Sex differences in fetal growth and immediate birth outcomes in a low-risk Caucasian population

To assess 11 formulae commonly used to estimate fetal weight in a population of premature fetuses who had abnormal Doppler velocimetry due to early-onset placental insufficiency. The performance of each formula was evaluated in subgroups of fetuses with expected growth and intrauterine growth restriction. Data were collected fromfetuses andmothers who delivered at three Brazilian hospitals between November and December We analyzed fetuses. Of these, The amniotic fluid volume was reduced in 87 The Hadlock formulae using three or four fetal biometric parameters had low absolute percentage error in the estimated fetal weight among preterm fetuses with abnormal Doppler studies who were born within 5 days of the ultrasound evaluation.

Growth, Doppler, and Fetal Assessment

First trimester growth restriction may predict miscarriage or adverse outcome later in the pregnancy, but determinants of early growth are not well described. Our objective was to examine factors influencing fetal and gestational sac size in the first trimester. Prospective observational study of singleton pregnancies before 12 weeks gestation.

HADLOCK ET AL. AJR were: (1) a history of regular menses, (2) known date of the previously published criteria for specific weeks in gestation [2,

Obstetric ultrasonography , or prenatal ultrasound , is the use of medical ultrasonography in pregnancy , in which sound waves are used to create real-time visual images of the developing embryo or fetus in the uterus womb. The procedure is a standard part of prenatal care in many countries, as it can provide a variety of information about the health of the mother, the timing and progress of the pregnancy, and the health and development of the embryo or fetus.

The International Society of Ultrasound in Obstetrics and Gynecology ISUOG recommends that pregnant women have routine obstetric ultrasounds between 18 weeks’ and 22 weeks’ gestational age the anatomy scan in order to confirm pregnancy dating, to measure the fetus so that growth abnormalities can be recognized quickly later in pregnancy, and to assess for congenital malformations and multiple pregnancies twins, etc.

Performing an ultrasound at this early stage of pregnancy can more accurately confirm the timing of the pregnancy, and can also assess for multiple fetuses and major congenital abnormalities at an earlier stage. There is no difference, however, in perinatal death or poor outcomes for infants. Below are useful terms on ultrasound: [4].

Large-for-gestational-age fetuses have an increased risk for spontaneous preterm birth

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Our aim was to develop gender-specific fetal growth curves in a low-risk population and to compare immediate birth outcomes. First, second, and third trimester fetal ultrasound examinations were conducted between and The data was selected using the following criteria: routine examinations in uncomplicated singleton pregnancies, Caucasian ethnicity, and confirmation of gestational age by a crown-rump length CRL measurement in the first trimester. These longitudinal fetal growth curves for the first time allow integration with neonatal and pediatric WHO gender-specific growth curves.

Boys exceed head growth halfway of the pregnancy, and immediate birth outcomes are worse in boys than girls. Gender difference in intrauterine growth is sufficiently distinct to have a clinically important effect on fetal weight estimation but also on the second trimester dating. Therefore, these differences might already play a role in early fetal or immediate neonatal management. Ultrasound has been an indispensable tool for diagnosis in obstetrics and fetal growth assessment for at least 4 decades [ 1 , 2 , 3 ].

Clinical management in pregnancies is increasing based on ultrasound measurements derived in the first trimester and on the recognition of pathological fetal growth, which depends on reliable, standardized growth curves [ 4 ].


Follow-up in 1 week. Robinson HP. BJOG ; Revised BUMS sept Mul T.

In vitro fertilization, with known date of conception, is likely the most accurate means of a similar study; however, their patients fulfilled more stringent dating criteria. (Hadlock FP, Deter RL, Harrist RB, Park SK: Fetal head circumference:​.

Background: Fetal growth is influenced by many factors such as race, socioeconomic status, genetics, geographical location, maternal diseases, and number of babies. Consequent upon these, fetal growth charts may vary from one location to another even within the same geographical entity. Objective: This study was designed to establish the fetal growth chart in antenatal women who had ultrasound scanning at the University of Nigeria Teaching Hospital, Enugu, South East Nigeria.

Patients and Methods: This is a descriptive analysis of fetal biometric measurement of antenatal women. Four hundred and seventy pregnant women were studied. Results: The nomogram for the femur length FL and biparietal diameter BPD for the different weeks of gestation from 13 th to the 40 th week were established.

Correlation coefficients between gestational age and the various fetal parameters were also reported. A regression model for prediction of fetal age using the fetal biometry was also deduced for the studied population. Conclusion: The fetal parameters used in this study were consistently smaller than reported values from European studies up to the 34 th week of gestation after which a catch-up growth till the 40 weeks was observed.

Fetal parameters observed in this study were larger than most of the reported Asian values. Assessment of gestational age in the second trimester by real-time ultrasound measurement of the femur length. Am J Obstet Gynecol ; Charts of fetal size: 4.


Henry L. Filly, MD. Ultrasound has become the essential tool of modern obstetric practice. With advances in technology and computer processing, what was once a mere curiosity has become crucial for the assessment of the placenta, membranes, fluid, and fetal anatomy, as is covered in the other portions of this text.

DEVELOPMENT STANDARDS OF THE IRONDALE/PORT HADLOCK New development or redevelopment using an existing (as of date of adoption of.

A prospective cohort of singleton pregnancies with ultrasonography performed in the third trimester between March and March in China was conducted. Cox proportional hazard models were used to assess the relationship between low EFWc i. For the Hadlock-EFWc, the corresponding sensitivity and specificity were Fetuses with low EFWc i. Adverse perinatal outcomes APOs late in gestation are a major cause of fetal and neonatal deaths worldwide despite a substantial improvement in obstetric care over the past decades [ 1 , 2 ].

However, the origins of the APOs vary and are mostly unknown, making the prediction difficult and limiting preventive action [ 3 ]. Using ultrasound to screen for fetuses with fetal growth restriction FGR , a major determinant of APOs, is a strategy to identify pregnancies at a higher risk of APOs and is widespread in obstetric practice [ 4 , 5 ].

Screening procedures for FGR need to identify small babies and then differentiate between those that are healthy and those that are pathologically small [ 4 ]. Assessment of fetal growth, such as an ultrasonographic estimated fetal weight EFW , has been shown to be an effective method to reduce perinatal mortality in high-risk pregnancies [ 3 , 6 ].

Hadlock et al. In this prospective cohort study, singleton pregnant women attended their routine third-trimester antenatal examinations at 28, 32, 36, 38, and 40 weeks of gestation within 1 week either side at the Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China, between March and March Pregnant women who had signed an informed consent document and completed the scans in the department of ultrasound of the hospital were sequentially enrolled in the study and followed up until delivery the last case was completed in June Exclusion criteria included women who had refused consent and who had multiple pregnancies.

Methods for Estimating the Due Date

To compare the accuracy of a new formula to one developed in and still in common use and to develop and compare racial and ethnic—specific and racial and ethnic—neutral formulas. Women with a certain last menstrual period confirmed by first-trimester ultrasonogram had longitudinal fetal measurements by credentialed study ultrasonographers blinded to the gestational age at their five follow-up visits.

Regression analyses were performed with linear mixed models to develop gestational age estimating formulas.

What is most interesting about Hadlock’s tables are that the results typically report 95% confidence intervals with standard deviations as ± weeks gestation. These.

Background: An active approach to the diagnosis of IUGR should be undertaken so that the foetus can be closely monitored and when indicated, be promptly delivered. All pregnant women whose gestational ages were assessed by ultrasonography in 1 st trimester was included in the study. An ultrasonographic biometric evaluation was done between weeks and repeated at weeks of gestational age and their ratios compared, using standard formulae. AC has got lowest FP and FN with a highest accuracy rate at both weeks of gestational age and weeks of gestational age.

The sensitivity, specificity and accuracy of AC is more at weeks of gestation than at weeks for diagnosis of IUGR. Intrauterine growth as estimated from live born birth-weight data at 24 to 42 weeks of gestation. William J. Am J Obstet Gynecol. Comparison of associated high-risk factors and perinatal outcome between symmetric and asymmetric fetal intrauterine growth retardation.

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Table2: Commonly used sonographic weight standards. Author. Date. Country. Subjects n. Parameters. Hadlock. USA. > 95% Caucasian middle class.

The prevalence of skeletal dysplasias is between 1 and and 1 and livebirths 1. The appropriate identification of lethal skeletal dysplasias is important not only for current pregnancy management, but also for genetic counseling concerning future pregnancies. Table I provides the genetic inheritance for but a few of the more common skeletal dysplasias. The severity of the effect on the skeletal system with lethal skeletal dysplasias makes 2nd trimester diagnosis possible.

Additional testing is necessary to confirm or exclude a specific skeletal dysplasia. For example, amniocentesis can be used to confirm a diagnosis of achondroplasia 3. Usually a definitive diagnosis cannot be made until a pediatric or pathologic evaluation of the neonate is undertaken. As with any suspected congenital anomaly, a detailed fetal anatomic survey is required whenever a skeletal dysplasia is suspected.

Ancillary sonographic findings frequently provide the clues that are necessary to narrow the differential diagnosis. The measurement of the femur length FL is part of standard 2nd and 3rd trimester biometry.

Lecture – 22 Resource Management

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