Introduction Small‐for‐gestational‐age (SGA) confers a higher perinatal risk of adverse outcomes. Birthweight cannot be accurately measured until delivery, therefore accurate estimated fetal weight (EFW) based on ultrasonography is important in identifying this high‐risk population. We aimed to establish the sensitivity of detecting SGA infants antenatally in a unit with a selective third‐trimester ultrasound policy and to investigate the association between EFW and birthweight in these babies. Material and methods A retrospective cohort study was conducted on non‐anomalous singleton pregnancies delivered after 36 weeks of gestation where SGA (<10th percentile) was diagnosed at delivery. The EFW at the time of the third‐trimester ultrasound scan was recorded using standard Hadlock formulae. Results In 2017, there were 8392 non‐anomalous singleton pregnancies live born after 36 weeks, excluding late bookers. 797 were live‐born SGA <10th percentile for birthweight and 464 <5th percentile, who met our inclusion criteria. The antenatal detection rate of SGA was 19.6% for babies with birthweight <10th percentile and 24.1% <5th percentile. There was a significant correlation between the EFW and birthweight of fetuses undergoing ultrasound assessment within 2 weeks of delivery (P < .001, r = 0.73 (Pearson correlation). For these cases, EFW was greater than the birthweight in 65% of cases. After adjusting all EFWs using the discrepancy between EFW and actual birthweight for those babies born within 48 hours of the scan, the mean difference between the birthweight and adjusted EFW 7 days before delivery was 111 g (95% CI 87‐136 g) and at 14 days was 200 g (95% CI 153‐248 g). Despite adjusting the EFW, 61/213 cases (28.6%) apparently lost weight between the ultrasound scan and delivery. Conclusions Small‐for‐gestational‐age infants with a birthweight <10th percentile are poorly identified antenatally with little improvement for those <5th percentile. In SGA babies, ultrasound EFW overestimated birthweight. Discrepancies between birthweight and EFW are not explicable only by the limitations of third‐trimester sonography, a reduction in fetal weight close to delivery in a proportion of liveborn SGA babies is plausible.
Objectives: International guidelines suggest that a temperature increase of 4 • C for more than 4 minutes can be dangerous for the fetus. For endocavitary examinations, self-heating of the probe plays a significant role, but this effect is not considered in calculating the thermal index. We measured the temperature rise at the probe surface during 23 transvaginal scans, to assess the thermal hazard in clinical practice and to sample data on scan duration and temperature increase for standard examinations. Methods: We monitored the temperature variations using 75μm fine wire K-type insulated thermocouples, mounted on the tip of the probe. The absence of artefacts due to the sensor was verified. 23 scans (16 for obstetrics and 7 for gynecology) were performed in the Obstetric Ultrasound department at a large maternity unit in London. Samsung WS80 + V5-9 and GE VolusonE8 + RIC5-9D were used. Colour flow mode was employed in approximately 70% of the scans. Results:The average duration of the scans was 7 minutes 15 seconds (minimum 3, maximum 18 minutes. The majority of the scans last around 4 minutes. The average peak temperature was 36.3 • C, minimum 34.1 • C, maximum 38 • C, with most of the scans showing a value around 37.5 • C, with no significant difference between the machines. For 20 cases, the highest temperature was seen at the end of the ultrasound examination, however in some cases temperature peaks were observed, likely caused by mode change a variation of the operating parameters. Conclusions: The measured temperature never approached the values reported as hazardous in the international standards. For an average body temperature of 36.5 • C, the most frequent temperature rise was around 1 • C. Results of duration and maximum temperature are in line with previous studies. Further investigations will match the modes used of the ultrasound equipment with the corresponding temperature variations.Supporting information can be found in the online version of this abstract OP29.04 Establishing infection prevention flowcharts for obstetric and gynecological ultrasound practitioners S.C. Westerway, J. Basseal ASUM, Sydney, NSW, AustraliaObjectives: To create effective profession specific infection control flowcharts for use by obstetric and gynecological ultrasound practitioners. Methods: A purposively developed online survey of 23 questions was constructed utilising Survey Monkey. The items were generated to represent the current knowledge and standards of ultrasound infection control practise from existing literature. A pre-test was performed to exclude access and technical glitches.A letter of invitation to participate was sent via email to numerous ultrasound related societies around the world who then forwarded it to their members. Participants clicked a link to the Survey Monkey to complete the questions.Results: There were 724 responses from practitioners who performed any type of obstetric or gynecologic ultrasound. This corresponded to 70% of the overall response rate. Data analysis identified a low lev...
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