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Grantz KL, Grewal J, Kim S, Grobman WA, Newman RB, Owen J, Sciscione A, Skupski D, Chien EK, Wing DA, Wapner RJ, Ranzini AC, Nageotte MP, Craigo S, Hinkle SN, D'Alton ME, He D, Tekola-Ayele F, Hediger ML, Buck Louis GM, Zhang C, Albert PS. Unified standard for fetal growth velocity: the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies. Am J Obstet Gynecol 2022; 227:916-922.e1. [PMID: 35926648 PMCID: PMC9729377 DOI: 10.1016/j.ajog.2022.07.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 07/26/2022] [Indexed: 01/27/2023]
Affiliation(s)
- Katherine L Grantz
- Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
| | - Jagteshwar Grewal
- Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
| | - Sungduk Kim
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | | | - Roger B Newman
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC
| | - John Owen
- University of Alabama at Birmingham, Birmingham, AL
| | - Anthony Sciscione
- Department of Obstetrics and Gynecology, ChristianaCare Health System, Newark, DE
| | | | - Edward K Chien
- Women and Infants Hospital of Rhode Island, Providence, RI; Cleveland Clinic, Cleveland, OH
| | - Deborah A Wing
- University of California, Irvine, Orange, CA; Fountain Valley Regional Hospital and Medical Center, Fountain Valley, CA
| | | | - Angela C Ranzini
- Saint Peter's University Hospital, New Brunswick, NJ; The MetroHealth System, Cleveland, OH
| | - Michael P Nageotte
- Miller Children's and Women's Hospital Long Beach/Long Beach Memorial Medical Center, Long Beach, CA
| | - Sabrina Craigo
- Department of Obstetrics and Gynecology, Tufts Medical Center, Boston, MA
| | - Stefanie N Hinkle
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | | | - Dian He
- Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD; The Prospective Group, Inc, Fairfax, VA
| | - Fasil Tekola-Ayele
- Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
| | - Mary L Hediger
- Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
| | | | - Cuilin Zhang
- Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD; Bia-Echo Asia Centre for Reproductive Longevity & Equality, Yong Loo Lin School of Medicine, National University of Singapore, Queenstown, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Queenstown, Singapore
| | - Paul S Albert
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
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Wu T, Gong X, Zhao Y, Zhang L, You Y, Wei H, Zuo X, Zhou Y, Xing X, Meng Z, Lv Q, Liu Z, Zhang J, Hu L, Li J, Li L, Chen C, Liu C, Sun G, Liu A, Chen J, Lv Y, Wang X, Wei Y. Fetal growth velocity references from a Chinese population-based fetal growth study. BMC Pregnancy Childbirth 2021; 21:688. [PMID: 34627184 PMCID: PMC8501691 DOI: 10.1186/s12884-021-04149-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/15/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Fetal growth velocity standards have yet to be established for the Chinese population. This study aimed to establish such standards suitable for the Chinese population. METHODS We performed a multicenter, population-based longitudinal cohort study including 9075 low-risk singleton pregnant women. Data were collected from the clinical records of 24 hospitals in 18 provinces of China. Demographic characteristics, reproductive history, fetal ultrasound measurements, and perinatal outcome data were collected. The fetal ultrasound measurements included biparietal diameter (BPD), abdominal circumference (AC), head circumference (HC), and femur diaphysis length (FDL). We used linear mixed models with cubic splines to model the trajectory of four ultrasound parameters and estimate fetal weight. Fetal growth velocity was determined by calculating the first derivative of fetal size curves. We also used logistic regression to estimate the association between fetal growth velocities in the bottom 10th percentile and adverse perinatal outcomes. RESULTS Fetal growth velocity was not consistent over time or among individuals. The estimated fetal weight (EFW) steadily increased beginning at 12 gestational weeks and peaked at 35 gestational weeks. The maximum velocity was 211.71 g/week, and there was a steady decrease in velocity from 35 to 40 gestational weeks. The four ultrasound measurements increased in the early second trimester; BPD and HC peaked at 13 gestational weeks, AC at 14 gestational weeks, and FDL at 15 gestational weeks. BPD and HC also increased from 19 to 24 and 19 to 21 gestational weeks, respectively. EFW velocity in the bottom 10th percentile indicated higher risks of neonatal complications (odds ratio [OR] = 2.23, 95% confidence interval [CI]: 1.79-2.78) and preterm birth < 37 weeks (OR = 3.68, 95% CI: 2.64-5.14). Sensitivity analyses showed that EFW velocity in the bottom 10th percentile was significantly associated with more adverse pregnancy outcomes for appropriate-for-gestational age neonates. CONCLUSIONS We established fetal growth velocity curves for the Chinese population based on real-world clinical data. Our findings demonstrated that Chinese fetal growth patterns are somewhat different from those of other populations. Fetal growth velocity could provide more information to understand the risk of adverse perinatal outcomes, especially for appropriate-for-gestational age neonates.
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Affiliation(s)
- Tianchen Wu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Xiaoli Gong
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China
| | - Yangyu Zhao
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China
| | - Lizhen Zhang
- Department of Obstetrics and Gynecology, Maternal and Child Health Hospital of Qinhuangdao, Qinhuangdao, 066000, China
| | - Yiping You
- Department of Obstetrics, Maternal and Child Health Hospital of Hunan, Changsha, 410007, China
| | - Hongwei Wei
- Department of Obstetrics, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530000, China
| | - Xifang Zuo
- Department of Obstetrics, Tongzhou Maternal and Child Health Hospital of Beijing, Beijing, 101100, China
| | - Ying Zhou
- Department of Obstetrics and Gynecology, the First Affiliated Hospital of Xiamen University, Xiamen, 361003, China
| | - Xinli Xing
- Maternal and Child Health Hospital of Dongchangfu District, Liaocheng, 252004, China
| | - Zhaoyan Meng
- Department of Obstetrics, Gansu Maternal and Child Health Hospital, Lanzhou, 730050, China
| | - Qi Lv
- Department of Obstetrics and Gynecology, Changchun Obstetrics-Gynecology Hospital, Changchun, 130042, China
| | - Zhaodong Liu
- Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fu Zhou, 350122, China
| | - Jian Zhang
- Department of Function, Maternal and Child Health Hospital of Shijiazhuang, Shijiazhuang, 050051, China
| | - Liyan Hu
- Children's Hospital of Shanxi, Women Health Center of Shanxi, Taiyuan, 030013, China
| | - Junnan Li
- Department of Obstetrics, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Li Li
- Department of Obstetrics, Zhengzhou Central Hospital, Zhengzhou, 450007, China
| | - Chulin Chen
- Department of Obstetrics, Maternal and Child Health Hospital of Changzhi, Changzhi, 046011, China
| | - Chunyan Liu
- Department of Obstetrics, Maternity and Infant Hospital of Shenyang, Shenyang, 110014, China
| | - Guoqiang Sun
- Department of Obstetrics, Hubei Maternal and Child Health Hospital, Wuhan, 430070, China
| | - Aiju Liu
- Department of Obstetrics, Inner Mongolia Maternal and Child Health Hospital, Hohhot, 010060, China
| | - Jingsi Chen
- Department of Prenatal Diagnosis, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China
| | - Yuan Lv
- Shengjing Hospital Affiliated to China Medical University, Shenyang, 117004, China
| | - Xiaoli Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China.
| | - Yuan Wei
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China.
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Fetal growth velocity: the NICHD fetal growth studies. Am J Obstet Gynecol 2018; 219:285.e1-285.e36. [PMID: 29803819 DOI: 10.1016/j.ajog.2018.05.016] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 05/16/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Accurately identifying pregnancies with accelerated or diminished fetal growth is challenging and generally based on cross-sectional percentile estimates of fetal weight. Longitudinal growth velocity might improve identification of abnormally grown fetuses. OBJECTIVE We sought to complement fetal size standards with fetal growth velocity, develop a model to compute fetal growth velocity percentiles for any given set of gestational week intervals, and determine association between fetal growth velocity and birthweight. STUDY DESIGN This was a prospective cohort study with data collected at 12 US sites (2009 through 2013) from 1733 nonobese, low-risk pregnancies included in the singleton standard. Following a standardized sonogram at 10w0d-13w6d, each woman was randomized to 1 of 4 follow-up visit schedules with 5 additional study sonograms (targeted ranges: 16-22, 24-29, 30-33, 34-37, and 38-41 weeks). Study visits could occur ± 1 week from the targeted GA. Ultrasound biometric measurements included biparietal diameter, head circumference, abdominal circumference, and femur length, and estimated fetal weight was calculated. We used linear mixed models with cubic splines for the fixed effects and random effects to flexibly model ultrasound trajectories. We computed velocity percentiles in 2 ways: (1) difference between 2 consecutive weekly measurements (ie, weekly velocity), and (2) difference between any 2 ultrasounds at a clinically reasonable difference between 2 gestational ages (ie, velocity calculator). We compared correlation between fetal growth velocity percentiles and estimated fetal weight percentiles at 4-week intervals, with 32 (±1) weeks' gestation for illustration. Growth velocity was computed as estimated fetal growth rate (g/wk) between ultrasound at that gestational age and from prior visit [ie, for 28-32 weeks' gestational age: velocity = (estimated fetal weight 32-28)/(gestational age 32-28)]. We examined differences in birthweight by whether or not estimated fetal weight and estimated fetal weight velocity were <5th or ≥5th percentiles using χ2. RESULTS Fetal growth velocity was nonmonotonic, with acceleration early in pregnancy, peaking at 13, 14, 15, and 16 weeks for biparietal diameter, head circumference, femur length, and abdominal circumference, respectively. Biparietal diameter, head circumference, and abdominal circumference had a second acceleration at 19-22, 19-21, and 27-31 weeks, respectively. Estimated fetal weight velocity peaked around 35 weeks. Fetal growth velocity varied slightly by race/ethnicity although comparisons reflected differences for parameters at various gestational ages. Estimated fetal weight velocity percentiles were not highly correlated with fetal size percentiles (Pearson r = 0.40-0.41, P < .001), suggesting that these measurements reflect different aspects of fetal growth and velocity may add additional information to a single measure of estimated fetal weight. At 32 (SD ± 1) weeks, if both estimated fetal weight velocity and size were <5th percentile, mean birthweight was 2550 g; however, even when size remained <5th percentile but velocity was ≥5th percentile, birthweight increased to 2867 g, reflecting the important contribution of higher growth velocities. For estimated fetal weight ≥5th percentile, but growth velocity <5th, birthweight was smaller (3208 vs 3357 g, respectively, P < .001). CONCLUSION We provide fetal growth velocity data to complement our previous work on fetal growth size standards, and have developed a calculator to compute fetal growth velocity. Preliminary findings suggest that growth velocity adds additional information over knowing fetal size alone.
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Deter RL, Lee W, Kingdom J, Romero R. Second trimester growth velocities: assessment of fetal growth potential in SGA singletons. J Matern Fetal Neonatal Med 2017; 32:939-946. [PMID: 29057683 DOI: 10.1080/14767058.2017.1395849] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To evaluate the validity of second trimester growth velocities as measures of fetal growth potential in Small-for-Gestational-Age (SGA) singletons. METHODS Second trimester growth velocities for biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur diaphysis length (FDL) were determined by linear regression analysis or direct measurement in 53 SGA singletons with normal growth outcomes (SGA N Group) and 73 with growth restriction (SGA GR) based on a composite fetal growth pathology score (FGPS1). The latter were subdivided into six groups based on their growth restriction pattern (Patterns group). Similar data were available for 118 singletons with normal neonatal growth outcomes (NNGO group). Coefficients of determination (R2) and growth velocities for each anatomical parameter were compared between Patterns subgroups and the SGA N, SGA GR and NNGO groups. RESULTS Median R2 values in the six Patterns subgroups ranged from 98.2% (Pattern 2, FDL) to 99.9% (Pattern 5, AC). Within each anatomical parameter set, no significant differences were found (Kruskal-Wallis). Patterns subgroup data were pooled to form the SGA GR group for each anatomical parameter. Mean values for the three main groups ranged from 98.4% (SGA N, FDL) to 99.6% (SGA N, HC). No significant differences between groups (ANOVA) were found for any anatomical parameter (ANOVA). Only 1.7-3.8% had R2 values <95th%. No significant differences in median second trimester growth velocities among different Patterns subgroups were found for any anatomical parameter. In the SGA N and SGA GR groups, mean BPD and HC values did not differ but were significantly smaller than the NNGO group values. No differences in mean FDL values were seen. With AC, all three means were significantly different, having the following order: NNGO > SGA N > SGA GR. Of all 504 second trimester growth rates, 92.5% were within their respective 95% reference ranges. CONCLUSION Growth in the second trimester is linear in fetuses at risk for growth restriction. Except for FDL, growth velocities were lower than those for fetuses with NNGO. Only AC had mean velocities that differed between the SGA N and the SGA GR groups. Since most velocities (92.5%) were within normal reference ranges, they are reasonable measures of growth potential in fetuses at risk for growth restriction.
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Affiliation(s)
- Russell L Deter
- a Department of Obstetrics and Gynecology , Texas Children's Hospital, Baylor College of Medicine , Houston , TX , USA
| | - Wesley Lee
- a Department of Obstetrics and Gynecology , Texas Children's Hospital, Baylor College of Medicine , Houston , TX , USA.,b Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research , Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health , Bethesda , MD and Detroit , MI , USA
| | - John Kingdom
- c Division of Maternal Fetal Medicine , Mount Sinai Hospital, University of Toronto , Toronto , ON , Canada
| | - Roberto Romero
- b Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research , Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health , Bethesda , MD and Detroit , MI , USA.,d Department of Obstetrics and Gynecology , University of Michigan , Ann Arbor , MI , USA.,e Department of Epidemiology & Biostatistics , Michigan State University , East Lansing , MI , USA.,f Department of Molecular Obstetrics and Genetics , Wayne State University , Detroit , MI , USA
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Ioannou C, Talbot K, Ohuma E, Sarris I, Villar J, Conde-Agudelo A, Papageorghiou AT. Systematic review of methodology used in ultrasound studies aimed at creating charts of fetal size. BJOG 2012; 119:1425-39. [PMID: 22882780 DOI: 10.1111/j.1471-0528.2012.03451.x] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Reliable ultrasound charts are necessary for the prenatal assessment of fetal size, yet there is a wide variation of methodologies for the creation of such charts. OBJECTIVE To evaluate the methodological quality of studies of fetal biometry using a set of predefined quality criteria of study design, statistical analysis and reporting methods. SEARCH STRATEGY Electronic searches in MEDLINE, EMBASE and CINAHL, and references of retrieved articles. SELECTION CRITERIA Observational studies whose primary aim was to create ultrasound size charts for bi-parietal diameter, head circumference, abdominal circumference and femur length in fetuses from singleton pregnancies. DATA COLLECTION AND ANALYSIS Studies were scored against a predefined set of independently agreed methodological criteria and an overall quality score was given to each study. Multiple regression analysis between quality scores and study characteristics was performed. MAIN RESULTS Eighty-three studies met the inclusion criteria. The highest potential for bias was noted in the following fields: 'Inclusion/exclusion criteria', as none of the studies defined a rigorous set of antenatal or fetal conditions which should be excluded from analysis; 'Ultrasound quality control measures', as no study demonstrated a comprehensive quality assurance strategy; and 'Sample size calculation', which was apparent in six studies only. On multiple regression analysis, there was a positive correlation between quality scores and year of publication: quality has improved with time, yet considerable heterogeneity in study methodology is still observed today. CONCLUSIONS There is considerable methodological heterogeneity in studies of fetal biometry. Standardisation of methodologies is necessary in order to make correct interpretations and comparisons between different charts. A checklist of recommended methodologies is proposed.
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Affiliation(s)
- C Ioannou
- Nuffield Department of Obstetrics and Gynaecology, University of Oxford, UK
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Fok TF, Hon KL, So HK, Wong E, Ng PC, Chang A, Lau J, Chow CB, Lee WH. Fetal growth velocities in Hong Kong Chinese infants. Neonatology 2005; 87:262-8. [PMID: 15722625 DOI: 10.1159/000084030] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2004] [Accepted: 10/21/2004] [Indexed: 11/19/2022]
Abstract
Few studies have investigated the velocities of fetal growth. The aim of the present study was to determine the pattern of 'fetal' growth velocities in a Chinese population. The gestation-specific measurements of the body weight, body length and head circumference in a representative sample of 5,045 male and 4,484 female newborns delivered between 26 and 42 weeks of gestation at 12 hospitals in Hong Kong were obtained. Peak growth velocity occurred before 30 weeks of gestation for head circumference, at week 30 for length and at week 30 for weight. When compared with data obtained from a French population, a significant difference in the growth velocity for body weight was observed below 32 weeks between French and Chinese infants, suggesting an ethnic difference in fetal growth of this parameter.
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Affiliation(s)
- T F Fok
- Department of Paediatrics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong.
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Bertino E, Di Battista E, Bossi A, Pagliano M, Fabris C, Aicardi G, Milani S. Fetal growth velocity: kinetic, clinical, and biological aspects. Arch Dis Child Fetal Neonatal Ed 1996; 74:F10-5. [PMID: 8653429 PMCID: PMC2528329 DOI: 10.1136/fn.74.1.f10] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
With the aim of determining fetal growth kinetics, prenatal data were analysed which had been longitudinally collected in the framework of a perinatal growth survey. The sample comprised 238 singleton normal pregnancies, selected in Genoa and Turin (between 1987 and 1990), and repeatedly assessed by ultrasound scans (five to nine per pregnancy). Five morphometric traits were considered: BPD (biparietal diameter), OFD (occipitofrontal diameter), HC (head circumference), FDL (femur diaphysis length) and AC (abdomen circumference). Growth rate seemed to increase in the early part of the second trimester, and decrease subsequently: velocity peaks were steeper and earlier for head diameters and circumference (about 18 weeks) than for femur length (20 weeks) and abdomen circumference (22 weeks). Velocity standards were traced using a longitudinal two-stage linear model: this ensures unbiased description of the shape of the growth curve, even when growth kinetics are asynchronous, and efficient estimation of the outer centiles--the most useful for diagnostic purposes.
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Affiliation(s)
- E Bertino
- Neonatal Unit, University of Torino, Italy
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Chang TC, Robson SC, Spencer JA, Gallivan S. Ultrasonic fetal weight estimation: analysis of inter- and intra-observer variability. JOURNAL OF CLINICAL ULTRASOUND : JCU 1993; 21:515-519. [PMID: 8270670 DOI: 10.1002/jcu.1870210808] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Standard ultrasound measurements were performed by two observers in 40 third-trimester fetuses. Observers were blinded to the results of the measurements. Estimated fetal weight (EFW) was calculated using two published formulae. The intra-observer standard deviation for EFW, assessed using one-way analysis of variance, was < 75 g for both observers. The 95% prediction intervals for inter-observer comparisons of EFW, calculated using the limits of agreement method, were -187.3 g to 139.8 g, and -159.9 g to 124.3 g, using the two formulae. The results suggest that measurements of EFW are reproducible. The prediction interval is comparable to the weekly fetal weight increment in normal fetuses.
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Affiliation(s)
- T C Chang
- Department of Obstetrics and Gynaecology, University College and Middlesex School of Medicine, London, United Kingdom
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Guihard-Costa AM, Droullé P, Larroche JC. Growth velocity of the biparietal diameter, abdominal transverse diameter and femur length in the fetal period. Early Hum Dev 1991; 27:93-102. [PMID: 1802668 DOI: 10.1016/0378-3782(91)90030-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In this study, fetal growth rates of the biparietal diameter (BPD), abdominal transverse diameter (ATD) and femur length were established from 4333 ultrasound examinations. The age of the fetuses ranged from 7 to 40 gestational weeks. The growth rates were computed by periods of 3 weeks, and the velocity curves were plotted with their 95% confidence interval. Results displayed multiphasic patterns of growth velocity for these variables, with a common peak of velocity at about 16 weeks. Between 16 and 28 weeks, growth velocity of femur length decreased, while the ATD and the BPD grew at the same constant rate. From 28 to 37 weeks, only the ATD maintained a high rate of growth. After 37 weeks, all growth rates decreased abruptly. In all cases, no sex differences in growth velocity were found.
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Cordano MC, Comte E, Bessis R, Papiernik E. Longitudinal follow-up of 100 patients at risk of intrauterine growth retardation: comparison of diagnosis in two periods. J Perinat Med 1988; 16:61-6. [PMID: 3042943 DOI: 10.1515/jpme.1988.16.1.61] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The concept of low birth weight includes two different entities: prematurity and intrauterine growth retardation. Both of them are major public health problems, because they increase perinatal morbidity and mortality Early diagnosis of IUGR leads to adequate decisions, making possible a reduction in perinatal morbidity and mortality. In order to make an early diagnosis of IUGR, clinical methods have proven to be insufficient. Ultrasonography is an important aid to this diagnosis, introducing the measurement of fetal diameters and perimeters. This study, designed to compare both methods, was carried out in at the Antoine Béclère Hospital, Clamart, France. Data processing was done in CLAP-PAHO/WHO. In the first period, retrospective analyses of 116 clinical histories with IUGR were performed. In this study, only fetal diameters were used and the accuracy of clinical and ultrasonographic diagnosis was evaluated. In the second period a prospective longitudinal follow-up study of 100 pregnant women at risk of developing IUGR was carried out. Clinical diagnosis was also evaluated, and compared to the ultrasonographic approach. The parameters used were the fetal diameters and perimeters (head and abdominal perimeters, and their relationship). Sensitivity, specificity and predictive values of the ultrasonic parameters were calculated (table I). The clinical and ultrasonographic diagnosis of both periods were compared with the purpose to analyze the effect of the measurement of fetal perimeters in the diagnostic accuracy. Newborns of the 100 patients in the prospective study were classified into two groups according to birth weight.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- M C Cordano
- Service of Obstetrics and Gynecology, Hôpital Antoine Béclère, France
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Fescina RH, Martell M. Intrauterine and extrauterine growth of cranial perimeter in term and preterm infants. A longitudinal study. Am J Obstet Gynecol 1983; 147:928-32. [PMID: 6650630 DOI: 10.1016/0002-9378(83)90248-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
In this study a cranial perimeter curve was established from 13 weeks of gestation to 6 months of postnatal life. Thirty cases were studied. The intrauterine section of the curve was derived from data obtained weekly by echography. The tenth and fiftieth percentiles of fetal measurements were greater than those described by other authors, who established intrauterine growth curves with data obtained after pretermed delivery. This pattern was used to assess the cranial perimeter growth to six months of corrected age in 48 preterm neonates of appropriate weight. Their values were below the standard at birth, reaching the normal measures on the expected date of confinement.
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