Comparative Diagnostic Performance of Estimated Fetal Weight and Isolated Abdominal Circumference for the Detection of Fetal Growth Restriction.

Autor: Whitham MD; Department of Obstetrics and Gynecology, University of Virginia School of Medicine, Charlottesville, VA, USA., Reynolds DM; Department of Obstetrics and Gynecology, University of Virginia School of Medicine, Charlottesville, VA, USA., Urban AR; Department of Obstetrics and Gynecology, University of Virginia School of Medicine, Charlottesville, VA, USA., Ennen CS; Department of Obstetrics and Gynecology, University of Virginia School of Medicine, Charlottesville, VA, USA., Dudley DJ; Department of Obstetrics and Gynecology, University of Virginia School of Medicine, Charlottesville, VA, USA.
Jazyk: angličtina
Zdroj: Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine [J Ultrasound Med] 2023 Feb; Vol. 42 (2), pp. 477-485. Date of Electronic Publication: 2022 May 03.
DOI: 10.1002/jum.16001
Abstrakt: Objectives: To describe the comparative incidence, detection of small-for-gestational age (SGA), and composite perinatal morbidity (CPM) associated with diagnostic criteria of fetal growth restriction (FGR) by estimated fetal weight (EFW) <10% with those with isolated abdominal circumference (AC) measurements <10%.
Methods: We performed a retrospective cohort study of 1587 patients receiving prenatal care and delivery at our institution. We included all patients with ultrasounds and delivery outcomes available, and excluded terminations, second trimester losses, and pregnancies without ultrasounds. EFW was calculated from Hadlock and use of the Duryea centiles, and AC from Hadlock's reference curves. We determined SGA at birth and defined CPM as birthweight less than 3% or birthweight less than 10% with neonatal morbidity.
Results: Of 1587 patients, 28 (1.8%) were classified as FGR by EFW <10%. Three of 12 patients with isolated AC <10% developed EFW <10% later in pregnancy (25%). The performance of each diagnostic criteria were comparable for the outcomes of SGA and CPM, with similar sensitivities, but with decreased specificity for SGA outcome, and an increased false positive rate for patients classified as FGR by isolated AC <10, with a tradeoff of decreased false negatives.
Conclusions: Broadening the diagnosis of FGR to include patients with isolated AC <10 did not significantly increase the detection of pregnancies at risk for SGA or CPM. Our conclusions may be limited by a lack of statistical power given a low frequency of SGA and CPM.
(© 2022 The Authors. Journal of Ultrasound in Medicine published by Wiley Periodicals LLC on behalf of American Institute of Ultrasound in Medicine.)
Databáze: MEDLINE
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