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Screening for small for dates fetuses: a controlled trial.

J P Neilson, S P Munjanja, C R Whitfield

British Medical Journal (Clinical Research Ed.)

|November 3, 1984

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A two-stage ultrasound screening accurately identified 94% of babies small for gestational age. However, this routine screening did not reduce perinatal risks in low-risk pregnancies.

Area of Science:

Obstetrics and Gynecology
Medical Imaging
Perinatal Medicine

Background:

Intrauterine growth retardation (IUGR) is associated with increased perinatal risks.
Early identification of IUGR is crucial for timely intervention.
Ultrasound screening is a key tool in monitoring fetal growth.

Purpose of the Study:

To evaluate a two-stage ultrasound screening schedule for identifying fetuses at risk of being small for gestational age (SGA).
To assess the effectiveness of this screening in reducing perinatal risks in low-risk pregnancies.

Main Methods:

A controlled trial involving 877 women with low-risk single pregnancies.
Stage 1: Early pregnancy assessment of gestational age.
Stage 2: Ultrasound measurement of crown-rump length and trunk area between 34-36 weeks' gestation, calculating the product for SGA prediction.

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Main Results:

The two-stage ultrasound schedule demonstrated high accuracy in predicting SGA, with 94% sensitivity and 90% specificity.
The screening method was confirmed as accurate, feasible, fast, and simple to perform.
The controlled trial found no significant reduction in perinatal risks with the routine application of this screening in low-risk pregnancies.

Conclusions:

Two-stage ultrasonography is an accurate and feasible method for screening pregnancies for potential small for gestational age infants.
Routine application of this specific screening protocol did not yield benefits in reducing perinatal risks for low-risk pregnancies.