scholarly journals CUSTOMISED FETAL GROWTH CHARTS VERSUS POPULATION-BASED GROWTH CHARTS IN IDENTIFYING ADVERSE FETAL OUTCOMES: A SYSTEMATIC REVIEW

2021 ◽  
Vol 21 (3) ◽  
pp. 136-144
Author(s):  
Muhammad zaim Sahul Hameed ◽  
Rosnah Sutan ◽  
Zaleha Abdullah mahdy
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Population Based ◽  
Future Research ◽  
Growth Chart ◽  
Growth Charts ◽  
Framework Analysis ◽  
Fetal Outcomes ◽  
Process Indicator ◽  
Pubmed Database

One for all antenatal growth charts may not adequately capture risks for adverse fetal outcomes. This review appraises studies on customised growth curves in preventing adverse fetal effects and compares them with population-based growth charts. A review was done on articles published in PubMed database, Cochrane database and Google Scholar. The search criteria were English written described fetal outcomes using a customised fetal growth chart published between 2007 and 2020. All selected articles reported antenatal follow-up data and compared the intervention using the customised antenatal growth chart to the population-based antenatal growth chart. The primary outcome measure was the incidence of small for gestational age (SGA) and stillbirths. The feasibility of using a customised fetal growth chart versus a population-based fetal growth chart was assessed as the process indicator. Twenty-two articles comparing the use of customised growth charts to population-based growth charts were found. Sixteen studies depicted a significant improvement in the detection of pathological SGA over a population-based growth chart ,and another two studies showed significant in detecting large gestational age (LGA). In conclusion, the customised growth charts improve the detection of pathological SGA antenatally. The feasibility of the intervention depends on the training, policy, infrastructure, staffing, awareness and ethics. A   summarised framework analysis for implementing customised growth charts is proposed for future research.

scholarly journals Intrauterine Growth Restriction: Effects of Physiological Fetal Growth Determinants on Diagnosis

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Kjell Haram ◽  
Eirik Søfteland ◽  
Radek Bukowski
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Growth Curves ◽  
Population Based ◽  
National Standards ◽  
Growth Potential ◽  
Reference Ranges ◽  
Mortality And Morbidity ◽  
False Positive Diagnosis ◽  
Menstrual History

The growth of the fetus, which is strongly associated with the outcome of pregnancy, reflects interplay of several physiological and pathological factors. The assessment of fetal growth is based on comparison of birthweight (BW) or estimated fetal weight (EFW) to standards which define reference ranges at a spectrum of gestational ages. Most birthweight standards do not take into account effects of physiological determinants of fetal growth. Additionally, gestational age in many standards is based on the menstrual history and is often inaccurate. Fetal growth norms should be based on an early ultrasound estimate of gestational age. Customized standards, which have included only ultrasound-dated pregnancies, seem to be superior to population-based birthweight norms in predicting perinatal mortality and morbidity. Adjustment for individual variation in customized growth curves reduces false-positive diagnosis of IUGR and may lead to a very significant reduction in intervention for suspected IUGR. Customized growth potential identifies better the risk for adverse outcome than the currently used national standards, but customized charts may fail in detecting growth-restricted stillbirth. An individual’s birthweight is the sum of physiological and pathological influences operating during pregnancy. Growth potential norms are a better discriminator of aberrations of fetal growth than population, ultrasound, and customized norms.

scholarly journals Modern concepts of low birth weight and fetal growth restriction

2021 ◽  
Vol 102 (3) ◽  
pp. 347-354
Author(s):  
O V Yakovleva ◽  
I E Rogozhina ◽  
T N Glukhova
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Fetal Growth Restriction ◽  
Growth Restriction ◽  
Abdominal Circumference ◽  
Ductus Venosus ◽  
Management Algorithm ◽  
Pubmed Database ◽  
Single Standard

The aim of this work is to study the state of the problem of the development of small-for-gestational-age fetus and fetal growth restriction over the past 5 years. A review of randomized trials of the PubMed database for the period of 2015 to 2020 was carried out. Experts reached an agreement on the definition of diagnostic criteria for small-for-gestational-age fetus and fetal growth restriction, a clinically valid classification was created, and the main monitoring strategies were developed. Due to the different pathogenesis, fetal growth restriction is divided into early and late. The observation algorithm includes tests that have shown higher sensitivity and specificity. There is no single standard for the median weight and abdominal circumference of a fetus, indicators of the reference range for fetal Doppler. Smoking cessation and taking acetylsalicylic acid at a dose of 150 mg at high risk of preeclampsia is recommended to prevent the small-for-gestational-age fetus and fetal growth restriction. The pregnancy management algorithm includes Doppler ultrasound examination of the umbilical artery, cardiotocography. If this pathology occurs before 32 weeks of pregnancy, the blood flow in ductus venosus is additionally examined, and after 32 weeks of pregnancy, the middle cerebral artery blood velocities and cerebroplacental ratio are assessed. Indicators of Doppler velocimetry and cardiotocography, which serve as criteria for early termination of pregnancy, are developed, measures are proposed to improve neonatal outcomes prevention of respiratory distress syndrome at 2434 weeks of gestation, as well as magnesium therapy for fetal neuroprotection. The problems of preventing fetal growth restriction and the algorithm for monitoring pregnant women who do not have risk factors for small-for-gestational-age fetus, management tactics and indications for delivery while slowing fetal weight gain remain unresolved.

New Reference for Neonatal Growth: 10-Year Data of Phramongkutklao Hospital

2020 ◽  
Vol 103 (12) ◽  
pp. 1284-1291
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Admission Rate ◽  
Large For Gestational Age ◽  
Growth Chart ◽  
Growth Charts ◽  
International Growth ◽  
Neonatal Growth ◽  
Growth Assessment

Background: Growth assessment including birth weight, length, and head circumference is important to identify infants at risk. However, using international growth curves may be inappropriate for growth assessment of Thai neonates. Objective: To generate a growth chart of infants at the Phramongkutklao Hospital (PMK), and to compare PMK’s growth chart assessment with other international growth charts. Materials and Methods: The authors generated a PMK growth chart from PMK’s newborn database between 2007 and 2016. Birth weight of infants born in 2017 was assessed by using the PMK growth chart in comparison with the Fenton, Lubchenco and Intergrowth Twenty-first growth charts. Results: To generate a PMK growth chart, 22,926 infants were enrolled to the present study. Comparing with other international growth charts, the Fenton exhibited a higher ninetieth percentile of birth weight than others, especially at gestational age of 36 to 41 weeks. In contrast, the Lubchenco exhibited the lowest tenth percentile of birth weight. In 2017, 2,314 infants were born and evaluated by using the PMK, the Fenton, the Lubchenco, and the Intergrowth-21st growth charts. Large for gestational age (LGA) was identified in 185 (8.64%), 55 (2.57%), 166 (7.75%) and 166 (7.75%) infants, respectively. In contrast, small for gestational age (SGA) was identified in 220 (10.27%), 228 (10.64%), 34 (1.59%) and 148 (6.91%) infants, respectively. The admission rate of infants diagnosed as LGA by PMK, but appropriate for gestational age (AGA) by Fenton was higher than other AGA infants. Conclusion: The PMK reference of neonatal growth is up-to-date and applicable. Growth assessment using the Fenton growth chart at late preterm and term gestations may be inaccurate to identify LGA infants. In contrast, the Lubchenco growth chart has limitation to identify SGA infants. Data accumulation from multi-centers at different regions of Thailand are warranted to generate a Thai neonatal growth reference. Keywords: Growth curve, Neonatal growth, Large for gestational age, Small for gestational age

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