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Obstetrics and Gynaecology Delivery date change after ultrasound linked with fetal growth restriction
Obstetrics and Gynaecology Delivery date change after ultrasound linked with fetal growth restriction
Delivery date change after ultrasound linked with fetal growth restriction
Monday, 29 November 1999 19:00 | 
| Specialties - Obstetrics and Gynaecology |
Postponing the delivery date based on ultrasound results may lead to the detection of intrauterine growth restriction as early as the first trimester, according to a report in the April BJOG.
"Postponing the delivery date based on ultrasound results may lead to the detection of intrauterine growth restriction as early as the first trimester, according to a report in the April BJOG: An International Journal of Obstetrics and Gynaecology.
"The findings in the present study suggest that fetuses that are seven or more days smaller than expected at dating ultrasound would benefit from increased surveillance," Dr. Malin Thorsell from Karolinska Institutet, Stockholm, told Reuters Health. "The obstetric outcome for growth restricted foetuses is improved if the growth restriction is detected at the time of delivery."
Dr. Thorsell and associates analyzed the association between fetal size at time of dating ultrasound and the risk of preterm delivery or small for gestational age births to evaluate if timing of dating ultrasound -- before 14 weeks of gestation (early) or after 16 weeks (late) -- affected this association.
For pregnancies where the expected date of delivery was postponed at least seven days, there was a significant 49 per cent increase in the risk of preterm birth when dating ultrasound was performed late, the authors report, whereas there was an insignificant increase (14 per cent) when dating ultrasound was performed early.
Postponing of the expected date of delivery was associated with an increased risk for small for gestational age birth for both early and late ultrasounds, the report indicates.
When fetuses were larger than expected (i.e., when the delivery was moved back more than seven days), there was an increased risk of preeclampsia but not for small for gestational age or preterm birth.
The increased risk of preterm birth associated with postponing the expected date of delivery in the late ultrasound dating group persisted when all cases of small for gestational age and preeclampsia were excluded from the analysis, the investigators say.
Surveillance of pregnancies that have an expected day of delivery postponed, "regardless of whether dating was performed early or late, may provide means for increasing the detection rate of fetal growth restriction," the researchers conclude.
"However, late dating seems to be more efficient than early dating for the detection of pregnancies at increased risk for small for gestational age, premature delivery, and preeclampsia, with a higher odds ratio in spite of a lower risk of postponed pregnancies."
"We are now studying if we can improve detection of early fetal growth restriction by randomizing these women to measurement of blood flow of the uterine vessels and of the umbilical artery in the 27th week as well as biometry in the 32nd week," Dr. Thorsell said."
"The findings in the present study suggest that fetuses that are seven or more days smaller than expected at dating ultrasound would benefit from increased surveillance," Dr. Malin Thorsell from Karolinska Institutet, Stockholm, told Reuters Health. "The obstetric outcome for growth restricted foetuses is improved if the growth restriction is detected at the time of delivery."
Dr. Thorsell and associates analyzed the association between fetal size at time of dating ultrasound and the risk of preterm delivery or small for gestational age births to evaluate if timing of dating ultrasound -- before 14 weeks of gestation (early) or after 16 weeks (late) -- affected this association.
For pregnancies where the expected date of delivery was postponed at least seven days, there was a significant 49 per cent increase in the risk of preterm birth when dating ultrasound was performed late, the authors report, whereas there was an insignificant increase (14 per cent) when dating ultrasound was performed early.
Postponing of the expected date of delivery was associated with an increased risk for small for gestational age birth for both early and late ultrasounds, the report indicates.
When fetuses were larger than expected (i.e., when the delivery was moved back more than seven days), there was an increased risk of preeclampsia but not for small for gestational age or preterm birth.
The increased risk of preterm birth associated with postponing the expected date of delivery in the late ultrasound dating group persisted when all cases of small for gestational age and preeclampsia were excluded from the analysis, the investigators say.
Surveillance of pregnancies that have an expected day of delivery postponed, "regardless of whether dating was performed early or late, may provide means for increasing the detection rate of fetal growth restriction," the researchers conclude.
"However, late dating seems to be more efficient than early dating for the detection of pregnancies at increased risk for small for gestational age, premature delivery, and preeclampsia, with a higher odds ratio in spite of a lower risk of postponed pregnancies."
"We are now studying if we can improve detection of early fetal growth restriction by randomizing these women to measurement of blood flow of the uterine vessels and of the umbilical artery in the 27th week as well as biometry in the 32nd week," Dr. Thorsell said."
