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Fetal Abdominal Circumference

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21. Mild fetal ventriculomegaly: diagnosis, evaluation, and management

can be genetic (see below) or can result from ?brosis secondary to fetal infection (eg, cytomegalovirus [CMV], toxoplasmosis, or Zika virus) or bleeding (eg, intra- ventricular hemorrhage). In many cases, the cause of aqueductal stenosis is unknown. Amassorcongenitaltumorcanalsoleadtocompression of the aqueduct with resultant ventriculomegaly. In rare cases, a tumor or choroid plexus papilloma may result in overproduction of cerebrospinal ?uid with resultant ven- triculomegaly. 17 Large isolated (...) - tures, including fetal growth restriction; periventricular, hepatic,andotherintraabdominalcalci?cations;echogenic fetal bowel; hepatosplenomegaly; ascites; meconium peri- tonitis;polyhydramnios,andmicrocephaly.However,these features maynotbeevidentuntil lateringestation, andnot all infectedfetuses will have other sonographic signs. Genetic disorders Approximately 5% of fetuses with apparently isolated mild to moderate ventriculomegaly have an abnormal karyo- type, 22 mostcommonlytrisomy21

2019 Society for Maternal-Fetal Medicine

22. Outcome in early-onset fetal growth restriction is best combining computerized fetal heart rate analysis with ductus venosus Doppler: insights from the Trial of Umbilical and Fetal Flow in Europe. Full Text available with Trip Pro

Flow in Europe was a European, multicenter, randomized trial aimed to determine according to which criteria delivery should be triggered in early fetal growth restriction. We present the key findings of the primary and secondary analyses.Women with fetal abdominal circumference <10th percentile and umbilical pulsatility index >95th percentile between 26-32 weeks were randomized to 1 of 3 monitoring and delivery protocols. These were: fetal heart rate variability based on computerized (...) Outcome in early-onset fetal growth restriction is best combining computerized fetal heart rate analysis with ductus venosus Doppler: insights from the Trial of Umbilical and Fetal Flow in Europe. Early-onset fetal growth restriction represents a particular dilemma in clinical management balancing the risk of iatrogenic prematurity with waiting for the fetus to gain more maturity, while being exposed to the risk of intrauterine death or the sequelae of acidosis.The Trial of Umbilical and Fetal

2018 American Journal of Obstetrics and Gynecology

23. Third Trimester Fetal Well-Being Studies

mid line structures ? Lateral ventricles ? Posterior fossa Heart ? Fetal heart rate (FHR), rhythm ? Cardiac size, axis ? Four-chamber view, outflow tracts Chest ? Chest mass (i.e., diaphragmatic hernia) Third Trimester Fetal Well-Being Studies: Criteria & Managing Results | June 2017 Clinical Practice Guideline Page 6 of 16 Recommendations Component Reporting/Recommendations Abdomen ? Stomach ? Kidneys ? Bladders ? Bowel INTERPRETATION OF RESULTS AND PATIENT MANAGEMENT 1. ASSESSMENT OF FETAL SIZE (...) Fetal Weight (EFW) ? Routinely measure: o Biparietal diameter (BPD) o Head circumference (HC) o Abdominal circumference (AC) o Femur length (FL) ? Take at least two measurements of each view and report the best or mean measurement. ? Outliers should trigger the need for a repeat measurement prior to reporting. ? Routinely report the Estimated Fetal Weight (EFW) using Hadlock’s 1 formula (for weight in grams) followed by the Alberta Health gender specific growth curves (see Appendix B) which

2018 Accelerating Change Transformation Team

24. Microcephaly at birth - the accuracy of three references for fetal head circumference. How can we improve prediction? Full Text available with Trip Pro

Microcephaly at birth - the accuracy of three references for fetal head circumference. How can we improve prediction? To evaluate the prediction of microcephaly at birth (micB) using established and two new reference ranges for fetal head circumference (HC) and to assess whether integrating additional parameters can improve prediction.Microcephaly in utero was defined as a fetal HC 3SD below the mean for gestational age according to Jeanty et al.'s reference range. The records of cases (...) with fetal microcephaly (Fmic) were evaluated for medical history, imaging findings, biometry and postnatal examination/autopsy findings. Microcephaly was confirmed at birth (micB) by an occipitofrontal circumference (OFC) or a brain weight at autopsy 2SD below the mean for gestational age. The new INTERGROWTH-21(st) Project and a recent Israeli reference for fetal growth were applied for evaluation of the Fmic positive predictive value (PPV) for diagnosis of micB cases. Optimal HC cut-offs were

2015 Ultrasound in Obstetrics and Gynecology

25. Fetal Abdominal Circumference

Fetal Abdominal Circumference Fetal Abdominal Circumference Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Fetal Abdominal (...) Circumference Fetal Abdominal Circumference Aka: Fetal Abdominal Circumference II. Technique Use ellipse Transverse abdominal Triad Deep portion of ( ) Spine III. Equation Abdominal Circumference = (AP + Transverse) x 1.57 IV. Accuracy Least accurate of measurements for estimating (except 26-32 weeks) Most useful beyond 15 weeks for calculating fetal weight, serial growth and diagnosing References V. Resources AJR Online version of Benson and Doubilet article above Images: Related links to external sites

2015 FP Notebook

26. Evaluating the accuracy and precision of sonographic fetal weight estimation models in extremely early-onset fetal growth restriction. (Abstract)

% - 49.5%) and random error (median 11.6%; range 9.7% - 23.8%) varied widely across models. The best performing model was Hadlock head circumference-abdominal circumference-femur length (HC-AC-FL), regardless of gestational age, fetal size, fetal presentation or asymmetry, with an overall systematic error of 1.5% and random error of 9.7%. Despite this, it only calculated the estimated fetal weight within 10% of birthweight in 64.6% of cases. There was a weak negative relationship between mean (...) Evaluating the accuracy and precision of sonographic fetal weight estimation models in extremely early-onset fetal growth restriction. Birthweight is a critical predictor of survival in extremely early-onset fetal growth restriction (fetal growth restriction diagnosed pre-28 weeks' gestation, with abnormal umbilical/uterine artery Doppler waveforms), therefore accurate fetal weight estimation is a crucial component of antenatal management. Currently available sonographic fetal weight estimation

2019 Acta Obstetricia et Gynecologica Scandinavica

27. Associations between estimated foetal weight discordance and clinical characteristics within dichorionic twins: The NICHD Fetal Growth Studies. (Abstract)

Associations between estimated foetal weight discordance and clinical characteristics within dichorionic twins: The NICHD Fetal Growth Studies. Birthweight discordance is well studied, with less known about longitudinal inter-twin differences in foetal growth.To examine inter-twin per cent differences in EFW (EFW% ), head (HC% ) and abdominal circumference (AC% ), and femur length (FL% ) across gestation in dichorionic twin gestations and explore associated characteristics.Foetal biometrics (...) were assessed by ultrasound and EFW calculated at ≤6 study visits among women with dichorionic twin pregnancies enrolled in the NICHD Fetal Growth Studies cohort (US, 2012-2013). Inter-twin per cent difference was defined: ([Sizelarger twin  - Sizesmaller twin ]/Sizelarger twin  × 100). Linear mixed models evaluated per cent differences in foetal biometrics at 15 weeks and their change per week overall and by maternal/neonatal characteristics in unadjusted and adjusted models.In 140 pregnancies

2019 Paediatric and perinatal epidemiology

28. Fetal Growth Patterns in Pregnancy-Associated Hypertensive Disorders: NICHD Fetal Growth Studies. (Abstract)

constituted the normotensive group. Growth curves for estimated fetal weight and individual biometric parameters including biparietal diameter, head circumference, abdominal circumference, femur and humerus length were calculated for each group using linear mixed models with cubic splines. Global and weekly pairwise comparisons were performed between women with a hypertensive disorder compared with normotensive women to analyze differences while adjusting for confounding variables. Delivery gestational (...) significantly smaller fetal abdominal circumference between 23 to 31 and 33 to 37 weeks' gestation (weekly pair-wise P values <.04). Scattered weekly growth differences were noted on other biometric parameters between these two groups. The consistent differences in estimated fetal weight and abdominal circumference were not observed between women with other hypertensive disorders and those who were normotensive. Women with severe preeclampsia delivered significantly earlier (mean gestational age 35.9 ± 3.2

2019 American Journal of Obstetrics and Gynecology

29. Glycemic control and fetal abdominal circumference Full Text available with Trip Pro

Glycemic control and fetal abdominal circumference To study about the correlation between the glycemic status and increase in fetal abdominal circumference in gestational diabetes patients and its relationship with fetal birth weight.Seventy-five gestational diabetes mellitus (GDM) patients were taken up for study with duly informed consent and suggested for anthropometry profile and glycemic profile with HbA1C. Fetal abdominal circumference was measured during routine scans. The patients were (...) followed up till delivery and the fetal birth was noted.Seventy-five gestational diabetic mothers who have attended a secondary level diabetic clinic and on regular follow-up were included in the study.Pre-GDM mothers, patients with co-morbid disease were excluded from the study.Fetal abdominal circumference correlated well with fluctuating glycemic control and fetal birth weight.

2012 Indian journal of endocrinology and metabolism

30. Maternal Sildenafil vs Placebo in Pregnant Women With Severe Early-Onset Fetal Growth Restriction: A Randomized Clinical Trial Full Text available with Trip Pro

. Participants included pregnant women between 20 and 30 weeks of gestation with severe fetal growth restriction, defined as fetal abdominal circumference below the third percentile or estimated fetal weight below the fifth percentile combined with Dopplers measurements outside reference ranges or a maternal hypertensive disorder. The trial was stopped early owing to safety concerns on July 19, 2018, whereas benefit on the primary outcome was unlikely. Data were analyzed from January 20, 2015, to January 18 (...) Maternal Sildenafil vs Placebo in Pregnant Women With Severe Early-Onset Fetal Growth Restriction: A Randomized Clinical Trial Maternal Sildenafil vs Placebo in Pregnant Women With Severe Early-Onset Fetal Growth Restriction: A Randomized Clinical Trial - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Clipboard, Search History, and several other advanced features are temporarily unavailable. COVID-19 is an emerging

2020 EvidenceUpdates

31. Intrapartum fetal surveillance – Indications

or fetal complications, intrapartum fetal monitoring may be performed by intermittent auscultation Consensus In women with hyper- or hypothyroidism and obstetric or fetal complications, intrapartum fetal monitoring should be performed according to the procedure for these complications Consensus Fetal weight deviation – 15 to – 22% Summary of evidence Grade of evidence Fetal weight deviation of more than -15 % in combination with deviating abdominal circumference is significantly associated with low (...) -15% 4 . 562 fostre havde vægtestimat under - 15%. 172 af disse havde ud over et vægtestimat på under -15% også et vigende abdominalomfang. Dette er i studiet defineret som vækst af abdominalomfang under 10 percentilen ved sammenligning af målinger i uge 20 og ved sidste scanning inden fødslen (Abdominal circumference growth velosity, ACGW). I gruppen af fostre med vægtestimat under -15% og vigende vækst af abdominalomfang fandtes en signifikant øget risiko for Apgar score under 7 efter 5 minutter

2017 Nordic Federation of Societies of Obstetrics and Gynecology

32. Are selection criteria for healthy pregnancies responsible for the gap between fetal growth in the French national Elfe birth cohort and the Intergrowth-21st fetal growth standards? Full Text available with Trip Pro

potential differences could be due to IG criteria for "healthy" pregnancies.We analysed data on femur length and abdominal circumference at the second and/or the third recommended ultrasound examination from 14 607 singleton pregnancies from the Elfe national birth cohort. We compared concordance of centile thresholds using the IG standards and current French references and used restricted cubic splines to plot z-scores by gestational age. A "healthy pregnancy" sub-sample was created based on maternal (...) and pregnancy selection criteria, as specified by IG.Mean gestational age-specific z-scores for femur length and abdominal circumference using French references fluctuated around 0 (-0.2 to 0.1), while those based on IG standards were higher (0.3-0.8). Using IG standards, 2.5% and 5.2% of fetuses at the third ultrasound were <10th centile for femur length and abdominal circumference, respectively, and 31.5% and 16.7% were >90th. Only 34% of pregnancies fulfilled IG low-risk criteria, but sub-analyses

2018 Paediatric and perinatal epidemiology

33. Melatonin Increases Fetal Weight in Wild-Type Mice but Not in Mouse Models of Fetal Growth Restriction Full Text available with Trip Pro

did, however, significantly increase abdominal circumference in P0+/- mice. Melatonin had no effect on placental weight in any group. Uterine arteries from eNOS-/- mice demonstrated aberrant function compared with WT but melatonin treatment did not affect uterine artery vascular reactivity in either of these genotypes. Umbilical arteries from melatonin treated P0+/- mice demonstrated increased relaxation in response to the nitric oxide donor SNP compared with control. The increased fetal weight (...) in WT mice and abdominal circumference in P0+/-, together with the lack of any effect in eNOS-/-, suggest that the presence of eNOS is required for the growth promoting effects of melatonin. This study supports further work on the possibility of melatonin as a treatment for FGR.

2018 Frontiers in physiology

34. Fetal Growth Velocity: the NICHD Fetal Growth Studies. Full Text available with Trip Pro

. Ultrasound biometric measurements included biparietal diameter, head circumference, abdominal circumference, and femur length, and estimated fetal weight was calculated. We used linear mixed models with cubic splines for the fixed effects and random effects to flexibly model ultrasound trajectories. We computed velocity percentiles in 2 ways: (1) difference between 2 consecutive weekly measurements (ie, weekly velocity), and (2) difference between any 2 ultrasounds at a clinically reasonable difference (...) by whether or not estimated fetal weight and estimated fetal weight velocity were <5th or ≥5th percentiles using χ2.Fetal growth velocity was nonmonotonic, with acceleration early in pregnancy, peaking at 13, 14, 15, and 16 weeks for biparietal diameter, head circumference, femur length, and abdominal circumference, respectively. Biparietal diameter, head circumference, and abdominal circumference had a second acceleration at 19-22, 19-21, and 27-31 weeks, respectively. Estimated fetal weight velocity

2018 American Journal of Obstetrics and Gynecology

35. Fetal Medicine Foundation fetal and neonatal population weight charts. Full Text available with Trip Pro

, should comprise all babies at a given gestational age, including those still in utero.Two sources of data were used for this study. For both, the inclusion criteria were singleton pregnancy, dating by fetal crown-rump length at 11 + 0 to 13 + 6 weeks' gestation, availability of ultrasonographic measurements of fetal head circumference (HC), abdominal circumference (AC) and femur length (FL) and live birth of phenotypically normal neonate. Dataset 1 comprised a sample of 5163 paired measurements (...) Fetal Medicine Foundation fetal and neonatal population weight charts. To develop fetal and neonatal population weight charts. The rationale was that, while reference ranges of estimated fetal weight (EFW) are representative of the whole population, the traditional approach of deriving birth-weight (BW) charts is misleading, because a large proportion of babies born preterm arise from pathological pregnancy. We propose that the reference population for BW charts, as in the case of EFW charts

2018 Ultrasound in Obstetrics and Gynecology

36. Pomegranate Juice Supplementation Alters Utero-Placental Vascular Function and Fetal Growth in the eNOS−/− Mouse Model of Fetal Growth Restriction Full Text available with Trip Pro

respectively in both genotypes. Contrary to our hypothesis, the changes in artery function induced by PJ were not associated with an increase in fetal weight. However, PJ supplementation reduced litter size and fetal abdominal and head circumference in both genotypes. Collectively the data do not support maternal PJ supplementation as a safe or effective treatment for FGR. (...) Pomegranate Juice Supplementation Alters Utero-Placental Vascular Function and Fetal Growth in the eNOS−/− Mouse Model of Fetal Growth Restriction The eNOS-/- mouse provides a well-characterized model of fetal growth restriction (FGR) with altered uterine and umbilical artery function and reduced utero- and feto-placental blood flow. Pomegranate juice (PJ), which is rich in antioxidants and bioactive polyphenols, has been posited as a beneficial dietary supplement to promote cardiovascular

2018 Frontiers in physiology

37. STRIDER NZAus: A multicentre randomised controlled trial of sildenafil therapy in early-onset fetal growth restriction Full Text available with Trip Pro

-treated [adjusted odds ratio (OR) 0.49, 95% CI 0.23-1.05] and had no effect on abdominal circumference Z-scores (P = 0.61). Sildenafil use was associated with a lower mean uterine artery pulsatility index after 48 hours of treatment (1.56 versus 1.81; P = 0.02). The live birth rate was 56/63 (88.9%) for sildenafil-treated and 47/59 (79.7%) for placebo-treated (adjusted OR 2.50, 95% CI 0.80-7.79); survival to hospital discharge free of major neonatal morbidity was 42/63 (66.7%) for sildenafil-treated (...) STRIDER NZAus: A multicentre randomised controlled trial of sildenafil therapy in early-onset fetal growth restriction To assess the effect of maternal sildenafil therapy on fetal growth in pregnancies with early-onset fetal growth restriction.A randomised placebo-controlled trial.Thirteen maternal-fetal medicine units across New Zealand and Australia.Women with singleton pregnancies affected by fetal growth restriction at 22+0 to 29+6 weeks.Women were randomised to oral administration of 25 mg

2019 EvidenceUpdates

38. The effect of a maternal meal on fetal liver blood flow. Full Text available with Trip Pro

The effect of a maternal meal on fetal liver blood flow. During the third trimester of development, the human fetus accumulates fat, an important energy reservoir during the early postnatal period. The fetal liver, perfused by the nutrient-rich and well-oxygenated blood coming directly from the placenta, is assumed to play a central role in these processes. Earlier studies have linked fetal liver blood flow with maternal nutritional status and response to the maternal oral glucose tolerance (...) was 39.3 (‒83.0-156.1) ml/min (p<0.001); in contrast, we observed no statistically significant change in the overweight group (‒44.5 (‒229.0-123.2) ml/min; p = 0.073). As a substitute for liver size, we divided the delta liver flow values by abdominal circumference and found no changes in the statistical significance results within or between the two weight groups.In our healthy study population, we observed a statistically significant difference in liver blood flow after maternal intake of a regular

2019 PLoS ONE

39. Prediction of small-for-gestational age by fetal growth rate according to gestational age. Full Text available with Trip Pro

the ultrasonographic parameters that contribute substantially to the birthweight determination.This was a retrospective study of 442 healthy pregnant women with singleton pregnancies. There were 328 adequate-for-gestational age (AGA) neonates and 114 SGA infants delivered between 37+0 and 41+6 weeks of gestation. We compared the biparietal diameters (BPD), head circumferences (HC), abdominal circumferences (AC), femur lengths (FL), and estimated fetal weights (EFW) obtained on each ultrasound to determine which (...) Prediction of small-for-gestational age by fetal growth rate according to gestational age. Small-for-gestational age (SGA) infants should be identified before birth because of an increased risk of adverse perinatal outcomes. The objective of this study was to assess the impact of fetal growth rate by gestational age on the prediction of SGA and to identify the optimal time to initiate intensive fetal monitoring to detect SGA in low-risk women. We also sought to determine which

2019 PLoS ONE

40. Fetal growth and fetoplacental circulation in pregnancies following bariatric surgery: a prospective study. (Abstract)

glucose tolerance test (OGTT) was performed at 27-30 weeks. Fetal head and abdominal circumference (AC), femur length (FL), estimated fetal weight (EFW) and fetoplacental Dopplers were measured at three time-points in pregnancy. Birthweight (BW) was recorded. Variables were modelled after adjustment for maternal/pregnancy characteristics. Model estimates are reported as posterior means and quantile-based 90% credible intervals (CrI).Fetal biometry, fetoplacental Doppler, BW.Compared (...) Fetal growth and fetoplacental circulation in pregnancies following bariatric surgery: a prospective study. To investigate the intrauterine fetal growth pattern and fetoplacental circulation in pregnancies following bariatric surgery.Prospective study.Maternity Unit, UK.One hundred and sixty-two pregnant women; 54 with previous bariatric surgery and 108 with no surgery but similar booking body mass index.Participants were seen at 11-14, 20-24, 30-33 and 35-37 weeks of gestation and an oral

2020 BJOG

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