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. 1980 May 17;280(6225):1203–1206. doi: 10.1136/bmj.280.6225.1203

Screening for the small-for-dates fetus: a two-stage ultrasonic examination schedule.

J P Nielson, C R Whitfield, T C Aitchison
PMCID: PMC1601481  PMID: 7190048

Abstract

To find an effective routine screening method for small-for-dates fetuses 474 women with singleton pregnancies participated in a two-stage ultrasonic examination schedule. At the first-stage examination, which was conducted in early pregnancy, fetal crown-rump length or biparietal diameter was measured for an accurate assessment of gestational age, which was essential for interpreting the results of the second-stage examination. The second-stage examination was performed at 34-36 weeks and entailed measuring seven fetal variables, the results of which were assessed singly and in combination after delivery to identify the best indicator of small-for-dates fetuses. Fetal head measurements proved to be the least sensitive indicators of growth retardation, correctly identifying only 56-59% of cases. Measurements of trunk area and circumference, however, correctly identified 81% and 83% of cases respectively, but the most effective screening index was the product of crown-rump length and trunk area: with this index 34 out of 36 small-for-dates fetuses (94%) were correctly identified. Calculating the product of crown-rump length and trunk area from ultrasonic displays is quick and simple, and combined with the first-stage examination is a highly reliable screening method for small-for-dates fetuses.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adelstein P., Fedrick J. Antenatal identification of women at increased risk of being delivered of a low birth weight infant at term. Br J Obstet Gynaecol. 1978 Jan;85(1):8–11. doi: 10.1111/j.1471-0528.1978.tb15817.x. [DOI] [PubMed] [Google Scholar]
  2. Campbell S. An improved method of fetal cephalometry by ultrasound. J Obstet Gynaecol Br Commonw. 1968 May;75(5):568–576. doi: 10.1111/j.1471-0528.1968.tb00161.x. [DOI] [PubMed] [Google Scholar]
  3. Campbell S., Dewhurst C. J. Diagnosis of the small-for-dates fetus by serial ultrasonic cephalometry. Lancet. 1971 Nov;2(7732):1002–1006. doi: 10.1016/s0140-6736(71)90324-2. [DOI] [PubMed] [Google Scholar]
  4. Campbell S. The prediction of fetal maturity by ultrasonic measurement of the biparietal diameter. J Obstet Gynaecol Br Commonw. 1969 Jul;76(7):603–609. doi: 10.1111/j.1471-0528.1969.tb06146.x. [DOI] [PubMed] [Google Scholar]
  5. Campbell S., Thoms A. Ultrasound measurement of the fetal head to abdomen circumference ratio in the assessment of growth retardation. Br J Obstet Gynaecol. 1977 Mar;84(3):165–174. doi: 10.1111/j.1471-0528.1977.tb12550.x. [DOI] [PubMed] [Google Scholar]
  6. Campbell S., Wilkin D. Ultrasonic measurement of fetal abdomen circumference in the estimation of fetal weight. Br J Obstet Gynaecol. 1975 Sep;82(9):689–697. doi: 10.1111/j.1471-0528.1975.tb00708.x. [DOI] [PubMed] [Google Scholar]
  7. Fleming J. E., Hall A. J., Robinson H. P., Wittmann B. K. Electronic area and perimeter measurement of ultrasonic images. J Clin Ultrasound. 1978 Dec;6(6):379–384. doi: 10.1002/jcu.1870060605. [DOI] [PubMed] [Google Scholar]
  8. Loeffler F. E. Clinical foetal weight prediction. J Obstet Gynaecol Br Commonw. 1967 Oct;74(5):675–677. doi: 10.1111/j.1471-0528.1967.tb03779.x. [DOI] [PubMed] [Google Scholar]
  9. McIlwaine G. M., Howat R. C., Dunn F., Macnaughton M. C. The Scottish perinatal mortality survey. Br Med J. 1979 Nov 3;2(6198):1103–1106. doi: 10.1136/bmj.2.6198.1103. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Robinson H. P., Fleming J. E. A critical evaluation of sonar "crown-rump length" measurements. Br J Obstet Gynaecol. 1975 Sep;82(9):702–710. doi: 10.1111/j.1471-0528.1975.tb00710.x. [DOI] [PubMed] [Google Scholar]
  11. Robinson H. P. Sonar measurement of fetal crown-rump length as means of assessing maturity in first trimester of pregnancy. Br Med J. 1973 Oct 6;4(5883):28–31. doi: 10.1136/bmj.4.5883.28. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Thomson A. M., Billewicz W. Z., Hytten F. E. The assessment of fetal growth. J Obstet Gynaecol Br Commonw. 1968 Sep;75(9):903–916. doi: 10.1111/j.1471-0528.1968.tb01615.x. [DOI] [PubMed] [Google Scholar]
  13. Varma T. R., Taylor H., Bridges C. Ultrasound assessment of fetal growth. Br J Obstet Gynaecol. 1979 Aug;86(8):623–632. doi: 10.1111/j.1471-0528.1979.tb10824.x. [DOI] [PubMed] [Google Scholar]
  14. Wittmann B. K., Robinson H. P., Aitchison T., Fleming J. E. The value of diagnostic ultrasound as a screening test for intrauterine growth retardation: comparison of nine parameters. Am J Obstet Gynecol. 1979 May 1;134(1):30–35. doi: 10.1016/0002-9378(79)90791-9. [DOI] [PubMed] [Google Scholar]

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