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Fetal Abdominal Circumference

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121. Impact of replacing Chinese ethnicity-specific fetal biometry charts with the INTERGROWTH-21<sup>st</sup> standard. (Full text)

Impact of replacing Chinese ethnicity-specific fetal biometry charts with the INTERGROWTH-21st standard. To assess the impact of adopting the INTERGROWTH-21(st) biometry standards in a Chinese population.Retrospective cohort study.A teaching hospital in Hong Kong.A total of 10 527 Chinese women with a singleton pregnancy having a second- or third-trimester fetal anomaly or growth scan between January 2009 and June 2014.Z-scores were derived for fetal abdominal circumference (AC (...) ), head circumference (HC), and femur length (FL) using the INTERGROWTH-21(st) and Chinese biometry standards. Pregnancies with aneuploidy, structural or skeletal abnormalities, or that developed pre-eclampsia were excluded. Z-scores were stratified as <2.5th, <5th, <10th, >90th, >95th, or >97.5th percentile. Birthweight centile, adjusted for gestation and gender, was categorised as ≤3rd, 3rd to ≤5th, 5th to ≤10th, and >10th. Pairwise comparison and the McNemar test were performed to assess biometry Z

2016 BJOG

122. Increased fetal adiposity prior to diagnosis of gestational diabetes in South Asians: more evidence for the 'thin-fat' baby. (Full text)

head circumference (HC), abdominal circumference (AC), femur length (FL) and biparietal diameter (BPD) were recorded at 11, 20 and 32 weeks. Anterior abdominal wall thickness (AAWT) as a marker of abdominal adiposity at 20 and 32 weeks was compared between groups. Adjustments were made for maternal age, BMI, parity, gestational weight gain, fetal sex and gestational age.Fetuses of women with GDM had significantly higher AAWT at 20 weeks (β 0.26 [95% CI 0.15, 0.37] mm, p < 0.0001) despite lower (...) Increased fetal adiposity prior to diagnosis of gestational diabetes in South Asians: more evidence for the 'thin-fat' baby. Gestational diabetes mellitus (GDM) is associated with an increased future risk of obesity in the offspring. Increased adiposity has been observed in the newborns of women with GDM. Our aim was to examine early fetal adiposity in women with GDM.Obstetric and sonographic data was collated for 153 women with GDM and 178 controls from a single centre in Chennai, India. Fetal

2016 Diabetologia

123. IMPLEMENTING THE INTERGROWTH-21<sup>st</sup> FETAL GROWTH STANDARDS IN FRANCE: A « FLASH » STUDY OF THE COLLEGE FRANÇAIS D'ECHOGRAPHIE FOETALE (CFEF). (Full text)

were recruited prospectively within the network of the national French College of Fetal Ultrasound, CFEF, over a 6-week period. Further selection was performed based on the criteria of the IG-21st Project in order to obtain a comparable population. Head circumference (HC) was used as the main fat-free skeletal measure of growth for comparison of French fetal size with that of the IG-21st population. The impact of switching to the IG-21st fetal growth standards was quantified by comparing Z-scores (...) calculated using the IG-21st standards with those calculated using locally derived reference ranges for HC, abdominal circumference (AC) and femur length (FL).Following selection, 4858 cases were analyzed. The distribution of HC demonstrated clear similarity between our French population and the IG-21st population: our observed centile curves closely matched those of IG-21st and the Z-scores were close to 0 across gestational age. The IG-21st standards performed as well as did locally derived charts

2016 Ultrasound in Obstetrics and Gynecology

124. Estimation of fetal weight in pregnancies past term. (Full text)

Estimation of fetal weight in pregnancies past term. The aim of the study was to investigate the accuracy of estimating fetal weight with ultrasound in pregnancies past term, using the eSnurra algorithm.In all, 419 women with pregnancy length of 290 days, attending a specialist consultation at Stavanger University Hospital, Norway, were included in a prospective observational study. Fetal weight was estimated using biparietal diameter (BPD) and abdominal circumference (AC). The algorithm (...) implemented in an electronic calculation (eSnurra) was used to compute estimated fetal weight (EFW). Results were compared with birthweight (BW).The mean interval between the ultrasound examination and birth was 2 days (SD 1.4). The median difference between BW and EFW was -6 g (CI -40 to +25 g) and the median percentage error was -0.1% (95% CI -1.0 to 0.6%). The median absolute difference was 190 g (95% CI 170-207 g). The BW was within 10% of EFW in 83% (95% CI 79-87%) of cases and within 15% of EFW

2016 Acta Obstetricia et Gynecologica Scandinavica

125. Placental growth factor as a marker of fetal growth restriction caused by placental dysfunction. (Full text)

Placental growth factor as a marker of fetal growth restriction caused by placental dysfunction. Discriminating between placentally-mediated fetal growth restriction and constitutionally-small fetuses is a challenge in obstetric practice. Placental growth factor (PlGF), measurable in the maternal circulation, may have this discriminatory capacity.Plasma PlGF was measured in women presenting with suspected fetal growth restriction (FGR; ultrasound fetal abdominal circumference <10th percentile (...) parameters for fetal assessment. For all cases, the relationship between PlGF and the sampling-to-delivery interval was determined.Low PlGF identified placental FGR with an area under the receiver-operator characteristic curve of 0.96 [95% CI 0.93-0.98], 98.2% [95% CI 90.5-99.9] sensitivity and 75.1% [95% CI 67.6-81.7] specificity. Negative and positive predictive values were 99.2% [95% CI 95.4-99.9] and 58.5% [95% CI 47.9-68.6], respectively. Low PlGF outperformed gestational age, abdominal

2016 Placenta

126. General movements after fetal growth restriction in relation to prenatal Doppler flow patterns. (Full text)

General movements after fetal growth restriction in relation to prenatal Doppler flow patterns. To investigate whether Doppler pulsatility indices (PIs) of the fetal circulation in cases of fetal growth restriction (FGR) are associated with the general movements (GMs) of the neonate after birth.This was a prospective observational cohort study including pregnancies with FGR diagnosed between June 2012 and September 2014. A diagnosis of FGR was based on an abdominal circumference or estimated (...) fetal weight < 10th percentile (in conjuction with abnormal Doppler) or declining fetal growth of at least 30 percentiles with respect to previous size measurements. Doppler parameters of the umbilical artery (UA), fetal middle cerebral artery (MCA) and ductus venosus (DV) were measured maximally 1 week prior to delivery. Cerebroplacental ratio (CPR) was calculated as MCA-PI divided by UA-PI. We assessed the quality of neonatal GMs 7 days after birth, around the due date if cases were born preterm

2016 Ultrasound in Obstetrics and Gynecology

127. National Curves of Fetal Growth in Singleton Fetuses of Greek Origin. (PubMed)

National Curves of Fetal Growth in Singleton Fetuses of Greek Origin. Foetal growth monitoring is an essential component of prenatal care with postnatal impact. The aim of the study was to construct reference ranges for foetal biometric parameters in Greek foetuses and to compare them with previously published models.Measurements from 1200 Greek foetuses were used to construct normal curves for biparietal diameter (BPD), occipitofrontal diameter (OFD), head circumference (HC), abdominal (...) circumference (AC), femoral length (FL) and the BPD/FL ratio according to the methodology described by Royston and Wright (1998). The model was validated in a second group of 1200 different foetuses using analysis of the corresponding standardized residuals (z-scores). The z-scores which were derived by our model were compared to those calculated using previously published models from other populations.BPD, OFD, HC, AC, FL and the BPD/FL ratio are accurately described by simple quadratic equations (R(2) > 0

2016 European journal of clinical investigation

128. Prediction of small for gestational age neonates by third trimester fetal biometry and impact of ultrasound-delivery interval. (Full text)

health in children. We included women, recruited in the first trimester, who had complete outcome data and had undergone third-trimester ultrasound examination. Demographic, clinical and biological variables were also collected from both parents. We compared prediction of delivery of a SGA neonate (birth weight < 10th percentile) by the following methods: abdominal circumference (AC) Z-score based on Hadlock curves (Hadlock AC), on INTERGROWTH-21st Project curves (Intergrowth AC) and on Salomon (...) Prediction of small for gestational age neonates by third trimester fetal biometry and impact of ultrasound-delivery interval. To compare third-trimester ultrasound screening methods to predict small-for-gestational age (SGA), and to evaluate the impact of the ultrasound-delivery interval on screening performance.In this prospective study, data were collected from a multicenter singleton cohort study investigating the links between various exposures during pregnancy with birth outcome and later

2016 Ultrasound in Obstetrics and Gynecology

129. Accelerated Fetal Growth Prior to Diagnosis of Gestational Diabetes Mellitus: A Prospective Cohort Study of Nulliparous Women. (Full text)

Accelerated Fetal Growth Prior to Diagnosis of Gestational Diabetes Mellitus: A Prospective Cohort Study of Nulliparous Women. To determine whether fetal overgrowth precedes the diagnosis of gestational diabetes mellitus (GDM) and to quantify the interrelationships among fetal overgrowth, GDM, and maternal obesity.We conducted a prospective cohort study of unselected nulliparous women and performed ultrasonic measurement of the fetal abdominal circumference (AC) and head circumference (HC (...) ) at 20 and 28 weeks of gestational age (wkGA). Exposures were diagnosis of GDM ≥28 wkGA and maternal obesity. The risk of AC >90th and HC-to-AC ratio <10th percentile was modeled using log-binomial regression, adjusted for maternal characteristics.Of 4,069 women, 171 (4.2%) were diagnosed with GDM at ≥28 wkGA. There was no association between fetal biometry at 20 wkGA and subsequent maternal diagnosis of GDM. However, at 28 wkGA, there was an increased risk of AC >90th percentile (adjusted relative

2016 Diabetes Care

130. The relationship between human placental morphometry and ultrasonic measurements of utero-placental blood flow and fetal growth. (Full text)

were associated with reduced growth velocity of the fetal abdominal circumference between 20 and 36 weeks (both P < 0.001).Placental area and weight are associated with uterine and umbilical blood flow, respectively, and both are associated with fetal growth rate.Copyright © 2015 Elsevier Ltd. All rights reserved. (...) The relationship between human placental morphometry and ultrasonic measurements of utero-placental blood flow and fetal growth. Ultrasonic fetal biometry and arterial Doppler flow velocimetry are widely used to assess the risk of pregnancy complications. There is an extensive literature on the relationship between pregnancy outcomes and the size and shape of the placenta. However, ultrasonic fetal biometry and arterial Doppler flow velocimetry have not previously been studied in relation

2016 Placenta

131. Relation of FTO gene variants to fetal growth trajectories: Findings from the Southampton Women's survey. (Full text)

genotyped for common gene variants in FTO (rs9939609, rs1421085) and MC4R (rs17782313). Linear mixed-effect models were used to analyse relations of gene variants with fetal growth.Fetuses with the rs9939609 A:A FTO genotype had faster biparietal diameter and head circumference growth velocities between 11 and 34 weeks gestation (by 0.012 (95% CI 0.005 to 0.019) and 0.008 (0.002-0.015) standard deviations per week, respectively) compared to fetuses with the T:T FTO genotype; abdominal circumference (...) Relation of FTO gene variants to fetal growth trajectories: Findings from the Southampton Women's survey. Placental function is an important determinant of fetal growth, and fetal growth influences obesity risk in childhood and adult life. Here we investigated how FTO and MC4R gene variants linked with obesity relate to patterns of fetal growth and to placental FTO expression.Southampton Women's Survey children (n = 1990) with measurements of fetal growth from 11 to 34 weeks gestation were

2016 Placenta

132. Consensus definition for placental fetal growth restriction: a Delphi procedure. (Full text)

), three solitary parameters (abdominal circumference (AC) < 3(rd) centile, estimated fetal weight (EFW) < 3(rd) centile and absent end-diastolic flow in the umbilical artery (UA)) and four contributory parameters (AC or EFW < 10(th) centile combined with a pulsatility index (PI) > 95(th) centile in either the UA or uterine artery) were agreed upon. For late FGR (≥ 32 weeks), two solitary parameters (AC or EFW < 3(rd) centile) and four contributory parameters (EFW or AC < 10(th) centile, AC or EFW (...) Consensus definition for placental fetal growth restriction: a Delphi procedure. To determine, by expert consensus, a definition for early and late fetal growth restriction (FGR) through a Delphi procedure.A Delphi survey was conducted among an international panel of experts on FGR. Panel members were provided with 18 literature-based parameters for defining FGR and were asked to rate the importance of these parameters for the diagnosis of both early and late FGR on a 5-point Likert scale

2016 Ultrasound in Obstetrics and Gynecology

133. Human umbilical and fetal cerebral blood flow velocity waveforms following maternal glucose loading: a cross-sectional observational study. (Full text)

rate (r = -0.47, p < 0.001). This reduction was not significant (p = 0.230) when the PI values were adjusted for fetal heart rate. The ratio MCA PI to UA PI was reduced (p = 0.001). The effect of OGTT on MCA PI was not related to fetal abdominal circumference whereas the effect on the adjusted UA PI values was correlated to abdominal circumference (r = -0.20, p = 0.045) but not to abdominal circumference Z-score (r = -0.16, p = 0.115). The influence of OGTT on the Doppler parameters as well (...) Human umbilical and fetal cerebral blood flow velocity waveforms following maternal glucose loading: a cross-sectional observational study. Our aim was to study umbilical and fetal cerebral arterial blood flow velocity waveforms related to fetal biometric measures and maternal body mass index, glucose levels and parity following maternal oral glucose loading.The study had an experimental design in a cross-sectional observational study including 105 low-risk pregnancies (30-32 weeks of gestation

2016 Acta Obstetricia et Gynecologica Scandinavica

134. Fetal weight monitoring and birth weight prediction: A new population-based approach. (Full text)

Fetal weight monitoring and birth weight prediction: A new population-based approach. To develop a complete, population-based system for ultrasound-based fetal size monitoring and birth-weight prediction for use in the second and third trimesters of pregnancy.Using 31 516 ultrasound examinations from a population-based Norwegian clinical database, we constructed fetal size charts for biparietal diameter, femur length and abdominal circumference from 24 to 42 weeks' gestation. A reference curve (...) of median birth weight for gestational age was estimated using 45 037 birth weights. We determined how individual deviations from the expected ultrasound measures predicted individual percentage deviations from expected birth weight. The predictive quality was assessed by explained variance of birth weight and receiver-operating characteristics curves for prediction of small-for-gestational age. A curve for intrauterine estimated fetal weight was constructed. Charts were smoothed using the gamlss non

2016 Ultrasound in Obstetrics and Gynecology

135. International Estimated Fetal Weight Standards of the INTERGROWTH-21<sup>st</sup> Project. (Full text)

Growth Longitudinal Study (FGLS) and INTERBIO-21st Fetal Study (FS), two components of the INTERGROWTH-21st Project, had ultrasound scans every 5 weeks from 9-14 weeks' until 40 weeks' gestation. At each visit, measurements of fetal head circumference (HC), biparietal diameter, occipitofrontal diameter, abdominal circumference (AC) and femur length (FL) were obtained blindly by dedicated research sonographers using standardized methods and identical ultrasound machines. Birth weight was measured (...) International Estimated Fetal Weight Standards of the INTERGROWTH-21st Project. Estimated fetal weight (EFW) and fetal biometry are complementary measures used to screen for fetal growth disturbances. Our aim was to provide international EFW standards to complement the INTERGROWTH-21st Fetal Growth Standards that are available for use worldwide.Women with an accurate gestational-age assessment, who were enrolled in the prospective, international, multicenter, population-based Fetal

2016 Ultrasound in Obstetrics and Gynecology

136. Estimation of Fetal Weight by MR Imaging to PREdict Neonatal MACROsomia (PREMACRO Study)

Ultrasound. Area Under the Receiver Operating Curve (AUROC) for prediction of macrosomia (≥ P97) [ Time Frame: Between 36 weeks and 36 weeks + 6 days of gestation ] AUROC for prediction of macrosomia (≥ P97 for gestational age) with Magnetic Resonance (4 mm slice thickness/ 20 mm gap) versus Ultrasound. Area Under the Receiver Operating Curve (AUROC) for prediction of macrosomia (Abdominal Circumference) [ Time Frame: Between 36 weeks and 36 weeks + 6 days of gestation ] AUROC for prediction (...) of macrosomia with Abdominal Circumference ≥ P90 for gestational age. Measured in cm with Ultrasound Area Under the Receiver Operating Curve (AUROC) for prediction of 'Small for gestational age' (SGA) [ Time Frame: Between 36 weeks and 36 weeks + 6 days of gestation ] Measured with Magnetic Resonnace (4 mm slice thickness)/ 20 mm gap) versus ultrasound. Comparative prediction rate for significant shoulder dystocia [ Time Frame: Between 36 weeks and 36 weeks + 6 days of gestation ] Ability of Magnetic

2016 Clinical Trials

137. Prediction of Growth Restricted Fetuses Using Femur Length to Mid-thigh Circumference Ratio: A Case-control Study

, such as the brain and heart, at the expense of the liver, muscle and fat and this results in decreased abdominal and thigh circumference measurements and hence theoretically increased HC/AC, FL/AC and FL/TC ratios (Colley et al., 1991). Fetal thigh circumference has a role to play in accurately measuring fetal weight when incorporated with other fetal parameters and provide a potentially straightforward method for assessing the deposition of muscle and fat in the growing fetus; there is a scope of using the FL (...) /TC ratio in predicting IUGR (Sanyal et al., 2012). Fetal thigh circumference to femur length ratio (FL/TC) seems to be potential for use in predicting IUGR (Shripad; Varalaxmi, 2005). Condition or disease Fetal Growth Restriction Detailed Description: Aim of work To determine usefulness of antenatally measured femur length to mid thigh circumference ratio to predict intra-uterine growth restricted fetuses. Study design Observational Case-Control study. Study population This study

2013 Clinical Trials

138. Perinatal morbidity and mortality in early-onset fetal growth restriction: cohort outcomes of the trial of randomized umbilical and fetal flow in Europe (TRUFFLE). (Full text)

early-onset fetal growth restriction based on time of antenatal diagnosis and delivery.We report cohort outcomes for a prospective multicenter randomized management study of fetal growth restriction (Trial of Randomized Umbilical and Fetal Flow in Europe (TRUFFLE)) performed in 20 European perinatal centers between 2005 and 2010. Women with a singleton fetus at 26-32 weeks of gestation, with abdominal circumference < 10(th) percentile and umbilical artery Doppler pulsatility index > 95(th (...) Perinatal morbidity and mortality in early-onset fetal growth restriction: cohort outcomes of the trial of randomized umbilical and fetal flow in Europe (TRUFFLE). Few data exist for counseling and perinatal management of women after an antenatal diagnosis of early-onset fetal growth restriction. Yet, the consequences of preterm delivery and its attendant morbidity for both mother and baby are far reaching. The objective of this study was to describe perinatal morbidity and mortality following

2013 Ultrasound in Obstetrics and Gynecology Controlled trial quality: uncertain

139. Fetal growth according to different reference ranges in twin pregnancies with placental insufficiency (Full text)

. The estimated fetal weight zeta-scores were calculated for both fetuses (abnormal Doppler and co-twin) according to the following criteria: Hadlock, Liao and Araújo. The abdominal circumference zeta-scores were calculated according to Hadlock, Liao, Araújo, Ong and Stirrup. The mean estimates of the zeta-score values were calculated using generalized estimating equation regression analysis. The mean gestational age at inclusion was 27.4 ± 4.7 weeks. The fetal sex and the interaction Doppler findings (...) × criteria correlated significantly with the zeta-score values (p < 0.001 for both variables). The estimated fetal weight mean zeta-scores (standard error) according to each criteria were as follows: Hadlock - abnormal Doppler: -2.98 (0.18), co-twin: -1.16 (0.15); Liao - abnormal Doppler: -2.89 (0.24), co-twin: -0.58 (0.19); and Araújo - abnormal Doppler: -3.05 (0.29), co-twin: -0.75 (0.18). Values for abdominal circumference were as follows: Hadlock - abnormal Doppler: -3.14 (0.26), co-twin: -1.13 (0.19

2015 Clinics

140. Analysis of the effectiveness of ultrasound and clinical examination methods in fetal weight estimation for term pregnancies (Full text)

height and abdominal circumference at the level of umbilicus. Accuracy was determined by mean percentage error, mean absolute percentage error and proportion of estimates within 10% of actual birth weight (birth weight ±10%). Patients were divided into two groups according to actual birth weight, the normal birth weight group (2500-3999 g) and high birth weight group (≥4000 g).All three methods statistically overestimated birth weight for the high and normal birth weight groups (p<0.001, p=1.000, p (...) Analysis of the effectiveness of ultrasound and clinical examination methods in fetal weight estimation for term pregnancies To compare the accuracy of clinical and ultrasonographic (USG) estimation of fetal weight in non-complicated, term pregnancies.Two hundred term pregnant women were included in the study. We used three formulae for the estimation of fetal weight at term; the Hadlock formula for the USG method, and two different formulas for clinical methods, maternal symphysis-fundal

2015 Turkish Journal of Obstetrics and Gynecology

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