirths are not SGA. In search for a better marker of fetal compromise secondary to placental insufficiency at term, some researchers have suggested that the cerebroplacental ratio (CPR), calculated as the simple ratio between the middle cerebral artery pulsatility index (MCA‐PI) and the umbilical artery pulsatility index (UA‐PI), is better related to placental insufficiency and fetal compromise at term than is birth weight (BW).…”

Second and third trimester fetal ultrasound population screening for risks of preterm birth and small-size and large-size for gestational age at birth: a population-based prospective cohort study

“…Monitoring could be intensified by additional assessments of fetal size, cervical length and umbilical artery waveforms using (Doppler) ultrasound and fetal wellbeing using cardiotocography, which might further improve detection of fetuses at risk of adverse outcomes whom may benefit from interventions, such as administering steroids for fetal lung maturation if preterm birth is imminent or termination of pregnancy if signs of placental insufficiency occur. Previous studies have shown that SGA or LGA newborns who were identified antenatally have lower risks of morbidity and mortality, compared to those who were unidentified antenatally [6][7][8][9]. However, it has also been suggested that prenatal diagnosis of abnormal fetal growth may lead to poorer outcomes due to subsequent interventions [43].…”

“…The majority of newborns who experience abnormal fetal growth are unidentified until birth [3][4][5][6]. SGA or LGA newborns who have not been identified antenatally have strongly increased risks of morbidity and mortality, compared to those who have been identified antenatally [6][7][8][9]. Abnormal fetal growth is an important reason for induction of labour and is therefore a common cause of induced preterm birth [3,10].…”

“…Abnormal fetal growth is an important reason for induction of labour and is therefore a common cause of induced preterm birth [3,10]. However, studies have shown that spontaneous preterm birth is often preceded by impaired or accelerated fetal growth [3,9]. Current pregnancy care protocols include dating ultrasounds and detailed structural ultrasounds at 20 weeks gestational age (GA) to assess congenital anomalies and fetal size [11,12].…”