Related Experiment Videos
Monitoring of fetuses with retarded BPD growth
Insights
Diagnosing fetal growth restriction is challenging. The ratio of fetal abdomen to head diameter measurements can help distinguish between infants born appropriate for gestational age (AGA) and small for gestational age (SGA).
Area of Science:
- Perinatal Medicine
- Fetal Development
- Neonatal Outcomes
Background:
- Retarded biparietal diameter (BPD) growth, below the 5th centile, is linked to adverse outcomes like low birth weight and increased perinatal mortality.
- However, a significant proportion of fetuses with BPD growth deviations at 32 weeks are born with normal weight, complicating diagnosis.
Purpose of the Study:
- To enhance the discriminatory accuracy between fetuses born appropriate for gestational age (AGA) and small for gestational age (SGA).
- To evaluate the utility of additional biochemical and physical tests in identifying intrauterine growth retardation.
Main Methods:
- Assessment of fetuses with deviating BPD growth using various biochemical and physical tests.
- Measurement of the ratio of fetal abdomen to head diameter.
- Evaluation of circumference measurements, urinary estriol levels, fetal breathing movements, and fetal heart rate (FHR) monitoring.
Main Results:
- The ratio of abdomen to head diameter was above the 50th centile in 72% of AGA infants and below the 50th centile in 75% of SGA infants.
- Circumference measurements showed limited utility.
- Urinary estriol levels did not consistently correlate with growth retardation.
- Fetal breathing movements were significantly lower in the retarded BPD growth group, but FHR monitoring had limited individual predictive value.
Conclusions:
- The fetal abdomen-to-head diameter ratio is a valuable parameter for differentiating between AGA and SGA infants.
- Routine fetal monitoring methods like FHR and urinary estriol levels have limited predictive power for individual cases of growth restriction.
Abstract:
Retarded BPD growth (less than 5th centile) is associated with low birth weight, preterm delivery, and increased perinatal mortality. However, 50% of the fetuses with deviating BPD growth in the 32nd week have normal weight at birth. In this study other biochemical and physical tests were applied to a group of fetuses with deviating BPD growth in order to improve the discriminatory rate between infants subsequently born AGA or SGA. Measurements of the ratio abdomen to head diameter were above the 50th centile in 72% of the infants born AGA and below the 50th centile in 75% of those born SGA. Circumference measurements were less useful in our hands. Urinary oestriol levels were not directly proportional to the intrauterine growth retardation. Recording of fetal breathing movements and nonstressed monitoring of fetal heart rate FHR) had little or no predictive value in the individual case although the incidence of fetal breathing movements was significantly lower in the group with retarded BPD growth.