Longitudinal studies of fetal growth with the use of dynamic image ultrasonography

To characterize the growth of individual fetuses, serial measurements of the crown-rump length (CRL), biparietal diameter (BPD), head circumference (HC), and abdominal circumference (AC) were made at specified intervals of 2 to 3 weeks (between 6 to 8 weeks [conceptual age] and delivery) in 20 normal fetuses with known dates of conception. Values for the HC-AC ratio and the estimated fetal weight were also obtained from these data. Measurements of CRL were similar to those reported previously, except in those cases in which the follicular phase was prolonged or the fetal growth potential was reduced. Mathematical modeling demonstrated that the linear-cubic model was optimal for the BPD and HC growth curves, the linear model for the AC, and the linear-quadratic model for fetal weight. The HC-AC ratio could not be modeled adequately because of significant individual variability. Optimal models for average longitudinal growth curves were determined for the BPD, HC, AC, and fetal weight from individual growth curves. These average longitudinal curves were similar in shape, mean values, and variability to those obtained in previous cross-sectional studies. Statistical analysis indicated that the coefficients of the average longitudinal curves are not likely to change by more than 5% to 15% if the size of the sample is increased very significantly. These results indicate that the average longitudinal growth curves are good estimators of the true population growth curves.