Screening for the small-for-dates fetus: a two-stage ultrasonic examination schedule. Issue 6225 (17th May 1980)

• Record Type: Journal Article
• Authors: Nielson, J P; Whitfield, C R; Aitchison, T C
• Is Part Of: BMJ. Volume 280:Issue 6225(1980)
• Page Start: 1203
• Page End: 1206
• Publication Date: 1980-05-17
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Periodicals; 610
• DOI: 10.1136/bmj.280.6225.1203
• Languages: English
• ISSNs: 0007-1447

Abstract

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.