Ultrasound screening for detection of intra-uterine growth retardation

Abstract

Intra-uterine growth retardation (IUGR) is a major problem in contemporary obstetrics. Early antenatal diagnosis is important if morbidity and mortality are to be minimized. We present the results of one years ultrasound fetometric screening for IUGR of the pregnant population in the city of Malmö. All pregnancies were dated by early biparietal diameter (BPD) measurement. From findings at 32 weeks of gestation, an IUGR risk-group (n = 436) was selected on the basis of predicted birthweight deviations with reference to standard curves, established at the Department, for BPD, abdominal diameter, femur length, and intra-uterine weight, all plotted against gestational age. The risk-group, which included 60 (77%) of the 78 IUGR infants eventually born, was subjected to additional fetometry examinations at 34, 36 and 38 weeks of gestation, in the total pregnant population of 2,068, each pregnancy was the subject of 2.3 examinations. Other fetometry variables were evaluated for their efficacy as IUGR markers, but were not found to be superior to the current screening procedure in which BPD and abdominal diameter are combined in a simple formula to assess intra-uterine growth. Overall, the screening procedure currently used at Malmö had a sensitivity of 64.1% and a specificity of 96.5%, the prevalence for IUGR being 3.8%.