Accuracy of clinical suspicion of growth restriction at term despite a normal growth ultrasound: A retrospective cohort study

摘要

Background Small for gestational age (SGA) is a major determinant of poor perinatal outcome. Detecting SGA at term using ultrasound is challenging and we often plan birth based on clinical assessment. Aims To determine the incidence of SGA infants with birthweight = 35 weeks reporting an EFW >= 10th centile (appropriate for gestational age, AGA) who subsequently had an induction of labour or caesarean birth at >= 37 weeks due to ongoing clinical suspicion of SGA between 2012-2014. The primary outcome was the incidence of SGA newborns using customised centiles. Results There were 532 women who had a planned birth for clinical suspicion of SGA during the study period. Of these, 205 (38.5%) had an AGA fetus on ultrasound >= 35 weeks but were subsequently delivered because of a persisting clinical suspicion of SGA on abdominal assessment. Sixty-eight percent (n = 139/205) delivered an SGA infant. Furthermore, almost half of these SGA infants (47.5%) had a birthweight = 10th centile in the late third trimester should not override clinical concerns of impaired fetal growth at term.