Can Abdominal Circumference Alone Be Used to Predict SGA or LGA Newborns?
BACKGROUND AND PURPOSE:
Guidelines recommend using estimated fetal weight (EFW) for growth which is comprised of:
Abdominal Circumference (AC)
Blue et. al. (American Journal of Perinatology, 2017) compared the sensitivity and specificity of abdominal circumference (AC) found in the literature against composite EFW to predict small for gestational age (SGA) or large for gestational age (LGA) newborns
Literature analysis of 40 studies with ultrasonographic AC or EFW
Prospective or retrospective study design published in 1995 or later
≥ 24 weeks gestation
SGA defined as birth weight < 10th percentile or <2,500 g at term
LGA defined as birth weight > 90th percentile or >4,000 g
Anomalous fetuses excluded due to difficulty in optimal measurement
To predict SGA: AC < 10th percentile, AC < 5th percentile, EFW < 10th percentile, EFW < 2.5 kg
To predict LGA: AC >35 cm, AC > 90th percentile, AC > 95th percentile, EFW > 4 kg, EFW > 90th percentile
To predict SGA, AC and EFW <10th percentile have similar performance characteristics
To predict LGA, AC cutoffs were comparable to EFW cutoffs, but performed better with better sensitivity when AC >35 cm
After 24 weeks, AC is comparable to EFW to predict both SGA and LGA, particularly PPV and NPVs
Compared to EFW, AC takes less time and training
The authors do not recommend replacing EFWs but suggest AC measurement may be helpful in areas with limited access to ultrasound
The authors conclude that this study supports RCOG’s recommendation that AC < 10th percentile can be used as a diagnostic criterion for growth restriction as opposed to ACOG that recommends the use of EFW < 10th percentile only
OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Jointly provided by
NOT ENOUGH CME HOURS
It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan