Fetal Size and Dating: Charts Recommended for Clinical Obstetric Practice

Loughna, Pamela; Chitty, Lyn S.; Evans, Tony; Chudleigh, Trish

doi:10.1179/174313409x448543

Cited by 175 publications

(186 citation statements)

References 5 publications

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“…14 73 79 84 91 98 104 112 15 92 100 106 115 123 132 142 16 116 125 134 144 155 166 179 17 145 156 167 179 193 206 222 18 179 193 206 222 239 255 275 19 219 236 252 272 293 313 337 20 267 287 307 330 356 380 410 21 322 347 370 399 429 459 494 22 385 415 443 477 514 549 591 23 457 492 526 566 610 651 Second, reliable data on last menstrual period were largely unavailable, which could lead to lower mean fetal weights by GA. 33,34 Third, late presentation to the prenatal clinic, a frequent occurrence in PNG, precluded pregnancy dating using CRL in most participants. Error margins of GA estimates based on fetal biometry increase with advancing GA, 15,19 and an episode of FGR before a dating measurement will underestimate GA, translating into lower fetal weight centiles. However, exclusion of pregnancies affected by severe maternal disease, congenital abnormalities, and stillbirth should have somewhat limited the number of fetuses that may have suffered early-onset FGR in this cohort.…”

Section: Discussionmentioning

confidence: 99%

“…16 In the second trimester, GA was estimated using the HC (FL if HC unavailable) until 24 GW + 6 days. 15 The biparietal diameter was not used for dating or growth assessments. 18 Measurements from enrollment scans were used to define GA.…”

Section: Methodsmentioning

confidence: 99%

“…): 92.5% of images fulfilled the criteria for inclusion in subsequent analyses. 15 A sample size calculation was not performed for this substudy, because the cohort size was determined by the number of healthy women presenting at an appropriate gestation and the availability of scanning equipment and trained personnel.…”

Section: Methodsmentioning

confidence: 99%

“…17 At the first ultrasound visit, gestational age (GA) in days was estimated in accordance with the British Medical Ultrasound Society guidelines using dating standards derived from a Caucasian population. 15 When available, CRL measurements were used to estimate GA until 75 mm (13 GW + 4 days). 16 In the second trimester, GA was estimated using the HC (FL if HC unavailable) until 24 GW + 6 days.…”

Section: Methodsmentioning

confidence: 99%

“…The fetal biometric parameters crown-rump length (CRL), abdominal circumference (AC), head circumference (HC), and femur length (FL) were measured. 15,16 The average of two measurements (three for CRL) was used when available. AC was measured using the ellipse facility (extreme perimeter of a wellmagnified circular section) in images that displayed a lateral spine, a short segment of the umbilical vein in the anterior third, and the stomach bubble.…”

Section: Methodsmentioning

confidence: 99%

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Fetal Size in a Rural Melanesian Population with Minimal Risk Factors for Growth Restriction: An Observational Ultrasound Study from Papua New Guinea

Unger

Karl

Wangnapi

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. We conducted a prospective longitudinal study of fetal size in rural Papua New Guinea (PNG) involving 439 ultrasound-dated singleton pregnancies with no obvious risk factors for growth restriction. Sonographically estimated fetal weights (EFWs; N = 788) and birth weights (N = 376) were included in a second-order polynomial regression model (optimal fit) to generate fetal weight centiles. Means for specific fetal biometric measurements were also estimated. Fetal weight centiles from a healthy PNG cohort were consistently lower than those derived from Caucasian and Congolese populations, which overestimated the proportion of fetuses measuring small for gestational age (SGA; 10th centile). Tanzanian and global reference centiles (Caucasian weight reference adapted to our PNG cohort) were more similar to those observed in our cohort, but the global reference underestimated SGA. Individual biometric measurements did not differ significantly from other cohorts. In rural PNG, a locally derived nomogram may be most appropriate for detection of SGA fetuses.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Fetal Size in a Rural Melanesian Population with Minimal Risk Factors for Growth Restriction: An Observational Ultrasound Study from Papua New Guinea

Unger

Karl

Wangnapi

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Earlier detection of hypochondroplasia: A large single‐center UK case series and systematic review

Sabir

Sheikh

Singh

et al. 2020

American J of Med Genetics Pt A

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Hypochondroplasia (HCH) is a rare autosomal dominant skeletal dysplasia condition caused by FGFR3 mutations leading to disproportionate short stature. Classically HCH presents in toddlers or school‐age children, as limb‐to‐trunk disproportion and is often mild and easily overlooked during infancy. We report experiences from a single‐center UK HCH‐cohort of 31 patients, the rate of antenatal HCH detection in our cohort (13/31, 41.9%) and describe relevant case‐data for this subset of 13 patients. Inclusion criteria were patients with confirmed molecular HCH diagnosis (by age 3 years) and presenting with short long‐bones or large head size on antenatal ultrasound scan. We then conducted a systematic literature review using PUBMED and MEDLINE, analyzing patients with HCH and related antenatal findings. Antenatally suspected (with subsequent molecular confirmation) HCH has been reported 15 times in the literature (2004–2019). Key markers (consistent in both groups) included reduced; femur length, humeral length and increased; biparietal diameter and head circumference. HCH is increasingly detected both antenatally and in infancy, contrary to previous descriptions. This is likely due to greater HCH awareness, improved imaging, and easier molecular testing. Thus, one should consider HCH outside the classical presenting period. Studying the natural history of younger patients with HCH is important with the advent of several targeted FGFR3 therapies currently in trials for Achondroplasia, that may soon be trialed in HCH.

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Cooperative Supramolecular Polymerization and Amplification of Chirality in C₃‐Symmetrical OPE‐Based Trisamides

García

Viruela

Matesanz³

et al. 2011

Chemistry A European J

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Objective To establish an algorithm for first‐trimester combined screening for trisomy 21 with biochemical testing from 7 to 14 weeks' gestation and ultrasound testing at 11–13 weeks. Methods This was a multicenter study of 886 pregnancies with trisomy 21 and 222 475 unaffected pregnancies with measurements of free β‐human chorionic gonadotropin (β‐hCG) and pregnancy‐associated plasma protein‐A (PAPP‐A) at 7–14 weeks' gestation. Multiple regression modeling of log‐transformed marker values was used to produce log multiples of the median (MoM) values for PAPP‐A and free β‐hCG. The models included terms for the center attended and the machine used for biochemical analysis, gestational age, maternal racial origin, maternal weight, smoking status and method of conception. Bivariate Gaussian distributions were fitted to log MoM PAPP‐A and log MoM free β‐hCG in trisomy 21 and in unaffected pregnancies. In each case the patient‐specific risk for trisomy 21 was estimated by multiplying the individual maternal age‐related risk with the likelihood ratio (LR) for fetal nuchal translucency (NT) according to the mixture model and the combined LR for maternal serum free β‐hCG and PAPP‐A. Estimates of detection rates for trisomy 21 and false‐positive rates were calculated for combined screening with measurements of NT at 12 weeks together with measurements of free β‐hCG and PAPP‐A from 8 to 13 weeks. Results In trisomy 21 pregnancies the mean log MoM free β‐hCG increased linearly with gestation between 7 and 14 weeks, whereas the relation between log MoM PAPP‐A and gestation was fitted by a quadratic equation such that the maximum separation between trisomy 21 and unaffected pregnancies occurs at 9–10 weeks. At a false‐positive rate of 3% the detection rate of combined screening at 12 weeks was 86% and this increased to 90% by biochemical testing at 9 weeks and ultrasound scanning at 12 weeks. The detection rate increased to 92% by measuring PAPP‐A at 9 weeks and free β‐hCG at the time of the scan at 12 weeks. Conclusion The performance of first‐trimester biochemical screening for trisomy 21 is best at 9–10 weeks rather than at 7–8 or 11–14 weeks. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.

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Fetal Size and Dating: Charts Recommended for Clinical Obstetric Practice

Abstract: Technique CRL measurements can be carried out trans-abdominally or trans-vaginally. A midline sagittal section of the whole embryo

Cited by 175 publications

References 5 publications

Fetal Size in a Rural Melanesian Population with Minimal Risk Factors for Growth Restriction: An Observational Ultrasound Study from Papua New Guinea

Fetal Size in a Rural Melanesian Population with Minimal Risk Factors for Growth Restriction: An Observational Ultrasound Study from Papua New Guinea

Earlier detection of hypochondroplasia: A large single‐center UK case series and systematic review

Cooperative Supramolecular Polymerization and Amplification of Chirality in C₃‐Symmetrical OPE‐Based Trisamides

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Fetal Size and Dating: Charts Recommended for Clinical Obstetric Practice

Abstract: Technique CRL measurements can be carried out trans-abdominally or trans-vaginally. A midline sagittal section of the whole embryo

Cited by 175 publications

References 5 publications

Fetal Size in a Rural Melanesian Population with Minimal Risk Factors for Growth Restriction: An Observational Ultrasound Study from Papua New Guinea

Fetal Size in a Rural Melanesian Population with Minimal Risk Factors for Growth Restriction: An Observational Ultrasound Study from Papua New Guinea

Earlier detection of hypochondroplasia: A large single‐center UK case series and systematic review

Cooperative Supramolecular Polymerization and Amplification of Chirality in C3‐Symmetrical OPE‐Based Trisamides

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Cooperative Supramolecular Polymerization and Amplification of Chirality in C₃‐Symmetrical OPE‐Based Trisamides