Routine third-trimester ultrasound assessment for intrauterine growth restriction

• Published in: American journal of obstetrics & gynecology MFM Vol. 6; no. 5; p. 101294
• Main Authors: Caradeux, Javier, Martínez-Portilla, Raigam J., Martínez-Egea, Judit, Ávila, Francisco, Figueras, Francesc
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-05-2024
• Subjects: diagnostic performance; growth assessment; obstetrical ultrasound; perinatal outcome; diagnostic performance; obstetrical ultrasound; perinatal outcome; growth assessment
• ISSN: 2589-9333; 2589-9333
• DOI: 10.1016/j.ajogmf.2024.101294

Intrauterine growth restriction significantly impacts perinatal outcomes. Undetected IUGR escalates the risk of adverse outcomes. Serial symphysis-fundal height measurement, a recommended strategy, is insufficient in detecting abnormal fetal growth. Routine third-trimester ultrasounds significantly improve detection rates compared with this approach, but direct high-quality evidence supporting enhanced perinatal outcomes from routine scanning is lacking.
In assessing fetal growth, abdominal circumference alone performs comparably to estimated fetal weight. Hadlock formulas demonstrate accurate fetal weight estimation across diverse gestational ages and settings. When choosing growth charts, prescriptive standards (encompassing healthy pregnancies) should be prioritized over descriptive ones. Customized fetal standards may enhance antenatal IUGR detection, but conclusive high-quality evidence is elusive. Emerging observational data suggest that longitudinal fetal growth assessment could predict adverse outcomes better. However, direct randomized trial evidence supporting this remains insufficient.