[Detection of small for gestational age fetuses during third trimester ultrasound. A monocentric observational study]

Abstract

Objectives: Fetus small for gestational age (SGA) screening rate is evaluated around 21,7 % in France. Recommendations were developed to improve the efficiency of ultrasound conducted in the third trimester (T3), because neonatal consequences can be significant. This study aims to evaluate screening of SGA during T3 ultrasound and to describe causes for failure and differences with the recommendations of CNGOF.

Methods: All children born between 2011 and 2012 with a birth weight below the 3rd percentile were included in this observational, retrospective, monocentric study. We noted that the diagnosis of SGA was placed on file. Then, as recommended by the CNGOF, we calculated estimated fetal weight (EFW) with Hadlock 3 and Hadlock 4, and the corresponding percentiles, using the biometrics from the ultrasound report. We thus could evaluate a new screening rate with SGA fetus identified through this technique.

Results: A total of 142 patients were included. By calculating correctly all EFW and checking abdominal circumference percentiles, the screening rate of SGA fetuses with T3 ultrasound increased from 40 % to 50 % and the overall screening rate (clinical and ultrasound) from 54 % to 66 %.

Conclusion: By following the recommendations we found a real improvement in fetal SGA screening rates to T3 ultrasound with a potential benefit for their care.

Keywords: Dépistage; Estimated fetal weight (EFW); Estimation de poids fœtal; Fetus small for gestational age (SGA); Fœtus petits pour l’âge gestationnel (PAG); Intrauterine growth restriction (IUGR); Retard de croissance intra-utérin (RCIU); Screening; Ultrasound; Échographie.