Details
Category: Volume 07 Issue 10 October 2019
Hits: 905

Title: A comparative Study of Sonographic Parameters with Neonatal Ponderal index as a predictor of IUGR

Authors: Dr Simi A, Dr Sapna Devi. D P

 DOI: https://dx.doi.org/10.18535/jmscr/v7i10.130

Abstract

   

Background: Intrauterine growth restriction is one of the commonest problems which increases the perinatal morbidity. The diagnosis  of impaired fetal growth is still a challenge as the standards of fetal measurements of growth ,both clinical and ultrasonographic parameters vary depending on the race and geographic location

Materials and Methods: This is a prospective study conducted at SAT hospital Thiruvanthapuram. Cases fulfilling the inclusion criteria were included in the study over a period of 6 months. Clinical and ultrasound parameters at the time of detection of IUGR was noted. These patients were followed up till delivery. At the time of delivery the neonatal ponderal index was calculated.

Results: Among the sonographic parameters abdominal circumference and estimated fetal weight was found to be highly sensitive in predicting IUGR. .

Conclusions- Serial USS follow-up of abdominal circumference and estimated fetal weight can help obstetricians in early detection of IUGR   before asking for costly investigations like Doppler, thus making checkups cost effective.

Keywords: IUGR, Abdominal circumference, sonographic estimated fetal weight, neonatal ponderal index.

References

  1. Georgieff MK, Sasanow SR, Chockalingam UM, Pereira GR. A comparison of the mid‐arm circumference/head circumference ratio and ponderal index for the evaluation of newborn infants after abnormal intrauterine growth. Acta Pædiatrica. 1988 Mar;77(2):214-9.
  2. Metcoff J. Clinical assessment of nutritional status at birth: Fetal malnutrition and SGA are not synonymous. Pediatric Clinics of North America. 1994 Oct 1;41(5):875-91.
  3. Miller HC, Hassanein K. Diagnosis of impaired fetal growth in newborn infants. Pediatrics. 1971 Oct 1;48(4):511-22
  4. Mohan M, Prasad SR, Chellani HK, Kapani V. Intrauterine growth curves in north Indian babies: weight, length, head circumference and ponderal index. Indian pediatrics. 1990 Jan;27(1):43-51
  5. .Mathai M. Prediction of small- for- gestational age infants  using  a specially  calibrated tape  measure  j. Obstet Gynecol.  1988; 95,313-4
  6. Callen PW. Ultrasonography in Obstetrics and Gynecology E-Book. Elsevier Health Sciences; 2011 Oct 17.
  7. Ounsted M, Moar VA, Scott A. Risk factors associated with small‐for‐dates and large‐for‐dates infants. BJOG: An International Journal of Obstetrics & Gynaecology. 1985 Mar;92(3):226-32.
  8. Belizán J, Villar J, Nardin JC, Malamud J, De Vicuña LS. Diagnosis of intrauterine growth retardation by a simple clinical method: measurement of uterine height. American Journal of Obstetrics & Gynecology. 1978 Jul 15;131(6):643-6
  9. Calvert Jp, Crean EE, Newcombe  RC, Pearson  JF, Antenatal screening by measurement of symphysiofundal height.  BMJ (din Res Ed) 1982; 285; 846-9.
  10. Ott WJ. Sonographic diagnosis of intrauterine growth restriction. Clinical obstetrics and gynecology. 1997 Dec 1;40(4):787-95
  11. Campbell S, Thomas A. Ultrasound measurement of the fetal head to abdomen circumference ratio in the assessment of growth retardation. BJOG: An International Journal of Obstetrics & Gynaecology. 1977 Mar;84(3):165-74.
  12. Colley NV Tremble JM, Henson CL, Cole TJ !lead circumference / Abdominal circumference ratio, Ponderal index and  fetal malnutrition should HC/ AC ratio be abandonded 7  J. Obstet  Cynecol1991; 98, 524-7.
  13. Benson CB, Doubilet PM, Saltzman DH, Jones TB. FL/AC ratio: poor predictor of intrauterine growth retardation. Investigative radiology. 1985 Oct;20(7): 727-30.
  14. Brown HL, Miller JJ, Gabert HA, Kissling GR. Ultrasonic recognition of the small-for-gestational-age fetus. Obstetrics and gynecology. 1987 Apr;69(4):631-5.
  15. Hadlock FP, Harrist RB, Sharman RS, Deter RL, Park SK. Estimation of fetal weight with the use of head, body, and femur measurements—a prospective study. American journal of obstetrics and gynecology. 1985 Feb 1;151(3):333-7.
  16. Chang TC, Robson SC, Boys RJ, Spencer JA. Prediction of the small for gestational age infant: which ultrasonic measurement is best?. Obstetrics and gynecology. 1992 Dec;80(6):1030-8.
  17. Baschat AA, Weiner CP. Umbilical artery Doppler screening for detection of the small fetus in need of antepartum surveillance. American journal of obstetrics and gynecology. 2000 Jan 1;182(1):154-8.
  1. Divon MY, Chamberlain PF, Sipos L, Manning FA, Platt LD. Identification of the small for gestational age fetus with the use of gestational age-independent indices of fetal growth. American journal of obstetrics and gynecology. 1986 Dec 1;155(6):1197-201.
  2. No GT. The investigation and management of the small–for–gestational–age fetus.
  3. Philipson EH, Sokol RJ, Williams T. Oligohydramnios: clinical associations and predictive value for intrauterine growth retardation. American Journal of Obstetrics &Gynecology. 1983 Jun 1;146(3):271-8.
  4. Chamberlain PF, Manning FA, Morrison I, Harman CR, Lange IR. Ultrasound evaluation of amniotic fluid volume: I. The relationship of marginal and decreased amniotic fluid volumes to perinatal outcome. American journal of obstetrics and gynecology. 1984 Oct 1;150(3):245-9.
  5. .Scott KE, Usher R. Fetal malnutrition: its incidence, causes, and effects. American Journal of Obstetrics & Gynecology. 1966 Apr 1;94(7):951-63.
  6. Bollapragada S. Wani R., Raval MY. Intrauterine growth retardation- Effect on outcome. July ed.Jr. of Obstetrics  and Gynaecology of India.  1996, 477-481.

Corresponding Author

Dr Sapna Devi. D P

Assistant Professor, Dept. of O and G, SAT Hospital, Govt. Medical College, Trivandrum, India