Title: Sonographic Parameters in the Evaluation of Fetal Growth Restriction
Authors: Dr Muthiah P., Dr Pradeep Vel M, Dr Adaikappan M.
DOI: https://dx.doi.org/10.18535/jmscr/v7i2.141
Abstract
Introduction: The World Health Oraganisation (WHO) has defined Low birth Weight (LBW) as babies weighing less than 2500 grams at birth irrespective of their gestational age. In developed countries, the incidence of LBW is less than 10% whereas in developing countries, it is in the range of 15 - 30% of the total births[1]. In India about 30% of babies born are of LBW due to Prematurity whereas the rest represent growth retarded babies[2]. Early detection of Intra Uterine Growth Restriction [IUGR] is of paramount importance for the clinician and hence apart from clinical evaluation, Ultrasound has gained a significant role in the evaluation of IUGR.
Aim: The aim of the study is to confirm the diagnosis of IUGR sonographically in clinically suspected patients using multiple parameters, to correlate the sonographic assessment of the fetus with the postnatal clinical assessment of the neonate and to analyze the predictability of each parameter used for diagnosis with the outcome of the results.
Materials and Methods: A total of 100 antenatal patients referred for ultrasound with clinical suspicion of IUGR are evaluated with various sonographic parameters and the parameters are assessed with the clinical outcome.
Results: After evaluation of 100 suspected cases of intrauterine growth retardation it is concluded that Intrauterine growth retardation is a multi-factorial disease with varying degree of severity. It is unlikely that a single Sonographic parameter will allow an accurate diagnosis in all cases. The type and degree of IUGR depends on the intensity and duration of the underlying disease. Thus, an ultrasound assessment performed long before delivery may be of limited value. Most of the sonographic parameters are gestational age dependent. Gestational age independent indices such as the AFV, the r BPD, the r AC and FL/AC ratio are helpful in this situation.
Conclusion: The diagnosis of IUGR depends on combination of multiple parameters rather than a single parameter and this has resulted in a high positive predictive rate of 95.35%.
Keywords: Intra Uterine Growth Restriction, Sonographic Parameters.
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