Document Detail


The use of ultrasound to detect small-for-gestational-age infants in patients with elevated human chorionic gonadotropin on maternal serum screening.
MedLine Citation:
PMID:  19742421     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We evaluated serial sonography for the antenatal detection of small-for-gestational-age (SGA) infants in pregnancies with elevated human chorionic gonadotropin (hCG) levels on midtrimester triple-marker screen. A retrospective cohort study was performed at Saddleback Memorial Medical Center where serial ultrasounds from 26 weeks to delivery are generally recommended for patients with hCG levels >2.0 Multiple of the Median (MoM). From 1999 to 2007, 659 subjects were identified for analysis. The incidence of intrauterine growth restriction (IUGR) and SGA were 5.2% and 7.3%, respectively. Antenatal ultrasound identified 31.3% of SGA infants. Compared with estimated fetal weight (EFW) <10th percentile alone, abdominal circumference (AC) <10th percentile improved the detection of SGA from 31.3% (95% confidence interval [CI], 18.7 to 46.3) to 35.4% (95% CI, 22.2 to 50.5). Using either EFW or AC further increased the sensitivity to 45.8% (95% CI, 31.4 to 60.8). The sensitivity for the detection of SGA was 100% when an EFW cutoff of 75% was used. Ultrasound can be used to detect SGA infants in patients with elevated hCG levels on midtrimester serum screening. A sonographic estimated fetal weight > or = 75th percentile appears to be a safe cutoff to rule out all fetuses at risk for SGA.
Authors:
Tamera Hatfield; Aaron B Caughey; David C Lagrew; Ryan Heintz; Judith H Chung
Publication Detail:
Type:  Journal Article     Date:  2009-09-09
Journal Detail:
Title:  American journal of perinatology     Volume:  27     ISSN:  1098-8785     ISO Abbreviation:  Am J Perinatol     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-22     Completed Date:  2010-04-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8405212     Medline TA:  Am J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  173-80     Citation Subset:  IM    
Copyright Information:
Thieme Medical Publishers.
Affiliation:
Department of Obstetrics and Gynecology, University of California, Irvine, Orange, CA, USA. mfm@uci.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Chorionic Gonadotropin / blood*
Cohort Studies
Female
Fetal Growth Retardation / diagnosis*
Fetal Weight
Humans
Infant, Newborn
Infant, Small for Gestational Age*
Oligohydramnios / epidemiology
Pre-Eclampsia / epidemiology
Predictive Value of Tests
Pregnancy
Pregnancy Trimester, Second
Retrospective Studies
Sensitivity and Specificity
Ultrasonography, Prenatal*
Waist Circumference
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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