Abstract
Objective: To compare the use of velocity charts and distance charts in screening small for gestational age fetuses (SGA).
Methods: We studied 78 SGA and 62 appropriate for gestational age (AGA) fetuses We defined AGA as birth weigth (BW) between 10 -90 centiles and SGA as BW < 10 centile for gestational age according to neonatal Italian standards (1). Each fetus had at least two ultrasound scanning of Head Circumference (HC), Femur Lenght (FL) and Abdominal Circumference (AC) measured at least six weeks apart; growth velocity was calculated as the difference between two measurements divided by the time interval in weeks. The prenatal diagnosis of SGA was made when the value of each biometric variable or its growth velocity were < 10 centile of the distance charts (2) or the velocity charts respectively (3). Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were calculated for each type of chart.
Results: There was no difference in the accuracy of the test, when distance or velocity charts were used for HC. For AC the sensitivity was significantly higher when velocity charts were used (sensitivity:62%; 95% IC: 0,51–0,73) compared to distance charts (sensitivity:29%; 95% CI:0,2–0,41). The sensitivity was also significantly higher for FL: 61,5%; 95% CI: 0,49–0,72 for velocity charts and 33%; 95% CI: 0,23–0,45 for distance charts. No difference was found for specificity, PPV and NPV.
Conclusion: Our results suggest that the use of velocity charts, instead of the widely used distance charts, could improve the sensitivity of screening SGA, without changing the specificity. (1) Parazzini F, et al. Ann Ost Gin Med Perin 1991; 112: 203–246 (2) Di Battista E, et al. Acta Obstet Gynecol Scand 2000; 79: 165–173 (3) Bertino E, et al. Archives of disease in Childhood 1996; 74: F10-F15
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Ciriminna, V., Bertino, E., Gaglioti, P. et al. 375 Usefulness of Prenatal Growth Velocity Charts to Detect Small for Gestational Age Fetuses.. Pediatr Res 58, 418 (2005). https://doi.org/10.1203/00006450-200508000-00404
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DOI: https://doi.org/10.1203/00006450-200508000-00404