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Related Concept Videos

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Teratogenicity

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The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
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Murine Fetal Echocardiography
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Screening for small-for-gestational-age fetuses.

Ditte N Hansen1,2, Helle S Odgaard1, Niels Uldbjerg3,4

  • 1Department of Obstetrics and Gynecology, Aalborg University Hospital, Aalborg, Denmark.

Acta Obstetricia Et Gynecologica Scandinavica
|November 1, 2019
PubMed
Summary
This summary is machine-generated.

The Danish selective screening program for small-for-gestational-age (SGA) fetuses has improved but has limitations. False diagnoses of SGA increased labor induction and cesarean sections.

Keywords:
estimated fetal weightoutcomeperformancescreeningsmall-for-gestational-ageultrasound

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Medicine
  • Fetal Medicine

Background:

  • Accurate antenatal identification of small-for-gestational-age (SGA) fetuses is crucial for reducing adverse perinatal outcomes.
  • Ultrasound estimates of fetal weight (EFWus) are the primary tool for SGA identification.
  • Denmark employs a selective screening approach for SGA, unlike universal screening.

Purpose of the Study:

  • To evaluate the performance of the Danish national SGA screening program.
  • To assess the consequences of false-positive and false-negative SGA diagnoses.

Main Methods:

  • Retrospective cohort study of 2928 singleton pregnancies from 2015.
  • Defined "risk of SGA" as EFWus ≤ -15% and "SGA" as birthweight ≤ -22% of expected for gestational age.

Main Results:

  • The Danish SGA screening program demonstrated a sensitivity of 62% with a 5.6% false-positive rate.
  • Screening sensitivity varied by gestational age at birth (79% preterm vs. 40% post-term) and SGA severity.
  • False SGA diagnoses were associated with increased rates of labor induction (ORadj=2.51) and cesarean section (ORadj=1.44).

Conclusions:

  • The Danish selective SGA screening program has improved over two decades.
  • Limitations include a high referral rate for ultrasound and reduced performance in post-term pregnancies.
  • False SGA diagnoses contribute to increased interventions like labor induction and cesarean delivery.