Fetal Growth Diagnosis and Management among Perinatal Medical Professionals: A Survey of Practice and Literature Review

Abstract

<b><i>Introduction:</i></b> This paper aimed to assess the knowledge of healthcare professionals (obstetric and gynecology residents, specialists, and midwives) in the field of perinatal medicine regarding fetal growth diagnosis and management. <b><i>Methods:</i></b> A questionnaire was created consisting of a set of questions regarding demographic data, methods of growth assessment, and management. It was a handout survey. The results were analyzed with the use of descriptive statistics and χ<sup>2</sup> analysis using the program Statistica. <b><i>Results:</i></b> 190 medical professionals have participated in the questionnaire. 86.3% of respondents agreed that pregnancy dating should be modified based on first-trimester ultrasound. 90.9% agreed that III trimester ultrasound has a ±15% margin of error. When asked which growth charts are best fit for assessing growth in a studied population, 10.7% marked standard, 37.4% reference, 26.2% customized, and 26.2% did not know the difference between the three choices. 60.3% stated that they use a growth chart to assess growth and qualify fetuses for monitoring. 70.2% used the 10th centile as a cutoff, 20.1% 5th centile, and 9.7% 3rd centile. Only 40.9% would diagnose fetal growth restriction based on fetal weight only. 28.7% using the 10th centile cutoff, 16.1% 5th centile, and 54.0% 3rd centile. Only a quarter of the respondents were able to name the growth chart or tool that they use for assessment. The most common responses were Yudkin, Hadlock, and online calculators of Fetal Medicina Barcelona and the Fetal Medicine Foundation. <b><i>Discussion:</i></b> A lot of confusion is observed primarily in the aspect of cutoff values for identification, subsequent monitoring, and management of fetal growth restriction. There is a need for extensive training and education in this field and uniform national recommendations.

Prediction of large‐for‐gestational‐age infant by fetal growth charts and hemoglobin A1c level in pregnancy complicated by pregestational diabetes

“…The primary exposure was suspected LGA, defined as an EFW ≥ 90 th percentile on prenatal ultrasound, calculated using the Hadlock, NICHD race/ethnicity‐specific and FMF growth charts. The Hadlock growth chart was selected because it is used widely in current clinical practice in the USA and has been shown to be accurate in comparison to older growth charts 35 , 36 . For the current study, we utilized Hadlock Formula C (Hadlock C: log 10 BW = 1.335 − 0.0034 × abdominal circumference (AC) × femur length (FL) + 0.0316 × biparietal diameter + 0.0457 × AC + 0.1623 × FL), which has demonstrated the best performance among the Hadlock formulas 10 , 37 .…”

Restricción de crecimiento intrauterino según curvas personalizadas peruanas: estudio de validación y precisión diagnóstica

“…Varios estudios han justificado su uso (8)(9)(10) , pero otros no están de acuerdo con estas consideraciones (11,12) . Por tanto, existe discrepancia entre los médicos sobre cuál de las curvas se deben usar para clasificar el crecimiento fetal (13) .…”