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Update Reference Charts: Fetal Biometry between the 15th and 42nd Week of Gestation
Nadja Hirschfeld1, Eike Bormann2, Helen Ann Koester3
1Gynecology and Obstetrics, St Franziskus-Hospital Munster GmbH, Munster, Germany.
Insights
New fetal growth charts for biparietal diameter (BPD) and other measurements up to 42 weeks gestation show statistically significant differences from existing references. These updated charts offer a valuable tool for prenatal diagnostics.
Area of Science:
- Obstetrics and Gynecology
- Fetal Medicine
- Medical Statistics
Background:
- Accurate fetal growth assessment is crucial for prenatal diagnostics.
- Existing fetal growth charts have limitations in certain gestational ranges.
- Establishing updated reference standards is essential for clinical practice.
Purpose of the Study:
- To establish new reference charts for key fetal biometric parameters.
- To extend existing fetal growth charts up to 42 weeks of gestation.
- To compare newly derived charts with established international standards.
Main Methods:
- Retrospective analysis of biometric data from 12,972 low-risk pregnancies.
- Evaluation of fetal measurements between 15 and 42 weeks of gestation.
- Descriptive analysis and regression modeling to generate percentile curves.
Main Results:
- New reference curves were generated for biparietal diameter (BPD), occipitofrontal diameter (OFD), head circumference (HC), abdominal circumference (AC), femur length (FL), and humerus length (HL).
- The study identified statistically significant differences between the new percentile curves and those from Snijders and Nicolaides, INTERGROWTH 21st Project, and WHO charts.
- Fetal biometric parameters initially showed linear growth, transitioning to cubic growth towards the end of pregnancy.
Conclusions:
- The developed percentile curves for fetal biometry differ from commonly used references.
- These new standard curves provide a valuable reference for prenatal diagnostic applications.
- Updated fetal growth charts are necessary to reflect current population data and improve diagnostic accuracy.
Objectives:
This study was designed to establish new reference charts for BPD (biparietal diameter), OFD (occipitofrontal diameter), HC (head circumference), CM (cisterna magna), TCD (transverse cerebellar diameter), PCV (posterior cerebral ventricle), AC (abdominal circumference), FL (femur length), and HL (humerus length) and extend known charts to 42 weeks of gestation. These new charts were compared to studies carried out by Snijders and Nicolaides, the INTERGROWTH 21st Project, and the WHO Fetal Growth Charts.
Methods:
In this retrospective cross-sectional single-center study of 12,972 low-risk pregnancies, biometric data between the 15th and 42nd weeks of gestation were evaluated. Only one examination per pregnancy was selected for statistical analysis. Descriptive analysis for the 5th, 50th, and 95th quantile was performed for each parameter as listed above. Regression models were used to fit the mean and the SD at each gestational age.
Results:
Initially the reference curves for BPD, OFD, HC, AC, FL, and HL show a linear increase, which changes into a cubic increase towards the end of pregnancy. The results of this study show statistically noticeable differences from the percentile curves of the studies listed above.
Conclusions:
The percentile curves in this study differ from the commonly used ones. The presented standard curves can be used as a reference in prenatal diagnostics.
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