Fetal growth was assessed by serial ultrasound cephalometry in 150 patients with uncomplicated placenta praevia and certain menstrual dates who were treated expectantly. Placental function was assessed by serial 24-hour total maternal urinary oestrogen assays. There were 24 (16 per cent) small-for-dates infants, more accurately predicted by serial cephalometry than by serial maternal urinary oestrogen assays. There was good correlation between fetal growth and the number of episodes of bleeding in pregnancy.
Consecutive ultrasonic measurements of the fetal head area, thorax area, abdomen area, head/thorax (H/T) area ratio and head/abdomen (H/A) area ratio were obtained from 100 patients with a normal pregnancy and from 186 patients with suspected intrauterine fetal growth retardation. Of all the measurements used, H/A area ratio was found to be most accurate in identifying intrauterine fetal growth retardation predicting 82.9 per cent at 33 weeks and 85.7 per cent at 36 to 38 weeks of gestation. This technique was also found to be useful in distinguishing between the two types of growth retardation. The H/A area ratio was helpful in identifying the growth acceleration pattern of a large baby.
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The date of delivery was assessed by ultrasound cephalometry in 350 patients whose duration of pregnancy was uncertain. Because of retarded fetal growth 30 patients were excluded from the study three weeks after the first examination. Of the remaining 320 patients 274 went into spontaneous labour and of these 250 (91.2 per cent) did so within nine days of the estimated date of delivery as determined by ultrasound cephalometry.
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