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Fetal Abdominal Circumference

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61. Maternal sildenafil for severe fetal growth restriction (STRIDER): a multicentre, randomised, placebo-controlled, double-blind trial. Full Text available with Trip Pro

at randomisation (before week 26 and 0 days or at week 26 and 0 days or later). We defined fetal growth restriction as a combination of estimated fetal weight or abdominal circumference below tenth percentile and absent or reversed end-diastolic blood flow in the umbilical artery on Doppler velocimetry. The primary outcome was the time from randomisation to delivery, measured in days. This study is registered with BioMed Central, number ISRCTN 39133303.Between Nov 21, 2014, and July 6, 2016, we recruited 135 (...) Maternal sildenafil for severe fetal growth restriction (STRIDER): a multicentre, randomised, placebo-controlled, double-blind trial. Severe early-onset fetal growth restriction can lead to a range of adverse outcomes including fetal or neonatal death, neurodisability, and lifelong risks to the health of the affected child. Sildenafil, a phosphodiesterase type 5 inhibitor, potentiates the actions of nitric oxide, which leads to vasodilatation of the uterine vessels and might improve fetal

2018 The Lancet. Child & Adolescent Health Controlled trial quality: predicted high

62. The impact of restricted gestational weight gain by dietary intervention on fetal growth in women with gestational diabetes mellitus. Full Text available with Trip Pro

therapy was initiated if necessary, according to local clinical guidelines.Glucose tolerance, HbA1c, weekly GWG before dietary treatment (difference between weight at GDM diagnosis and pre-pregnancy weight, divided by the number of weeks) and SD score for fetal abdominal circumference were comparable across the three groups at diagnosis of GDM at 276 ± 51 weeks (gestation time is given as weeksdays). The women were followed for 100 ± 51 weeks, during which 54% received supplementary insulin therapy (...) The impact of restricted gestational weight gain by dietary intervention on fetal growth in women with gestational diabetes mellitus. We aimed to investigate the impact of maternal gestational weight gain (GWG) during dietary treatment on fetal growth in pregnancies complicated by gestational diabetes (GDM).This was a retrospective cohort study of 382 women consecutively diagnosed with GDM before 34 weeks' gestation with live singleton births in our centre (Center for Pregnant Women

2018 Diabetologia

63. Point of Care Ultrasound Screening for Abnormal Fetal Growth During Routine Antenatal Visits

Posted : October 22, 2018 Last Update Posted : March 6, 2019 See Sponsor: The University of Texas Medical Branch, Galveston Information provided by (Responsible Party): The University of Texas Medical Branch, Galveston Study Details Study Description Go to Brief Summary: Abdominal circumference (AC) in the fetus is the single most useful indicator of fetal growth abnormalities. Measurement of AC as well as DVP do not require extensive training. Our objective is to evaluate if introduction of bedside (...) , including trained sonographers and physicians to perform and review the ultrasound, as well as a full examination with multiple fetal measurements and images. A number of recent analyses show that measurement of the abdominal circumference (AC) in the fetus is the single most useful indicator of fetal growth abnormalities. Measurement of AC as well as DVP do not require extensive training, long time to acquire, or expensive ultrasound machines. They can be easily performed in the office by providers who

2018 Clinical Trials

64. Fetal Interventricular Septum Thickness and Maternal Gestational Diabetes Control

be adversely affected by gestational diabetes mellitus. For instance, the abdominal circumference measurement during routine fetal biometry was used successfully to identify pregnancies with a higher risk of fetal macrosomia (Schaefer-Graf 2003, De Reu 2008, Rosati 2010). In recent years, the fetal interventricular septum thickness, as detected by two-dimensional ultrasound, was shown to be significantly thicker in the presence of gestational diabetes mellitus, independently of maternal glycemic control (...) Not Applicable Detailed Description: Rational for the study If fetal interventricular septum hypertrophy in pregnancies with gestational diabetes mellitus appears prior to either fetal abdominal circumference measurement > 90th percentile or the abnormal maternal glucose levels, then future management of women with gestational diabetes mellitus might be targeted earlier at these pregnancies to ensure a more favorable outcome. Objective To determine the thickness of fetal interventricular septum in women

2018 Clinical Trials

65. Human yolk sac size reflects involvement in embryonic and fetal growth regulation. Full Text available with Trip Pro

. Maternal weight was negatively associated with the yolk sac diameter (P = 0.007) and so was maternal height (P = 0.011), fat mass (P = 0.037), and lean body mass (P = 0.018), but not body mass index (P = 0.121). Significant effects were predominantly due to the female embryos and could be traced at 24 weeks of gestation. That is, a small yolk sac : crown-rump length ratio in early pregnancy was associated with a high fetal abdominal circumference (P < 0.001) and estimated fetal weight (P = 0.001 (...) Human yolk sac size reflects involvement in embryonic and fetal growth regulation. The human yolk sac provides the embryo with stem cells, nutrients, and gas exchange. We hypothesized that more maternal resources, reflected in body size and body composition, would condition a a larger yolk sac, ensuring resources for the growing embryo. Thus, we aimed to determine the relation between maternal size in early pregnancy and yolk sac size.This subsidiary study was embedded in the multinational

2018 Acta Obstetricia et Gynecologica Scandinavica

66. Essential variables for reporting research studies on fetal growth restriction - a Delphi consenus. Full Text available with Trip Pro

including maternal characteristics, prenatal investigations, management and pregnancy/neonatal outcomes. Essential parameters included hypertensive complications in the current pregnancy, smoking, parity, maternal age, abdominal circumference, estimated fetal weight, umbilical artery Doppler (pulsatility index and end-diastolic flow), middle cerebral artery Doppler, indications for intervention, pregnancy outcome (live birth, stillbirth or neonatal death), gestational age at delivery, birthweight (...) Essential variables for reporting research studies on fetal growth restriction - a Delphi consenus. To achieve consensus on the minimum reporting set of study variables for fetal growth restriction (FGR) research studies. Determination of a list of variables considered essential to be reported independent of a specific hypothesis is likely to improve the study quality by inclusion of essential end-points, enhancing the consistency among studies and minimizing potential confounding. This in turn

2018 Ultrasound in Obstetrics and Gynecology

67. Genetic and Environmental Influences on Fetal Growth Vary during Sensitive Periods in Pregnancy Full Text available with Trip Pro

Genetic and Environmental Influences on Fetal Growth Vary during Sensitive Periods in Pregnancy Aberrant fetal growth is associated with morbidities and mortality during childhood and adult life. Although genetic and environmental factors are known to influence in utero growth, their relative contributions over pregnancy is unknown. We estimated, across gestation, the genetic heritability, contribution of shared environment, and genetic correlations of fetal growth measures (abdominal (...) circumference (AC), humerus length (HL), femur length (FL), and estimated fetal weight (EFW)) in a prospective cohort of dichorionic twin gestations recruited through the NICHD Fetal Growth Studies. Structural equation models were fit at the end of first trimester, during mid-gestation, late second trimester, and third trimester of pregnancy. The contribution of fetal genetics on fetal size increased with gestational age, peaking in late second trimester (AC = 53%, HL = 57%, FL = 72%, EFW = 71%; p < 0.05

2018 Scientific reports

68. Evaluation of automated tool for 2D fetal biometry. (Abstract)

Evaluation of automated tool for 2D fetal biometry. To determine whether an automated tool can automatically measure the fetal head circumference (HC), abdominal circumference (AC) and femur length (FL) on frozen 2D ultrasound images.Ultrasound images from 100 pregnancies between 20 to 40 weeks of gestation were assessed, ensuring equal distribution of data throughout gestational age. For each pregnancy, three standard biometric variables (HC, AC, FL) were measured three times (nine independent (...) were calculated and expressed as percentages to correct for fetal growth with advancing gestation.After exclusion of one pregnancy (due to technical failure), a total of 891 images, 297 for each biometric variable, were analyzed. The algorithm failed to place calipers for the AC in 9 images, whereas there were no failures on HC and FL. In the subjective quality assessment of automatic caliper placement, 475 images (53.3%) were judged to be clinically acceptable and did not require any adjustment

2018 Ultrasound in Obstetrics and Gynecology

69. Fetal Biometric Charts and Reference Equations for Pregnant Women Living in Port Said and Ismailia Governorates in Egypt Full Text available with Trip Pro

was between the 12th and 41st weeks of gestation, recruited from the district general hospital in Ismailia and Port Said to measure ultrasonographically biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL), then for each measurement separate regression models were fitted to estimate both the mean and the Standard deviation at each gestational age.New Egyptian charts were reported for BPD, HC, AC, and FL. Reference equations for the dating of pregnancy were (...) Fetal Biometric Charts and Reference Equations for Pregnant Women Living in Port Said and Ismailia Governorates in Egypt To construct new fetal biometric charts and equations for some fetal biometric parameters for women between 12th and 41st weeks living in Ismailia and Port Said Governorates in Egypt.This cross-sectional study was carried out on 656 Egyptian women (from Ismailia and Port Said governorates) with an uncomplicated pregnancy, and all were sure of their dates. The selected group

2018 Open access Macedonian journal of medical sciences

70. Fetal growth and incidence of atopic dermatitis in early childhood: Results of the Ulm SPATZ Health Study Full Text available with Trip Pro

diagnosis by age 3 years. Measurements of 386 newborns in the Ulm SPATZ Health Study were converted into adjusted z-scores categorized as "low" (≤1 SD below mean), "normal," or "high" (≥1 SD above mean). AD cases were defined using parent- or pediatrician-report of physician-diagnosis or clinical diagnosis. Adjusted risk ratios (RR) with 95% confidence intervals (95% CI) were calculated using modified Poisson regression. Compared to normal, both low and high 2nd trimester abdominal circumference [RR (...) 1.51, (95% CI 1.01; 2.24) and 1.83 (1.21; 2.76)], high 2nd trimester head- abdominal circumference ratio [1.69 (1.16; 2.48)], and faltering 2nd to 3rd trimester [1.59 (1.04; 2.43)] head circumference were associated with greater AD risk. High 3rd trimester femur length [0.54 (0.31; 0.94)] was associated with lower risk. Using more inclusive exposure cut-points (0.8 SD), lower 1st trimester crown-rump length was also associated with greater AD risk. Our data suggest several different patterns

2018 Scientific reports

71. The effects of gestational diabetes mellitus on fetal growth and neonatal birth measures in an African cohort. Full Text available with Trip Pro

up with repeated fetal ultrasounds. At 24-28 weeks' gestation a 2-h 75 g oral glucose tolerance test was performed and GDM was diagnosed using the World Health Organization's 2013 criteria. Neonatal birth measures were assessed.The study involved 741 women; 83 (11.2%) with GDM and 658 (88.8%) without. A total of 4040 fetal ultrasounds were performed. GDM exposure was associated with an increase in fetal growth measures, especially abdominal circumference, which was already seen at 16-18 weeks (...) differences in fetal growth were observed, with GDM-exposed male fetuses being more affected with larger abdominal circumferences than females. A low rate of macrosomia was observed compared with historical GDM populations.© 2018 Diabetes UK.

2018 Diabetic Medicine

72. The mediating effects of gestational diabetes on fetal growth and adiposity in women who are overweight and obese: secondary analysis of the LIMIT randomised trial. Full Text available with Trip Pro

], abdominal circumference [direct effect 0.26 (95% CI: 0.11-0.41), P = 0.001; total effect 0.26 (95% CI: 0.11-0.42), P = 0.001] and estimated fetal weight [direct effect 0.22 (95% CI: 0.08-0.35), P = 0.002; total effect 0.22 (95% CI: 0.08-0.35), P = 0.002], with no evidence of mediation by treated gestational diabetes. There was no apparent association between maternal BMI and fetal adiposity measures, or mediation by treated gestational diabetes.We show an important association between increased maternal (...) gestation.Fetal ultrasound measures at 36 weeks of gestation and baseline BMI from women randomised to the LIMIT trial Standard Care group (n = 912 women) were used to conduct causal mediation analyses using regression-based methods.Ultrasound measures of fetal biometry and adiposity at 36 weeks of gestation.Increased maternal BMI was associated with increased measures of fetal head circumference [direct (unmediated) effect 0.18 (95% CI: 0.05-0.31), P = 0.005; total effect 0.17 (95% CI: 0.02-0.31), P = 0.018

2018 BJOG Controlled trial quality: uncertain

73. Femur-Sparing Pattern of Abnormal Fetal Growth in Pregnant Women from New York City After Maternal Zika Virus Infection. Full Text available with Trip Pro

for the 21st Century Project and World Health Organization Fetal Growth Chart sonographic standards were applied to obtain Z-scores and/or percentiles for fetal head circumference, abdominal circumference, and femur length specific for each gestational week. A novel 2014 International Fetal and Newborn Growth Consortium for the 21st Century Project standard was also developed to generate Z-scores for fetal body ratios with respect to femur length (head circumference:femur length, abdominal (...) circumference:femur length). Data were then grouped within clinically relevant gestational age strata (<24, 24-27 6/7, 28-33 6/7, >34 weeks) to analyze time-dependent effects of Zika virus infection on fetal size. Statistical analysis was performed using Wilcoxon signed-rank test on paired data, comparing either abdominal circumference or head circumference to femur length.A total of 56 pregnant women were included in the study with laboratory evidence of a confirmed or possible recent Zika virus infection. Based

2018 American Journal of Obstetrics and Gynecology

74. Fetal Growth Patterns in Pregnancies With First-Trimester Bleeding. Full Text available with Trip Pro

, parity, and racial-ethnic group and neonatal sex in a sensitivity analysis.In 2,307 eligible women, 410 (17.8%) reported first-trimester bleeding, of whom 176 bled for 1 day and 234 bled for more than 1 day. Women with more than 1 day of bleeding demonstrated decreased fetal abdominal circumference from 34 to 39 weeks of gestation compared with women without bleeding. For women with more than 1 day of bleeding, compared with women without bleeding, estimated fetal weight was 68-107 g smaller from 35 (...) to 39 weeks of gestation. Mean birth weight at term was 88 g smaller, confirming differences in calculated fetal weight, and SGA neonates were delivered to 148 (8.5%), 9 (5.7%), and 33 (15.7%) women in the no bleeding, 1 day, and more than 1 day of bleeding groups, respectively.More than 1 day of first-trimester vaginal bleeding was associated with smaller estimated fetal weight late in pregnancy driven by smaller abdominal circumference. The magnitude of decrease in birth weight was small, albeit

2018 Obstetrics and Gynecology

75. Fetal growth velocity and body proportion in the assessment of growth. Full Text available with Trip Pro

and interval between exams. The second strategy refers to the use of fetal body proportions to classify fetuses as either symmetric or asymmetric using 1 of several ratios; these include the head circumference to abdominal circumference ratio, transverse cerebellar diameter to abdominal circumference ratio, and femur length to abdominal circumference ratio. Although these ratios are associated with small for gestational age at birth and with adverse perinatal outcomes, their predictive accuracy is too low (...) for clinical practice. Furthermore, these associations become questionable when other, potentially more specific measures such as umbilical artery Doppler are being used. Furthermore, these ratios are of limited use in determining the etiology underlying fetal smallness. It is possible that the use of the 2 gestational-age-independent ratios (transverse cerebellar diameter to abdominal circumference and femur length to abdominal circumference) may have a role in the detection of mild-moderate fetal growth

2018 American Journal of Obstetrics and Gynecology

76. Diagnosis and surveillance of late-onset fetal growth restriction. Full Text available with Trip Pro

in pregnancy (around 37 weeks) increases the detection rate for birthweight <3rd centile. Contrary to early fetal growth restriction, umbilical artery Doppler velocimetry alone does not provide good differentiation between late smallness for gestational age and fetal growth restriction. A combination of biometric parameters (with severe smallness usually defined as estimated fetal weight or abdominal circumference <3rd centile) with Doppler criteria of placental insufficiency (either in the maternal (...) Diagnosis and surveillance of late-onset fetal growth restriction. By consensus, late fetal growth restriction is that diagnosed >32 weeks. This condition is mildly associated with a higher risk of perinatal hypoxic events and suboptimal neurodevelopment. Histologically, it is characterized by the presence of uteroplacental vascular lesions (especially infarcts), although the incidence of such lesions is lower than in preterm fetal growth restriction. Screening procedures for fetal growth

2018 American Journal of Obstetrics and Gynecology

77. Consensus definition and essential reporting parameters of selective fetal growth restriction in twin pregnancy: a Delphi procedure. Full Text available with Trip Pro

agreed to participate and entered the first round; 48 (80%) completed all four rounds. For the definition of sFGR irrespective of chorionicity, one solitary parameter (estimated fetal weight (EFW) of one twin < 3rd centile) was agreed. For monochorionic twin pregnancy, at least two out of four contributory parameters (EFW of one twin < 10th centile, abdominal circumference of one twin < 10th centile, EFW discordance of ≥ 25%, and umbilical artery pulsatility index of the smaller twin > 95th centile (...) Consensus definition and essential reporting parameters of selective fetal growth restriction in twin pregnancy: a Delphi procedure. Twin pregnancy complicated by selective fetal growth restriction (sFGR) is associated with increased perinatal mortality and morbidity. Inconsistencies in the diagnostic criteria for sFGR employed in existing studies hinder the ability to compare or combine their findings. It is therefore challenging to establish robust evidence-based management or monitoring

2018 Ultrasound in Obstetrics and Gynecology

78. Gestational diabetes and ultrasound-assessed fetal growth in South Asian and White European women: findings from a prospective pregnancy cohort. Full Text available with Trip Pro

10,705 singletons (4747 White European and 5958 South Asian) from a prospective cohort of women attending an antenatal clinic in Bradford, in the North of England. All women completed a 75-g oral glucose tolerance test at 26-28 weeks' gestation. Ultrasound measurements of fetal head circumference (HC), femur length (FL) abdominal circumference (AC), and estimated fetal weight (EFW), and corresponding anthropometric measurements at birth were used to derive fetal growth trajectories. Associations (...) Gestational diabetes and ultrasound-assessed fetal growth in South Asian and White European women: findings from a prospective pregnancy cohort. Maternal gestational diabetes (GDM) is an established risk factor for large size at birth, but its influence on intrauterine fetal growth in different ethnic populations is less well understood. Here, we examine the joint associations of GDM and ethnicity with longitudinal fetal growth in South Asian and White European origin women.This study included

2018 BMC Medicine

79. Foetal weight prediction models at a given gestational age in the absence of ultrasound facilities: application in Indonesia. Full Text available with Trip Pro

at a given gestational age was assessed using multi-prediction accuracy measures.Four weight prediction models based on fundal height and its combinations with gestational age (between 32 and 41 weeks) and ultrasonic estimates of foetal head circumference and foetal abdominal circumference have been developed. Multiple comparison criteria show that the proposed models were more accurate than the existing models (mean prediction errors between - 0.2 and 2.4 g and median absolute percentage errors between (...) Foetal weight prediction models at a given gestational age in the absence of ultrasound facilities: application in Indonesia. Birth weight is one of the most important indicators of neonatal survival. A reliable estimate of foetal weight at different stages of pregnancy would facilitate intervention plans for medical practitioners to prevent the risk of low birth weight delivery. This study has developed reliable models to more accurately predict estimated foetal weight at a given gestation age

2018 BMC Pregnancy and Childbirth

80. Fetal growth restriction in rural Bangladesh: a prospective study Full Text available with Trip Pro

Fetal growth restriction in rural Bangladesh: a prospective study Fetal growth restriction (FGR) and low birth weight(LBW) are serious public health problems. In developing countries, the incidence of low birth weight is predominantly the result of FGR, and both low birth weight and FGR are associated with neonatal death and later growth and development. Fetal growth charts are important for assessing the size of the fetus during pregnancy. The aims of this study were to describe the fetal (...) growth pattern of a population in rural Bangladesh where maternal undernutrition is prevalent and to compare the timing of FGR in that population with WHO and INTERGROWTH- 21st international reference values.From November 2001 to October 2003, pregnant women were recruited in Matlab, a sub district of Bangladesh, and underwent three follow-up ultrasound examinations during pregnancy for measurement of the parameters of the fetal head, abdomen, and femur. The data were fitted to a linear-cubic model

2018 Tropical medicine and health

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