Assessment of Accuracy of Three Ultrasound Methods for Prediction of Intrauterine Growth Restriction

Abstract

Background: Fetal growth restriction (FGR) is defined as a failure to achieve the endorsed growth potential. The diagnosis of fetal ‘smallness’ is currently performed on the basis of an estimated fetal weight (EFW) below a given threshold, most commonly the 10th centile. Aim of the Work: To assess accuracy of transcerebellar diameter (TCD)/ abdominal circumference (AC) ratio, head circumference (HC)/ abdominal circumference (AC) ratio and hepato-cephalic index (HCI) in predicting intrauterine growth restriction (IUGR) after 20 weeks of gestation in pregnant women at risk of developing IUGR. Patients and Methods: This Prospective nested cohort study was conducted on 77 pregnant women at risk for IUGR at Ain-shams University maternity hospital Cairo, Egypt. Patients were selected according to the following inclusion and exclusion criteria. Results: the present study showed a statistically significant difference between group I (IUGR) and group II non-IUGR as regards TCD/AC ratio with a cut-off value ≥ 13.77 with a sensitivity and specificity 93.1% and 87.5% respectively. Conclusion: Three ratios (TCD/AC, HC/AC, and HCI) are of great value for prediction of IUGR after 20 weeks of gestation. However, TCD/AC ratio had a better diagnostic validity and accuracy compared to HC/AC and HCI in predicting IUGR. Recommendations: Further studies to investigate TCD/AC ratio, HC/AC ratio and HCI in multiple gestation. Key words: Three Ultrasound, Intrauterine growth restriction, FGR