Evaluation of early third-trimester ultrasound screening for intrauterine growth retardation.

Skovron, Mary Louise; Gs, Berkowitz; Lapinski, Robert; Kim, J M; Chitkara, Usha

doi:10.7863/jum.1991.10.3.153

Cited by 44 publications

(34 citation statements)

References 11 publications

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“…However, the rarest and severest form of the disease is fortunately the one that is easier to diagnose either by its common association with maternal hypertension or by second trimester abnormal fetal growth and/or uterine Doppler studies. Recent research has shown that early severe growth restriction may be detected from the first trimester using combinations of fetal biometry, maternal biochemistry and uterine Dopplers . The prediction models presented in our study apply for the late SGA.…”

Section: Discussionmentioning

confidence: 89%

Performance of the ultrasound examination in the early and late third trimester for the prediction of birth weight deviations

et al. 2013

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Section: Discussionmentioning

confidence: 89%

Performance of the ultrasound examination in the early and late third trimester for the prediction of birth weight deviations

et al. 2013

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“…Additionally, some research findings support the use of a small (<10th percentile) abdominal circumference as a sensitive predictor of small for gestational age [7-10]. However, small abdominal circumference alone, in the absence of growth restriction has not been associated with adverse neonatal outcomes [1-5,7,8,11-17]. …”

Section: Introductionmentioning

confidence: 99%

Association of third-trimester abdominal circumference with provider-initiated preterm delivery

Hawkins

Schnettler

Modest

et al. 2013

The Journal of Maternal-Fetal & Neonatal Medicine

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Objective Evaluate the association of a small third-trimester abdominal circumference (AC < 10th percentile) in the setting of a normal estimated fetal weight (EFW ≥ 10th percentile) with gestational age at delivery, indication for delivery and neonatal outcomes. Methods Retrospective cohort study at an academic hospital of women with singleton pregnancy seen for ultrasound from 28+0-33+6 weeks of gestation during 2009-2011. Outcomes were compared between two groups: normal AC (AC and EFW ≥ 10th percentile) and small AC (AC < 10th percentile and EFW ≥ 10th percentile). Results Among 592 pregnancies, fetuses in the small AC group (n = 55) experienced a higher incidence of overall preterm delivery (RR: 2.2, 95% Cl: 1.3–3.7) and provider-initiated preterm delivery (RR: 3.7, Cl: 1.8–7.5) compared to those in the normal AC group (n = 537). Neonates in the small AC group had a lower median birth weight whether delivered at term (p < 0.001) or preterm (p = 0.04), but were not more likely to experience intensive care unit admission or respiratory distress syndrome (all p ≥ 0.35). Conclusions Small AC, even in the setting of an EFW ≥ 10th percentile, was associated with a higher incidence of overall and provider-initiated preterm delivery despite similar neonatal outcomes. Further investigation is warranted to determine whether these preterm deliveries could be prevented.

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“…However, most SGA babies remain unnoticed until birth, even when routine third-trimester ultrasound is performed [3,4]. Moreover, according to pregnancy audits, most instances of avoidable stillbirth are related with a failure to antenatally detect SGA [5].…”

Section: Introductionmentioning

confidence: 99%

Update on the Diagnosis and Classification of Fetal Growth Restriction and Proposal of a Stage-Based Management Protocol

Figueras

Gratacós²

2014

Fetal Diagn Ther

609

672

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Small fetuses are defined as those with an ultrasound estimated weight below a threshold, most commonly the 10th centile. The first clinically relevant step is the distinction of ‘true' fetal growth restriction (FGR), associated with signs of abnormal fetoplacental function and poorer perinatal outcome, from constitutional small-for-gestational age, with a near-normal perinatal outcome. Nowadays such a distinction should not be based solely on umbilical artery Doppler, since this index detects only early-onset severe forms. FGR should be diagnosed in the presence of any of the factors associated with a poorer perinatal outcome, including Doppler cerebroplacental ratio, uterine artery Doppler, a growth centile below the 3rd centile, and, possibly in the near future, maternal angiogenic factors. Once the diagnosis is established, differentiating into early- and late-onset FGR is useful mainly for research purposes, because it distinguishes two clear phenotypes with differences in severity, association with preeclampsia, and the natural history of fetal deterioration. As a second clinically relevant step, management of FGR and the decision to deliver aims at an optimal balance between minimizing fetal injury or death versus the risks of iatrogenic preterm delivery. We propose a protocol that integrates current evidence to classify stages of fetal deterioration and establishes follow-up intervals and optimal delivery timings, which may facilitate decisions and reduce practice variability in this complex clinical condition.

show abstract

Evaluation of early third-trimester ultrasound screening for intrauterine growth retardation.

Cited by 44 publications

References 11 publications

Performance of the ultrasound examination in the early and late third trimester for the prediction of birth weight deviations

Performance of the ultrasound examination in the early and late third trimester for the prediction of birth weight deviations

Association of third-trimester abdominal circumference with provider-initiated preterm delivery

Update on the Diagnosis and Classification of Fetal Growth Restriction and Proposal of a Stage-Based Management Protocol

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