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Validation of Reference Charts for Mid-Trimester Fetal Biometry
Fetal Diagnosis and Therapy
|March 14, 2018
Summary
The Intergrowth-21st Project charts show good performance for fetal head measurements but less accuracy for abdominal circumference and femur length in the Dutch population. Local charts remain superior for certain fetal measurements.
Area of Science:
- Obstetrics and Gynecology
- Fetal Medicine
- Medical Statistics
Background:
- The Intergrowth-21st Project aims to standardize fetal growth monitoring globally.
- Accurate fetal growth assessment is crucial for identifying intrauterine growth restriction and other complications.
Purpose of the Study:
- To evaluate the performance of the Intergrowth-21st Project charts for fetal biometry in a Dutch singleton pregnancy cohort.
- To compare the diagnostic accuracy of international versus local reference charts for fetal measurements.
Main Methods:
- Retrospective analysis of ultrasound data from 43,923 healthy singleton pregnancies in the Netherlands (18-23 weeks gestation).
- Fetal measurements (head circumference, biparietal diameter, abdominal circumference, femur length) were converted to Z-scores using Dutch and Intergrowth charts.
- Z-score distributions were compared against the standard normal distribution.
Main Results:
- Intergrowth charts demonstrated good performance for head circumference and biparietal diameter.
- Performance was suboptimal for abdominal circumference (AC) and femur length (FL) in the Dutch population.
- Dutch women are taller and heavier than the reference population, with maternal height positively correlating with birthweight.
Conclusions:
- While Intergrowth charts are a step towards global standardization, local charts currently offer better performance for AC and FL in the Netherlands.
- Incorporating maternal anthropometric data, such as height, may improve the detection of abnormal fetal growth.
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