International Journal of Infertility & Fetal Medicine

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VOLUME 6 , ISSUE 1 ( January-April, 2015 ) > List of Articles

RESEARCH ARTICLE

Identification of Fetal Growth Patterns with Customized Growth Charts: A prospective study in South India

Badanahatti Radhika, Vavilala Suseela, Praveen Kumar Nirmalan

Citation Information : Radhika B, Suseela V, Nirmalan PK. Identification of Fetal Growth Patterns with Customized Growth Charts: A prospective study in South India. Int J Infertil Fetal Med 2015; 6 (1):30-34.

DOI: 10.5005/jp-journals-10016-1098

License: CC BY-NC 4.0

Published Online: 01-04-2015

Copyright Statement:  Copyright © 2015; The Author(s).


Abstract

Aim

To determine the diagnostic effectiveness of symphysis fundus height (SFH) measures plotted on customized growth charts for the identification of fetal growth patterns in a tertiary care perinatal center in south India.

Materials and methods

Serial SFH of pregnant women with singleton babies booked for antenatal care up to 22 weeks was measured from 24 weeks of gestation and plotted on customized growth charts that were developed using the gestation related optimal weight (GROW) software downloaded from www.gestation.net to identify fetal growth patterns. Fetal growth patterns were also ascertainedusing ultrasound in the antenatal period and confirmed at birth using a neonatal growth classification. The diagnostic effectiveness of SFH was compared with ultrasound and neonatal classifications using sensitivity, specificity, area under the ROC curve and likelihood ratio tests

Results

The study included 666 pregnant women who presented at the antenatal clinics from January 2010 to October 2010. On ultrasound examination, 564 (84.6%) fetuses were AGA, 78 (11.7%) fetuses were LGA and 19 (2.9%) were SGA and 5 (0.8%) showed crossing centile from higher to lower pattern. On serial SFH measures, 426 (64.0%) of the fetuses were normal growth, 180 (27.0%) were excessive growth and 40 (6.0%) were slow growth. Serial SFH measures had a positive likelihood ratio of 4.7 (8.5 for USG) for the identification of SGA and a negative likelihood ratio of 0.06 for the detection of LGA.

Conclusion

The SFH measures plotted on a customized GROW curve have the potential to develop into a low cost screening tool to identify fetuses with altered growth. The diagnostic effectiveness of SFH plotted on customized growth charts has to be improved further through the development of appropriate customized growth charts for India before application on a larger scale.

How to cite this article

Radhika B, Suseela V, Nirmalan PK. Identification of Fetal Growth Patterns with Customized Growth Charts: A prospective study in South India. Int J Infertil Fetal Med 2015;6(1):30-34.


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