Impact on obstetric outcome of third‐trimester screening for small‐for‐gestational‐age fetuses

Callec, R.; Lamy, Claire; Perdriolle-Galet, E.; Patte, Charlotte; Heude, Barbara; Morel, Olivier

doi:10.1002/uog.14755

Cited by 31 publications

(15 citation statements)

References 23 publications

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“…Nevertheless, the performance of SFH measurement for the identification of abnormal fetal growth has been shown to be poor. As an alternative, universal third‐trimester screening to determine estimated fetal weight centile (EFWc) is also offered in some countries, and has shown better performance than SFH, but still, can only identify around half or less of small fetuses.…”

Section: Introductionmentioning

confidence: 99%

Prediction of fetal growth restriction using estimated fetal weight vs a combined screening model in the third trimester

Miranda

Rodríguez-López

Triunfo

et al. 2017

Ultrasound in Obstet & Gyne

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Section: Introductionmentioning

confidence: 99%

Prediction of fetal growth restriction using estimated fetal weight vs a combined screening model in the third trimester

Miranda

Rodríguez-López

Triunfo

et al. 2017

Ultrasound in Obstet & Gyne

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“…Fetal growth restriction and being small-for-gestational age (SGA) are major causes of adverse perinatal outcome [1][2][3] . Ultrasound is the method commonly used in practice for SGA screening; however, screening accuracy is variable between studies and is relatively poor [4][5][6][7][8][9][10][11][12] . Biometric measurements are reported on the basis of fetal growth curves.…”

Section: Introductionmentioning

confidence: 99%

Prediction of small‐for‐gestational‐age neonate by third‐trimester fetal biometry and impact of ultrasound–delivery interval

Reboul

Delabaere

Luo

et al. 2017

Ultrasound in Obstet & Gyne

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“…Yet, there has been considerable controversy about the need for serial biometry measurements during pregnancy [9,10], and at the present time, professional organizations do not recommend this approach [11]. Controversies include: which reference range or standard to use for fetal size and growth (e.g., local vs. international) [12–15], the timing at which fetal biometry should be obtained [16], the need for serial measurements [17], which specific anatomic parameters to monitor (e.g., abdominal circumference, head circumference, estimated fetal weight), and the precise cutoff points to identify abnormalities. Moreover, the diagnostic endpoint is also a subject of controversy.…”

Section: Introductionmentioning

confidence: 99%

Single and Serial Fetal Biometry to Detect Preterm and Term Small- and Large-for-Gestational-Age Neonates: A Longitudinal Cohort Study

et al. 2016

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ObjectivesTo assess the value of single and serial fetal biometry for the prediction of small- (SGA) and large-for-gestational-age (LGA) neonates delivered preterm or at term.MethodsA cohort study of 3,971 women with singleton pregnancies was conducted from the first trimester until delivery with 3,440 pregnancies (17,334 scans) meeting the following inclusion criteria: 1) delivery of a live neonate after 33 gestational weeks and 2) two or more ultrasound examinations with fetal biometry parameters obtained at ≤36 weeks. Primary outcomes were SGA (<5th centile) and LGA (>95th centile) at birth based on INTERGROWTH-21st gender-specific standards. Fetus-specific estimated fetal weight (EFW) trajectories were calculated by linear mixed-effects models using data up to a fixed gestational age (GA) cutoff (28, 32, or 36 weeks) for fetuses having two or more measurements before the GA cutoff and not already delivered. A screen test positive for single biometry was based on Z-scores of EFW at the last scan before each GA cut-off so that the false positive rate (FPR) was 10%. Similarly, a screen test positive for the longitudinal analysis was based on the projected (extrapolated) EFW at 40 weeks from all available measurements before each cutoff for each fetus.ResultsFetal abdominal and head circumference measurements, as well as birth weights in the Detroit population, matched well to the INTERGROWTH-21st standards, yet this was not the case for biparietal diameter (BPD) and femur length (FL) (up to 9% and 10% discrepancy for mean and confidence intervals, respectively), mainly due to differences in the measurement technique. Single biometry based on EFW at the last scan at ≤32 weeks (GA IQR: 27.4–30.9 weeks) had a sensitivity of 50% and 53% (FPR = 10%) to detect preterm and term SGA and LGA neonates, respectively (AUC of 82% both). For the detection of LGA using data up to 32- and 36-week cutoffs, single biometry analysis had higher sensitivity than longitudinal analysis (52% vs 46% and 62% vs 52%, respectively; both p<0.05). Restricting the analysis to subjects with the last observation taken within two weeks from the cutoff, the sensitivity for detection of LGA, but not SGA, increased to 65% and 72% for single biometry at the 32- and 36-week cutoffs, respectively. SGA screening performance was higher for preterm (<37 weeks) than for term cases (73% vs 46% sensitivity; p<0.05) for single biometry at ≤32 weeks.ConclusionsWhen growth abnormalities are defined based on birth weight, growth velocity (captured in the longitudinal analysis) does not provide additional information when compared to the last measurement for predicting SGA and LGA neonates, with both approaches detecting one-half of the neonates (FPR = 10%) from data collected at ≤32 weeks. Unlike for SGA, LGA detection can be improved if ultrasound scans are scheduled as close as possible to the gestational-age cutoff when a decision regarding the clinical management of the patient needs to be made. Screening performance for SGA is higher for neonates that will...

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Impact on obstetric outcome of third‐trimester screening for small‐for‐gestational‐age fetuses

Abstract: Objectives To evaluate the performance of screening for small-for-gestational-age (SGA) fetuses by ultrasound biometry at 30-35 weeks' gestation, and to

Cited by 31 publications

References 23 publications

Prediction of fetal growth restriction using estimated fetal weight vs a combined screening model in the third trimester

Prediction of fetal growth restriction using estimated fetal weight vs a combined screening model in the third trimester

Prediction of small‐for‐gestational‐age neonate by third‐trimester fetal biometry and impact of ultrasound–delivery interval

Single and Serial Fetal Biometry to Detect Preterm and Term Small- and Large-for-Gestational-Age Neonates: A Longitudinal Cohort Study

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