Clinical Implications of Second and Third Trimester Surveillance Ultrasounds of Growth-Restricted Fetuses

Objective We sought to investigate the positive predictive value of ultrasound-diagnosed fetal growth restriction (FGR) for estimating small for gestational age (SGA) at birth. Secondary objectives were to describe clinical interventions performed as a result of FGR diagnosis. Study Desig...

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Autores principales:	Amanda M. Craig, Karampreet Kaur, Sarah A. Heerboth, Heidi Chen, Chelsea J. Lauderdale, Chevis Shannon, Lisa C. Zuckerwise
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Medical Publishers, Inc. 2021
Materias:	fetal growth restriction ultrasound pregnancy antenatal corticosteroids Gynecology and obstetrics RG1-991
Acceso en línea:	https://doaj.org/article/a75d95971f504004aa7e810a87e3542a
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spelling	oai:doaj.org-article:a75d95971f504004aa7e810a87e3542a2021-11-24T00:04:15ZClinical Implications of Second and Third Trimester Surveillance Ultrasounds of Growth-Restricted Fetuses2157-69982157-700510.1055/s-0041-1740170https://doaj.org/article/a75d95971f504004aa7e810a87e3542a2021-10-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1740170https://doaj.org/toc/2157-6998https://doaj.org/toc/2157-7005Objective We sought to investigate the positive predictive value of ultrasound-diagnosed fetal growth restriction (FGR) for estimating small for gestational age (SGA) at birth. Secondary objectives were to describe clinical interventions performed as a result of FGR diagnosis. Study Design This was a retrospective cohort of pregnancies diagnosed with FGR over 3 years at a single institution. Maternal demographics, antenatal and delivery data, and neonatal data were collected. Descriptive statistics and linear regression were conducted. Results We included 406 pregnancies with diagnosis of FGR in second or third trimester. Median birth weight percentile was 17 (interquartile range: 5–50) and only 35.0% of these fetuses were SGA at birth. The positive predictive value of a final growth ultrasound below the 10th percentile for SGA at birth was 56.9%. Patients averaged eight additional growth ultrasounds following FGR diagnosis. One hundred and fourteen (28.1%) received antenatal steroids prior to delivery, and 100% of those delivered after more than 7 days following administration. There were 6 fetal deaths and 14 neonatal deaths. Conclusion In the majority of cases, pregnancies diagnosed with FGR during screening ultrasounds resulted in normally grown neonates and term deliveries. These patients may be receiving unnecessary ultrasounds and premature courses of corticosteroids.Amanda M. CraigKarampreet KaurSarah A. HeerbothHeidi ChenChelsea J. LauderdaleChevis ShannonLisa C. ZuckerwiseThieme Medical Publishers, Inc.articlefetal growth restrictionultrasoundpregnancyantenatal corticosteroidsGynecology and obstetricsRG1-991ENAmerican Journal of Perinatology Reports, Vol 11, Iss 04, Pp e132-e136 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	fetal growth restriction ultrasound pregnancy antenatal corticosteroids Gynecology and obstetrics RG1-991
spellingShingle	fetal growth restriction ultrasound pregnancy antenatal corticosteroids Gynecology and obstetrics RG1-991 Amanda M. Craig Karampreet Kaur Sarah A. Heerboth Heidi Chen Chelsea J. Lauderdale Chevis Shannon Lisa C. Zuckerwise Clinical Implications of Second and Third Trimester Surveillance Ultrasounds of Growth-Restricted Fetuses
description	Objective We sought to investigate the positive predictive value of ultrasound-diagnosed fetal growth restriction (FGR) for estimating small for gestational age (SGA) at birth. Secondary objectives were to describe clinical interventions performed as a result of FGR diagnosis. Study Design This was a retrospective cohort of pregnancies diagnosed with FGR over 3 years at a single institution. Maternal demographics, antenatal and delivery data, and neonatal data were collected. Descriptive statistics and linear regression were conducted. Results We included 406 pregnancies with diagnosis of FGR in second or third trimester. Median birth weight percentile was 17 (interquartile range: 5–50) and only 35.0% of these fetuses were SGA at birth. The positive predictive value of a final growth ultrasound below the 10th percentile for SGA at birth was 56.9%. Patients averaged eight additional growth ultrasounds following FGR diagnosis. One hundred and fourteen (28.1%) received antenatal steroids prior to delivery, and 100% of those delivered after more than 7 days following administration. There were 6 fetal deaths and 14 neonatal deaths. Conclusion In the majority of cases, pregnancies diagnosed with FGR during screening ultrasounds resulted in normally grown neonates and term deliveries. These patients may be receiving unnecessary ultrasounds and premature courses of corticosteroids.
format	article
author	Amanda M. Craig Karampreet Kaur Sarah A. Heerboth Heidi Chen Chelsea J. Lauderdale Chevis Shannon Lisa C. Zuckerwise
author_facet	Amanda M. Craig Karampreet Kaur Sarah A. Heerboth Heidi Chen Chelsea J. Lauderdale Chevis Shannon Lisa C. Zuckerwise
author_sort	Amanda M. Craig
title	Clinical Implications of Second and Third Trimester Surveillance Ultrasounds of Growth-Restricted Fetuses
title_short	Clinical Implications of Second and Third Trimester Surveillance Ultrasounds of Growth-Restricted Fetuses
title_full	Clinical Implications of Second and Third Trimester Surveillance Ultrasounds of Growth-Restricted Fetuses
title_fullStr	Clinical Implications of Second and Third Trimester Surveillance Ultrasounds of Growth-Restricted Fetuses
title_full_unstemmed	Clinical Implications of Second and Third Trimester Surveillance Ultrasounds of Growth-Restricted Fetuses
title_sort	clinical implications of second and third trimester surveillance ultrasounds of growth-restricted fetuses
publisher	Thieme Medical Publishers, Inc.
publishDate	2021
url	https://doaj.org/article/a75d95971f504004aa7e810a87e3542a
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Clinical Implications of Second and Third Trimester Surveillance Ultrasounds of Growth-Restricted Fetuses

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