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Outcomes of fetuses with small head circumference on second-trimester ultrasonography.
MedLine Citation:
PMID:  22692804     Owner:  NLM     Status:  Publisher    
OBJECTIVE: We examined the outcomes of pregnancies in which the fetal head circumference (HC) was below the 5(th) centile at the routine second-trimester scan. MATERIALS AND METHODS: We retrospectively analysed outcomes of 18 377 women according to HC Z scores at second-trimester ultrasound examination between 2001 and 2008. We collected all major malformations, intrauterine deaths and other abnormal outcomes. RESULTS: Six hundred seventy-four fetuses (3.7%) had an HC below the 5(th) centile. Twenty-one major malformations were noted, consisting mainly of neurological abnormalities (3.1%). There were seven intra uterine fetal death (1.3%). Of all the fetuses, 26% were lost to follow-up. Outcome and neurological development was normal in 467 cases, based on neonatal examination and/or parent or general practitioner reports. Major abnormalities were noted in respectively 26.2%, 3.0% and 1.1% of fetuses with Z scores < -2.5, -2.5 to -2.0, and -2 to -1.645, compared with 0.3% of fetuses with normal HC (p < 10(-4) ). CONCLUSION: A head circumference below the 5(th) centile at second-trimester scan is associated with various abnormalities, especially neurological disorders. The outcome was worse when the HC was smaller. An HC Z score below -2.5 was strongly associated with neurological and chromosomal abnormalities. Conversely, an HC Z score below -1.645 but above -2, excluding cases with prenatally diagnosed malformations, seems to be reassuring for favorable neonatal outcome. © 2012 John Wiley & Sons, Ltd.
Benjamin Deloison; Gihad E Chalouhi; Jean-Pierre Bernard; Yves Ville; Laurent J Salomon
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-13
Journal Detail:
Title:  Prenatal diagnosis     Volume:  -     ISSN:  1097-0223     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-6     Citation Subset:  -    
Copyright Information:
© 2012 John Wiley & Sons, Ltd.
Department of Obstetrics and Gynecology, Faculté de médecine, Université Paris Descartes, Sorbonne Paris Cite, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants Malades, 149 rue de Sèvres, 75015, Paris, France; SFAPE (Société Française d'Amélioration des Pratiques Echographiques), Paris, France.
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