Diagnosing Small for Gestational Age during second trimester routine screening: Early sonographic clues

Area of Science:

• Perinatal medicine
• Fetal medicine
• Diagnostic imaging

Background:

• Small for gestational age (SGA) is defined as birth weight at or below the 10th percentile, associated with increased infant complications.
• Current diagnostic accuracy for SGA is suboptimal, highlighting the need for early predictive markers.
• Second-trimester ultrasound (US) parameters are crucial for fetal growth assessment.

Purpose of the Study:

• To evaluate the diagnostic performance of specific ultrasound parameters in predicting SGA.
• To assess the utility of umbilical vein (UV), right portal vein (RPV), and portal sinus (PS) diameters as early SGA predictors.

Main Methods:

• A prospective study involving 93 pregnant women (32 SGA, 61 controls).
• Ultrasound examinations, including UV, RPV, and PS measurements, were conducted between 20-22 weeks of gestation.
• SGA diagnosis was confirmed by birth weight below the 10th percentile.

Main Results:

• Significantly lower median UV diameter (2.20 vs. 2.40 mm) in the SGA group.
• Significantly lower median RPV diameter (2 vs. 2.10 mm) in the SGA group.
• Significantly lower median PS diameter (2 vs. 20.10 mm) in the SGA group.

Conclusions:

• Umbilical vein, right portal vein, and portal sinus diameters show potential as early predictors for SGA.
• Routine assessment of these fetal venous parameters during second-trimester screening can enhance SGA detection rates.
• Early identification of SGA through these ultrasound markers facilitates timely intervention and management.