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The impact of optimal dating on the assessment of fetal growth

Authors
  • Fries, N.1
  • Dhombres, F.1, 2
  • Massoud, M.1, 3
  • Stirnemann, J. J.4, 5
  • Bessis, R.1
  • Haddad, G.1
  • Salomon, L. J.1, 4, 5
  • 1 Collége Français d’Echographie Foetale, CFEF, Teyran, 34820, France , Teyran (France)
  • 2 Sorbonne Université, Paris, France , Paris (France)
  • 3 Hôpital Femme Mère Enfant et Université Claude Bernard Lyon 1, Bron, 69500, France , Bron (France)
  • 4 Université Paris-Descartes, Paris, France , Paris (France)
  • 5 Université de Paris, 149, Rue de Sèvres, Cedex 15, Paris, 75743, France , Paris (France)
Type
Published Article
Journal
BMC Pregnancy and Childbirth
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Feb 27, 2021
Volume
21
Issue
1
Identifiers
DOI: 10.1186/s12884-021-03640-9
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundThe impact of using the Intergrowth (IG) dating formulae in comparison to the commonly used Robinson dating on the evaluation of biometrics and estimated fetal weight (EFW) has not been evaluated.MethodsNationwide cross-sectional study of routine fetal ultrasound biometry in low-risk pregnant women whose gestational age (GA) had been previously assessed by a first trimester CRL measurement. We compared the CRL-based GA according to the Robinson formula and the IG formula. We evaluated the fetal biometric measurements as well as the EFW taken later in pregnancy depending on the dating formula used. Mean and standard deviation of the Z scores as well as the number and percentage of cases classified as <3rd, < 10th, >90th and > 97th percentile were compared.ResultsThree thousand five hundred twenty-two low-risk women with scans carried out after 18 weeks were included. There were differences of zero, one and 2 days in 642 (18.2%), 2700 (76.7%) and 180 (5%) when GA was estimated based on the Robinson or the IG formula, respectively. The biometry Z scores assessed later in pregnancy were all statistically significantly lower when the Intergrowth-based dating formula was used (p < 10− 4). Likewise, the number and percentage of foetuses classified as <3rd, < 10th, >90th and > 97th percentile demonstrated significant differences. As an example, the proportion of SGA foetuses varied from 3.46 to 4.57% (p = 0.02) and that of LGA foetuses from 17.86 to 13.4% (p < 10− 4).ConclusionThe dating formula used has a quite significant impact on the subsequent evaluation of biometry and EFW. We suggest that the combined and homogeneous use of a recent dating standard, together with prescriptive growth standards established on the same low-risk pregnancies, allows an optimal assessment of fetal growth.

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