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Obstetrical Aspects

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Abstract

Being born small for gestational age (SGA) is classified as being born with a fetal weight or an abdominal circumference below the 10th percentile for gestational age. In the past, a variety of cutoffs have been used, adding some uncertainty to the value of individual definitions of SGA. Of note, the diagnosis of SGA does not allow a distinction between infants who are constitutionally small, growth-restricted and small, or growth-restricted but not small. In general, up to 70 % of infants are considered constitutionally small due to maternal ethnicity, parity, body mass index, and female gender, and thus are not at risk of increased morbidity and mortality; it is important to realize that fetal size is not equivalent to fetal growth. Therefore, a single fetal biometry will not be able to reliably distinguish between SGA and intrauterine growth restriction (IUGR).

Keywords

Obstet Gynecol Fetal Growth Fetal Growth Restriction Intrauterine Growth Restriction Fetal Weight 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Chang TC, Robson SC, Boys RJ, Spencer JA. Prediction of the small for gestational age infant: which ultrasonic measurement is best? Obstet Gynecol. 1992;80:1030-1038.Google Scholar
  2. 2.
    Chard T, Costeloe K, Leaf A. Evidence of growth retardation in neonates of apparently normal weight. Eur J Obstet Gynecol Reprod Biol. 1992;45:59-62.Google Scholar
  3. 3.
    Ott WJ. The diagnosis of altered fetal growth. Obstet Gynecol Clin North Am. 1988;15:237-263.Google Scholar
  4. 4.
    Mongelli M, Wilcox M, Gardosi J. Estimating the date of confinement: ultrasonographic biometry versus certain menstrual dates. Am J Obstet Gynecol. 1996;174:278-281.Google Scholar
  5. 5.
    Neilson JP. Ultrasound for fetal assessment in early pregnancy. Cochrane Database Syst Rev. 2000;(02)CD000182.Google Scholar
  6. 6.
    Yang H, Kramer MS, Platt RW, et al. How does early ultrasound scan estimation of gestational age lead to higher rates of preterm birth? Am J Obstet Gynecol. 2002;186:433-437.Google Scholar
  7. 7.
    Mendez H. Introduction to the study of pre- and postnatal growth in humans: a review. Am J Med Genet. 1985;20:63-85.Google Scholar
  8. 8.
    Resnik R. Intrauterine growth restriction. Obstet Gynecol. 2002;99:490-496.Google Scholar
  9. 9.
    Guidetti DA, Divon MY, Braverman JJ, Langer O, Merkatz IR. Sonographic estimates of fetal weight in the intrauterine growth retardation population. Am J Perinatol. 1990;7:5-7.Google Scholar
  10. 10.
    Jouannic JM, Grange G, Goffinet F, Benachi A, Carbrol D. Validity of sonographic formulas for estimating fetal weight below 1,250 g: a series of 119 cases. Fetal Diagn Ther. 2001;16:254-258.Google Scholar
  11. 11.
    Mongelli M, Ek S, Tambyrajia R. Screening for fetal growth restriction: a mathematical model of the effect of time interval and ultrasound error. Obstet Gynecol. 1998;92:908-912.Google Scholar
  12. 12.
    Gardosi J, Francis A. A customized standard to assess fetal growth in a US population. Am J Obstet Gynecol. 2009;201:25.e1-7.Google Scholar
  13. 13.
    Chauhan SP, Gupta LM, Hendrix NW, Berghella V. Intrauterine growth restriction: comparison of American College of Obstetricians and Gynecologists practice bulletin with other national guidelines. Am J Obstet Gynecol. 2009;200:409.e1-e6.Google Scholar
  14. 14.
    Alfirevic Z, Neilson JP. Doppler ultrasonography in high-risk pregnancies: systematic review with meta-analysis. Am J Obstet Gynecol. 1995;172:1379-1387.Google Scholar
  15. 15.
    Bilardo CM, Wolf H, Stigter RH, et al. Relationship between monitoring parameters and perinatal outcome in severe, early intrauterine growth restriction. Ultrasound Obstet Gynecol. 2004;23:119-125.Google Scholar
  16. 16.
    Baschat AA. Doppler application in the delivery timing of the preterm growth-restricted fetus: another step in the right direction. Ultrasound Obstet Gynecol. 2004;23:111-118.Google Scholar
  17. 17.
    Baschat AA, Cosmi E, Bilardo CM, et al. Predictors of neonatal outcome in early-onset placental dysfunction. Obstet Gynecol. 2007;109:253-261.Google Scholar
  18. 18.
    Turan S, Turan OM, Berg C, et al. Computerized fetal heart rate analysis, Doppler ultrasound and biophysical profile score in the prediction of acid-base status of growth-restricted fetuses. Ultrasound Obstet Gynecol. 2007;30:750-756.Google Scholar
  19. 19.
    GRIT Study Group. A randomised trial of timed delivery for the compromised preterm fetus: short term outcomes and Bayesian interpretation. BJOG. 2003;110:27-32.Google Scholar
  20. 20.
    TRUFFLE multicentre group. TRial of Umbilical and Fetal FLow in Europe (TRUFFLE) Study. www.trufflestudy.org/truffle/index.htm. Accessed February 20, 2013.
  21. 21.
    Kennelly MM, Farah N, Turner MJ, Stuart B. Aortic isthmus Doppler velocimetry: role in assessment of preterm fetal growth restriction. Prenat Diagn. 2010;30:395-401.Google Scholar

Copyright information

© Springer Healthcare 2013

Authors and Affiliations

  1. 1.Institute for Pediatric Endocrinology and Preventive MedicineHomburgGermany

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