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Monitoring fetal growth
Evidence review O
NICE Guideline, No. 201
National Guideline Alliance (UK).
Monitoring fetal growth
Review question
What is the best method using third trimester measurements to predict birth weight?
Introduction
In the UK, it is current practice for women with low risk pregnancies to have symphysis-fundal height (SFH) measurements during the third trimester to monitor growth of the baby. Routine ultrasound is not current practice. This question aims to compare which technique is most accurate in monitoring fetal growth.
Summary of the protocol
See Table 1 for a summary of the Population, Index test, Reference standard and Outcomes and prioritisations of this review.
Table 1
Summary of the protocol.
For further details see the review protocol in appendix A.
Methods and process
This evidence review was developed using the methods and process described in Developing NICE guidelines: the manual 2014. Methods specific to this review question are described in the review protocol in appendix A.
Declarations of interest were recorded according to NICE’s conflicts of interest policy.
Clinical evidence
Included studies
Nineteen studies were included in this review, 11 retrospective cohort studies (Aviram 2017, Barel 2016, Ben-Haroush 2007, Blue 2018, Blue 2019, Callec 2015, Gabbay-Benziv 2016, Khan 2019, Lin 1990, Rad 2018, Turitz 2014); 6 prospective cohort studies (Akolekar 2019, Erkamp 2020, Sekar 2016, Skovron 1991, Sovio 2015, Sovio 2018); 1 nested case-control study (Harding 1995); and 1 population based study (Monier 2015).
The included studies are summarised in Table 2.
Two studies were conducted in Australia (Harding 1995, Sekar 2016); 1 study was conducted in France (Callec 2015); 3 studies were conducted in Israel (Aviram 2017, Barel 2016, Ben-Haroush 2007); 4 studies were conducted in the UK (Akolekar 2019, Khan 2019, Sovio 2015, Sovio 2018); 1 study was conducted in the Netherlands (Erkamp 2020), 6 studies were conducted in USA (Blue 2018, Blue 2019, Lin 1990, Rad 2018, Skovron 1991, Turitz 2014). One study did not mention which country it was conducted in (Gabbay-Benziv 2016).
Two additional studies (Bardin 2020, Duncan 2020) were identified in final update searches for the review that met the protocol inclusion criteria but did not affect the evidence base or draft recommendations. The searches were initially updated in May 2020 but due to the atypical prolongation of guideline development due to COVID-19 pandemic, the searches were updated again in September 2020. New evidence identified in this final update search which did not impact on the conclusions were not fully included in the report but are referenced in appendix M.
See the literature search strategy in appendix B and study selection flow chart in appendix C.
Excluded studies
Studies not included in this review are listed, and reasons for their exclusion are provided in appendix K.
Summary of studies included in the evidence review
Summaries of the studies that were included in this review are presented in Table 2.
Table 2
Summary of included studies.
See the full evidence tables in appendix D and the forest plots in appendix E.
Quality assessment of studies included in the evidence review
See the evidence profiles in appendix F.
Included studies
A systematic review of the economic literature was conducted but no economic studies were identified which were applicable to this review question.
A single economic search was undertaken for all topics included in the scope of this guideline. See supplementary material 2 for details.
Excluded studies
There was no economic evidence identified for this review question and therefore there is no excluded studies list in appendix K.
Summary of included economic evidence
No economic studies were identified which were applicable to this review question.
Economic model
No economic modelling was undertaken for this review because the committee agreed that other topics were higher priorities for economic evaluation.
Evidence statements
Clinical evidence statements
Ultrasound done more than 7 days before delivery had poor sensitivity for small-for-gestational age (SGA; 11 studies, low quality evidence) and very good specificity for SGA (12 studies, moderate quality evidence). When ultrasound was done fewer than 7 days before delivery the sensitivity for SGA remained poor but was slightly improved (4 studies, low quality evidence) and the specificity for SGA was very good (4 studies, high quality evidence).
Ultrasound done more than 7 days before delivery had poor sensitivity for large-for-gestational age (LGA; 4 studies, moderate quality evidence) and very good specificity for LGA (4 studies, very low quality evidence). When ultrasound was done fewer than 7 days before delivery the sensitivity for LGA remained poor but was improved (2 studies, low quality evidence) and the specificity for LGA was very good (2 studies, low quality evidence).
Symphysis-fundal height measurements done more than 7 days before delivery had very poor sensitivity for SGA (1 study, high quality evidence) and moderate specificity for SGA (1 study, high quality evidence).
The committee’s discussion of the evidence
Interpreting the evidence
The outcomes that matter most
The committee agreed that they would prioritise sensitivity over specificity for this diagnostic test accuracy review. They considered the impact of true positives (correctly identifying SGA/LGA babies and allowing for appropriate management to be in place for their birth), true negatives (reassuring mothers of babies who are appropriate-for-gestational age), false positives (potentially promoting definitive interventions that are unnecessary – for example earlier induction for LGA babies) and false negatives (failing to identify babies that may require more intensive monitoring and peripartum care) and noted that false negatives could be particularly impactful – hence a particular need to focus on the sensitivity of tests. The committee considered the positive and negative predictive values as additional information alongside sensitivity and specificity in order to allow them to understand what the impact of a system that recommended a certain action for all positive or negative test results would have.
The quality of the evidence
The quality of the evidence ranged from high to very low, typically evidence was downgraded for issues relating to inconsistency and imprecision. The inconsistency may have been driven in parts by subtly different approaches to imaging (for example using different variants of formulae available for estimating size on ultrasound) although the criteria for the review were chosen to minimise this.
The committee noted that there was very little evidence available on the accuracy of SFH measurements (one small study looking at SGA and no studies looking at LGA) and particularly on the accuracy of repeated measurements as opposed to a one-off assessment.
Benefits and harms
The evidence showed that ultrasound is not very sensitive for SGA or LGA, though it is more sensitive when done closer to delivery and it is more sensitive than SFH measurement – although this outcome is based on a single small study. Ultrasound was quite specific for both SGA and LGA, again this was improved if done closer to delivery and again more accurate than for SFH measurement.
Overall the evidence suggested that neither of the main modalities for assessing fetal growth were particularly accurate, with sensitivity being particularly poor (at best a point estimate of 70% for ultrasound done for LGA less than 7 days from delivery).
The results of this review were interpreted alongside evidence review Q on routine third trimester ultrasound for fetal growth. That review broadly concluded that routinely ultrasound scanning all women in the third trimester (as opposed to selectively scanning those in whom there were concerns or clinical suspicions of adverse outcomes) did not convey a clinically important benefit. Selective scanning criteria in low risk pregnancies vary but typically were at least partially informed by SFH measurements. While the evidence in this review suggested that SFH measurement is not very sensitive, SFH measurement is easily performed with little resource implications and essentially no adverse effects (in terms of the test itself, inaccurate results will still have adverse effects). If SFH measurement was not done routinely, it would make the selective choice of who should receive an ultrasound scan more challenging. Therefore overall the committee agreed, despite the (limited) evidence of low sensitivity, it was appropriate to offer SFH measurement at each antenatal appointment after 24+0 weeks unless the woman is already undergoing regular growth scans (in which case there would be no additional benefit). However, the committee noted that SFH measurement should not be taken more frequently than every 2 weeks, in cases where the woman has frequent appointments. The committee also agreed that the SFH measurements should be plotted onto a growth chart so that growth can be monitored. This is also indicated in the Saving Babies Lives Care Bundle version 2 (2019).
The committee were aware that there are some risk factors for fetal growth restriction and agreed that a risk assessment should be done in early pregnancy (at booking appointment) when all pre and early pregnancy risk factors could be considered and again in the second trimester, when other risk factors may have become apparent (for example gestational hypertension). The committee were aware of available risk assessment tools, such as those in the Saving Babies Lives Care Bundle version 2 (2019) and RCOG Green-Top guideline on investigation and management of small-for-gestational age fetus (2013).
The committee also made informal consensus based recommendations about the response to concerns about babies being either SGA or LGA as per SFH measurement. For babies possibly being SGA, the committee agreed an ultrasound was required as being SGA may be associated with critical adverse outcomes including stillbirth that could require intervention of some kind. The urgency of this ultrasound would be dictated by the overall clinical findings and whether or not there were other reasons to be concerned about the wellbeing of the baby (for example a reduction in fetal movements) or mother (for example raised blood pressure or proteinuria). If there were concerns about the SFH being LGA, the committee made a weaker recommendation to consider an ultrasound (for example to check for volume of amniotic fluid), however, LGA is less commonly associated with critical adverse outcomes such as stillbirth and may not warrant further investigation or intervention (particularly if the baby has been consistently LGA as opposed to changing growth trajectories), although LGA increases the risk of for example shoulder dystocia.
Cost effectiveness and resource use
It was noted that diagnostic outcomes would not in themselves lend to recommendations for routine ultrasound scanning as the committee were of the view that such recommendations should be made in conjunction with clinical outcomes such as stillbirth and NICU admission. Therefore, the committee discussed this topic in conjunction with the clinical and economic evidence included in Evidence Review Q (Wastlund 2019). This study included diagnostic outcomes which were identified in this clinical review (Sovio 2018) and assessed the sensitivity and specificity of routine and selective ultrasound for identifying LGA and SGA.
The sensitivity of ultrasound was generally poor from studies included in the accompanying clinical review. The implications for cost effectiveness should be viewed in the context of the consequential management strategies of the diagnostic outcomes. Increasing true positives or reducing false negatives will impact on costs and effects if women receive appropriate treatment. For example, a lower false positive would reduce the costs and harms associated with unnecessary emergency caesarean sections. As the clinical review conducted in Evidence Review Q demonstrated no important differences between routine and selective ultrasound, the committee did not recommend routine ultrasound testing as it would likely not be a cost effective use of resources given the increase in cost and no improvement in clinical outcomes. This conclusion was supported by economic evidence (Wastlund 2019) in evidence review Q.
Mindful of the substantial costs in routine provision, the committee’s recommendation to offer symphysis fundal height measurement to all women reflects current practice. The committee highlighted that many trusts in England currently offer routine ultrasound for SGA detection. Where these recommendations lead to a reduction in routine ultrasound testing then a significant cost saving will be achieved. At the same time selective ultrasound for suspected LGA is not commonly done and there is a possibility that the weak consider recommendation may increase scans in some places for this indication although this is not expected to have significant resource impact.
Other factors the committee took into account
Evidence review Q showed that there was no important benefit of routine ultrasound assessment as opposed to selective assessment on clinically important outcomes. This review assessed accuracy of tests including ultrasound. The more accurate ultrasound is, the more likely that its routine use could have benefits. However if the subsequent management of the various possible diagnoses does not result in benefit then simply having an accurate test will not lead to better downstream outcomes.
The committee also noted that, while this is not an outcome in the protocol of evidence review Q, studies included in that review showed a higher detection rate of SGA/LGA cases in the routine arm compared with the selective arm. This is logical as unless ultrasound had 0% sensitivity or the choice of who should receive selective ultrasound was perfect (in other words all cases received ultrasound) detection rate will always be greater to some degree. The fact that the overall conclusion of review Q was that routine ultrasound did not convey a clinical benefit over selective ultrasound, shows that regardless of what the precise increase in detection rate is, it did not translate into a clinically meaningful benefit (or that any benefits were offset by possible harms of false positives).
References
Akolekar 2019
Akolekar, R., Panaitescu, A. M., Ciobanu, A., Syngelaki, A., Nicolaides, K. H., Two-stage approach for prediction of small-for-gestational-age neonate and adverse perinatal outcome by routine ultrasound examination at 35-37 weeks’ gestation, Ultrasound in obstetrics & gynecology, 04, 04, 2019 [PubMed: 31271475]Aviram 2017
Aviram, A., Yogev, Y., Ashwal, E., Hiersch, L., Hadar, E., Gabbay-Benziv, R., Prediction of large for gestational age by various sonographic fetal weight estimation formulas-which should we use?, Journal of Perinatology, 37, 513–517, 2017 [PubMed: 28151496]Barel 2016
Barel, O., Maymon, R., Elovits, M., Smorgick, N., Tovbin, J., Vaknin, Z., Evaluation of Fetal Weight Estimation Formulas in Assessing Small-for-Gestational-Age Fetuses, Ultraschall in der Medizin, 37, 283–9, 2016 [PubMed: 25075910]Barden 2020
Bardin, R., Aviram, A., Hiersch, L., Hadar, E., Gabbay-Benziv, R., False diagnosis of small for gestational age and macrosomia-clinical and sonographic predictors, Journal of Maternal Fetal and Neonatal Medicine., 2020 [PubMed: 32429707]Ben-Haroush 2007
Ben-Haroush, A., Yogev, Y., Hod, M., Bar, J., Predictive value of a single early fetal weight estimate in normal pregnancies, European Journal of Obstetrics, Gynecology, & Reproductive BiologyEur J Obstet Gynecol Reprod Biol, 130, 187–92, 2007 [PubMed: 16720074]Blue 2018
Blue, N. R., Beddow, M. E., Savabi, M., Katukuri, V. R., Mozurkewich, E. L., Chao, C. R., A Comparison of Methods for the Diagnosis of Fetal Growth Restriction Between the Royal College of Obstetricians and Gynaecologists and the American College of Obstetricians and Gynecologists, Obstetrics & GynecologyObstet Gynecol, 131, 835–841, 2018 [PubMed: 29630011]Blue 2019
Blue, N. R., Savabi, M., Beddow, M. E., Katukuri, V. R., Fritts, C. M., Izquierdo, L. A., Chao, C. R., The Hadlock Method Is Superior to Newer Methods for the Prediction of the Birth Weight Percentile, Journal of ultrasound in medicine, 38, 587–596, 2019 [PubMed: 30244476]Callec 2015
Callec, R., Lamy, C., Perdriolle-Galet, E., Patte, C., Heude, B., Morel, O., Eden Mother-Child Cohort Study Group, Impact on obstetric outcome of third-trimester screening for small-for-gestational-age fetuses, Ultrasound in obstetrics & gynecology, 46, 216–20, 2015 [PubMed: 25487165]Duncan 2020
Duncan, J. R., Odibo, L., Hoover, E. A., Odibo, A. O., Prediction of Large for Gestational Age Neonates by Different Growth Standards, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine., 29, 2020 [PubMed: 32860453]Erkamp 2020
Erkamp, J. S., Voerman, E., Steegers, E. A. P., Mulders, Agmgj, Reiss, I. K. M., Duijts, L., Jaddoe, V. W. V., Gaillard, R., Second and third trimester fetal ultrasound population screening for risks of preterm birth and small-size and large-size for gestational age at birth: a population-based prospective cohort study, BMC Medicine, 18, 63, 2020 [PMC free article: PMC7137302] [PubMed: 32252740]Gabbay-Benziv 2016
Gabbay-Benziv, R., Aviram, A., Bardin, R., Ashwal, E., Melamed, N., Hiersch, L., Wiznitzer, A., Yogev, Y., Hadar, E., Prediction of Small for Gestational Age: Accuracy of Different Sonographic Fetal Weight Estimation Formulas, Fetal Diagnosis and Therapy, 40, 205–213, 2016 [PubMed: 26942906]Harding 1995
Harding, K., Evans, S., Newnham, J., Screening for the small fetus: a study of the relative efficacies of ultrasound biometry and symphysiofundal height, Australian & New Zealand Journal of Obstetrics & Gynaecology, 35, 160–4, 1995 [PubMed: 7677678]Khan 2019
Khan, N., Ciobanu, A., Karampitsakos, T., Akolekar, R., Nicolaides, K. H., Prediction of large-for-gestational-age neonate by routine third-trimester ultrasound, Ultrasound in obstetrics & gynecology, 54, 326–333, 2019 [PubMed: 31236963]Lin 1990
Lin, C. C., Sheikh, Z., Lopata, R., The association between oligohydramnios and intrauterine growth retardation, 76, 1100–4, 1990 [PubMed: 2234721]Monier 2015
Monier, I., Blondel, B., Ego, A., Kaminiski, M., Goffinet, F., Zeitlin, J., Poor effectiveness of antenatal detection of fetal growth restriction and consequences for obstetric management and neonatal outcomes: a French national study, 122, 518–27, 2015 [PubMed: 25346493]Rad 2018
Rad, S., Beauchamp, S., Morales, C., Mirocha, J., Esakoff, T. F., Defining fetal growth restriction: abdominal circumference as an alternative criterion, Journal of Maternal-Fetal and Neonatal Medicine, 31, 3089–3094, 2018 [PubMed: 28817998]Sekar 2016
Sekar, R., Khatun, M., Barrett, H. L., Duncombe, G., A prospective pilot study in assessing the accuracy of ultrasound estimated fetal weight prior to delivery, Australian and New Zealand Journal of Obstetrics and Gynaecology, 56, 49–53, 2016 [PubMed: 26299881]Skovron 1991
Skovron, M. L., Berkowitz, G. S., Lapinski, R. H., Kim, J. M., Chitkara, U., Evaluation of early third-trimester ultrasound screening for intrauterine growth retardation, J Ultrasound MedJournal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 10, 153–9, 1991 [PubMed: 2027188]Turitz 2014
Turitz, A. L., Quant, H., Schwartz, N., Elovitz, M., Bastek, J. A., Isolated abdominal circumference < 5% or estimated fetal weight 10 to 19% as predictors of small for gestational age infants, American Journal of Perinatology, 31, 469–476, 2014 [PubMed: 23966127]
Appendices
Appendix A. Review protocol
Appendix B. Literature search strategies
Appendix C. Clinical evidence study selection
Study selection for: What is the best method using third trimester measurements to predict birth weight? (PDF, 111K)
Appendix D. Clinical evidence tables
Appendix E. Forest plots
Appendix F. GRADE tables
Appendix G. Economic evidence study selection
Economic evidence study selection for review question: What is the best method using third trimester measurements to predict birth weight?
A single economic search was undertaken for all topics included in the scope of this guideline. No economic studies were identified which were applicable to this review question. See supplementary material 2 for details.
Appendix H. Economic evidence tables
Economic evidence tables for review question: What is the best method using third trimester measurements to predict birth weight?
No evidence was identified which was applicable to this review question.
Appendix I. Economic evidence profiles
Economic evidence profiles for review question: What is the best method using third trimester measurements to predict birth weight?
No evidence was identified which was applicable to this review question.
Appendix J. Economic analysis
Economic analysis for review question: What is the best method using third trimester measurements to predict birth weight?
No economic analysis was conducted for this review question.
Appendix K. Excluded studies
Excluded studies for review question: What is the best method using third trimester measurements to predict birth weight?
Clinical studies
Table 6Excluded studies and reasons for their exclusion
| Study | Reason for exclusion |
|---|---|
| Akolekar, R., Ciobanu, A., Zingler, E., Syngelaki, A., Nicolaides, K. H., Routine assessment of cerebroplacental ratio at 35-37 weeks’ gestation in the prediction of adverse perinatal outcome, American Journal of Obstetrics & GynecologyAm J Obstet Gynecol, 221, 65.e1–65.e18, 2019 [PubMed: 30878322] | Did not assess accuracy of ultrasound or SFH measurement for predicting birth weight. |
| Akolekar, R., Syngelaki, A., Gallo, D. M., Poon, L. C., Nicolaides, K. H., Umbilical and fetal middle cerebral artery Doppler at 35-37 weeks’ gestation in the prediction of adverse perinatal outcome, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 46, 82–92, 2015 [PubMed: 25779696] | Did not assess accuracy of ultrasound or SFH measurement for predicting birth weight. |
| Atkinson,M.W., Maher,J.E., Owen,J., Hauth,J.C., Goldenberg,R.L., Copper,R.L., The predictive value of umbilical artery Doppler studies for preeclampsia or fetal growth retardation in a preeclampsia prevention trial, Obstetrics and Gynecology, 83, 609–612, 1994 [PubMed: 8134075] | Index test not of interest (Doppler ultrasound) |
| Baird, S. M., Davies-Tuck, M., Coombs, P., Knight, M., Wallace, E. M., Detection of the growth-restricted fetus: which centile charts?, Sonography, 3, 81–86, 2016 | Did not assess accuracy of ultrasound or SFH measurement for predicting birth weight. |
| Bais, J. M., Eskes, M., Pel, M., Bonsel, G. J., Bleker, O. P., Effectiveness of detection of intrauterine growth retardation by abdominal palpation as screening test in a low risk population: an observational study, European Journal of Obstetrics, Gynecology, & Reproductive Biology, 116, 164–9, 2004 [PubMed: 15358457] | Index test not of interest for review: clinical examination only |
| Bakalis, S., Peeva, G., Gonzalez, R., Poon, L. C., Nicolaides, K. H., Prediction of small-for-gestational-age neonates: screening by biophysical and biochemical markers at 30-34 weeks, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 46, 446–51, 2015 [PubMed: 25826154] | Incorrect index tests (only US in combination with non-protocol relevant tests). |
| Bakalis, S., Silva, M., Akolekar, R., Poon, L. C., Nicolaides, K. H., Prediction of small-for-gestational-age neonates: screening by fetal biometry at 30-34 weeks, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 45, 551–558, 2015 [PubMed: 25523866] | Incorrect index tests (only US by Z-score). |
| Basuki, T. R., Caradeux, J., Eixarch, E., Gratacos, E., Figueras, F., Longitudinal Assessment of Abdominal Circumference versus Estimated Fetal Weight in the Detection of Late Fetal Growth Restriction, Fetal Diagnosis & TherapyFetal Diagn Ther, 45, 230–237, 2019 [PubMed: 29339641] | Incorrect index tests (only US by Z-score) |
| Beattie, R. B., Dornan, J. C., Antenatal screening for intrauterine growth retardation with umbilical artery Doppler ultrasonography, British Medical Journal, 298, 631–635, 1989 [PMC free article: PMC1835873] [PubMed: 2496788] | Index test not of interest for review: doppler ultrasound (umbilical artery) |
| Bergman, E., Axelsson, O., Kieler, H., Sonesson, C., Petzold, M., Relative growth estimated from self-administered symphysis fundal measurements, Acta Obstetricia et Gynecologica Scandinavica, 90, 179–85, 2011 [PubMed: 21241264] | Testing began before third trimester. |
| Bergman, E., Axelsson, O., Petzold, M., Sonesson, C., Kieler, H., Self-administered symphysis-fundus measurements analyzed with a novel statistical method for detection of intrauterine growth restriction: A clinical evaluation, Acta Obstetricia et Gynecologica Scandinavica, 90, 890–896, 2011 [PubMed: 21564029] | Testing began before third trimester. |
| Bligh, L. N., Al Solai, A., Greer, R. M., Kumar, S., Diagnostic Performance of Cerebroplacental Ratio Thresholds at Term for Prediction of Low Birthweight and Adverse Intrapartum and Neonatal Outcomes in a Term, Low-Risk Population, Fetal Diagnosis and Therapy, 43, 191–198, 2018 [PubMed: 28746928] | Incorrect index tests (only CPR). |
| Blue, N. R., Beddow, M. E., Savabi, M., Katukuri, V. R., Chao, C. R., Comparing the Hadlock fetal growth standard to the Eunice Kennedy Shriver National Institute of Child Health and Human Development racial/ethnic standard for the prediction of neonatal morbidity and small for gestational age, American Journal of Obstetrics & GynecologyAm J Obstet Gynecol, 219, 474.e1–474.e12, 2018 [PubMed: 30118689] | Inclusion criteria matching Blue 2018 included in review, cohort likely significantly overlapping, included only the larger study to minimise risk for double counting and data loss |
| Broere-Brown, Z. A., Schalekamp-Timmermans, S., Jaddoe, V. W. V., Steegers, E. A. P., Deceleration of fetal growth rate as alternative predictor for childhood outcomes: a birth cohort study, BMC Pregnancy & ChildbirthBMC Pregnancy Childbirth, 19, 216, 2019 [PMC free article: PMC6598289] [PubMed: 31248385] | Testing began before third trimester. |
| Caradeux, J., Eixarch, E., Mazarico, E., Basuki, T. R., Gratacos, E., Figueras, F., Second- to third-trimester longitudinal growth assessment for prediction of small-for-gestational age and late fetal growth restriction, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 51, 219–224, 2018 [PubMed: 28332335] | Insufficient data provided for calculation of accuracy outcomes. |
| Caradeux, J., Eixarch, E., Mazarico, E., Basuki, T. R., Gratacos, E., Figueras, F., Second- to Third-Trimester Longitudinal Growth Assessment for the Prediction of Largeness for Gestational Age and Macrosomia in an Unselected Population, Fetal Diagnosis & TherapyFetal Diagn Ther, 43, 284–290, 2018 [PubMed: 28719900] | Testing began before third trimester. |
| Caradeux, J., Eixarch, E., Mazarico, E., Basuki, T. R., Gratacos, E., Figueras, F., Longitudinal growth assessment for prediction of adverse perinatal outcome in fetuses suspected to be small-for-gestational age, Ultrasound in Obstetrics & GynecologyUltrasound Obstet Gynecol, 52, 325–331, 2018 [PubMed: 28782171] | Majority of population suspected FGR on inclusion. |
| Carberry, A. E., Gordon, A., Bond, D. M., Hyett, J., Raynes-Greenow, C. H., Jeffery, H. E., Customised versus population-based growth charts as a screening tool for detecting small for gestational age infants in low-risk pregnant women, Cochrane Database of Systematic Reviews, 2014 [PMC free article: PMC7175785] [PubMed: 24830409] | Systematic review, checked for references. |
| Cavalcante, R. O., Caetano, A. C., Nacaratto, D. C., Helfer, T. M., Martins, W. P., Nardozza, L. M., Moron, A. F., AraujoJunior, E., Fetal thigh and upper-arm volumes by three-dimensional ultrasound to predict low postnatal body mass index, Journal of Maternal-Fetal & Neonatal Medicine, 28, 1047–52, 2015 [PubMed: 25001426] | Inappropriate reference standard (BMI). |
| Cavallaro, A., Ash, S. T., Napolitano, R., Wanyonyi, S., Ohuma, E. O., Molloholli, M., Sande, J., Sarris, I., Ioannou, C., Norris, T., Donadono, V., Carvalho, M., Purwar, M., Barros, F. C., Jaffer, Y. A., Bertino, E., Pang, R., Gravett, M. G., Salomon, L. J., Noble, J. A., Altman, D. G., Papageorghiou, A. T., Quality control of ultrasound for fetal biometry: results from the INTERGROWTH-21<sup>st</sup> Project, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 52, 332–339, 2018 [PubMed: 28718938] | Reporting on quality control, no accuracy outcomes. |
| Chauhan, S. P., Scardo, J. A., Hendrix, N. W., Magann, E. F., Morrison, J. C., Accuracy of sonographically estimated fetal weight with and without oligohydramnios. A case-control study, J Reprod MedThe Journal of reproductive medicine, 44, 969–73, 1999 [PubMed: 10589409] | Index test not of interest for review: reduced amniotic fluid by ultrasound |
| Choi, S. K. Y., Gordon, A., Hilder, L., Henry, A., Hyett, J. A., Brew, B. K., Joseph, F., Jorm, L., Chambers, G. M., Performance of six birthweight and estimated fetal weight standards for predicting adverse perinatal outcomes: a 10-year nationwide population-based study, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology., 16, 2020 [PubMed: 32672406] | No protocol relevant outcomes (association with adverse outcomes not diagnostic accuracy) |
| Ciobanu, A., Anthoulakis, C., Syngelaki, A., Akolekar, R., Nicolaides, K. H., Prediction of small-for-gestational-age neonates at 35-37 weeks’ gestation: contribution of maternal factors and growth velocity between 32 and 36 weeks, Ultrasound in obstetrics & gynecology, 53, 630–637, 2019 [PubMed: 30912210] | Insufficient data provided for calculation of accuracy outcomes. |
| Ciobanu, A., Formuso, C., Syngelaki, A., Akolekar, R., Nicolaides, K. H., Prediction of small-for-gestational-age neonates at 35-37 weeks’ gestation: contribution of maternal factors and growth velocity between 20 and 36 weeks, Ultrasound in obstetrics & gynecology, 53, 488–495, 2019 [PubMed: 30779239] | Insufficient data provided for calculation of accuracy outcomes. |
| Ciobanu, A., Khan, N., Syngelaki, A., Akolekar, R., Nicolaides, K. H., Routine ultrasound at 32 vs 36 weeks’ gestation: prediction of small-for-gestational-age neonates, Ultrasound in obstetrics & gynecology, 53, 761–768, 2019 [PubMed: 30883981] | Insufficient data provided for calculation of accuracy outcomes. |
| Ciobanu, A., Rouvali, A., Syngelaki, A., Akolekar, R., Nicolaides, K. H., Prediction of small for gestational age neonates: screening by maternal factors, fetal biometry, and biomarkers at 35-37 weeks’ gestation, American journal of obstetrics and gynecology, 220, 486.e1–486.e11, 2019 [PubMed: 30707967] | Insufficient data provided for calculation of accuracy outcomes. |
| Dall’Asta, A., Rizzo, G., Kiener, A., Volpe, N., Di Pasquo, E., Roletti, E., Mappa, I., Makatsariya, A., Maruotti, G. M., Saccone, G., Sarno, L., Papaccio, M., Fichera, A., Prefumo, F., Ottaviani, C., Stampalija, T., Frusca, T., Ghi, T., Identification of large-for-gestational age fetuses using antenatal customized fetal growth charts: Can we improve the prediction of abnormal labor course?, European Journal of Obstetrics, Gynecology, & Reproductive BiologyEur J Obstet Gynecol Reprod Biol, 248, 81–88, 2020 [PubMed: 32199297] | Only included population of women with suspected high risk of macrosomia |
| De Reu,P.A., Smits,L.J., Oosterbaan,H.P., Nijhuis,J.G., Value of a single early third trimester fetal biometry for the prediction of birth weight deviations in a low risk population, Journal of Perinatal Medicine, 36, 324–329, 2008 [PubMed: 18598122] | Inappropriate index test (single metric not EFW). |
| Di Lorenzo, G., Monasta, L., Ceccarello, M., Cecotti, V., D’Ottavio, G., Third trimester abdominal circumference, estimated fetal weight and uterine artery doppler for the identification of newborns small and large for gestational age, European Journal of Obstetrics Gynecology and Reproductive Biology, 166, 133–138, 2013 [PubMed: 23122032] | Insufficient data provided for calculation of accuracy outcomes. |
| Ego, A., Prunet, C., Lebreton, E., Blondel, B., Kaminski, M., Goffinet, F., Zeitlin, J., Customized and non-customized French intrauterine growth curves. i - Methodology, Journal de Gynecologie Obstetrique et Biologie de la Reproduction, 45, 155–164, 2016 [PubMed: 26422365] | Not in English. |
| Fadigas, C., Saiid, Y., Gonzalez, R., Poon, L. C., Nicolaides, K. H., Prediction of small-for-gestational-age neonates: screening by fetal biometry at 35-37 weeks, Ultrasound in Obstetrics & Gynecology, 45, 559–65, 2015 [PubMed: 25728139] | Insufficient data provided for calculation of accuracy outcomes. |
| Figueras,F., Figueras,J., Meler,E., Eixarch,E., Coll,O., Gratacos,E., Gardosi,J., Carbonell,X., Customised birthweight standards accurately predict perinatal morbidity, Archives of Disease in Childhood Fetal and Neonatal Edition, 92, F277–F280, 2007 [PMC free article: PMC2675427] [PubMed: 17251224] | Did not assess accuracy of ultrasound or SFH measurement for predicting birth weight. |
| Flatley, C., Kumar, S., Is the fetal cerebroplacental ratio better that the estimated fetal weight in predicting adverse perinatal outcomes in a low risk cohort?, Journal of maternal-fetal & neonatal medicine, 32, 2380–2386, 2019 [PubMed: 29455616] | Did not assess accuracy of ultrasound or SFH measurement for predicting birth weight. |
| Flatley, C., Kumar, S., Is the fetal cerebroplacental ratio better that the estimated fetal weight in predicting adverse perinatal outcomes in a low risk cohort?, BJOG: An International Journal of Obstetrics and Gynaecology, 125, 6, 2018 [PubMed: 29455616] | Duplicate. |
| Francis, A., Gardosi, J., Effectiveness of ultrasound biometry at 34-36 weeks in the detection of SGA at birth, BJOG: An International Journal of Obstetrics and Gynaecology, 123 (Supplement 2), 22, 2016 | Duplicate. |
| Francis, A., Hugh, O., Gardosi, J., Customized vs INTERGROWTH-21<sup>st</sup> standards for the assessment of birthweight and stillbirth risk at term, American Journal of Obstetrics & GynecologyAm J Obstet Gynecol, 218, S692–S699, 2018 [PubMed: 29422208] | Did not assess accuracy of ultrasound or SFH measurement for predicting birth weight. |
| Frick, A. P., Syngelaki, A., Zheng, M., Poon, L. C., Nicolaides, K. H., Prediction of large-for-gestational-age neonates: screening by maternal factors and biomarkers in the three trimesters of pregnancy, Ultrasound in obstetrics & gynecology, 47, 332–9, 2016 [PubMed: 26446185] | Insufficient data provided for calculation of accuracy outcomes. |
| Gjessing, H. K., Grottum, P., Okland, I., Eik-Nes, S. H., Fetal size monitoring and birth-weight prediction: a new population-based approach, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 49, 500–507, 2017 [PubMed: 27130245] | Insufficient data provided for calculation of accuracy outcomes. |
| Gonzalez Gonzalez, N. L., Gonzalez Davila, E., Cabrera, F., Padron, E., Castro, J. R., Garcia Hernandez, J. A., Customized weight curves for Spanish fetuses and newborns, Journal of maternal-fetal & neonatal medicine, 27, 1495–9, 2014 [PubMed: 24168175] | Assessed accuracy of birthweight charts. |
| Gonzalez Gonzalez, N. L., Plasencia, W., Gonzalez Davila, E., Padron, E., Garcia Hernandez, J. A., Di Renzo, G. C., Bartha, J. L., The effect of customized growth charts on the identification of large for gestational age newborns, Journal of maternal-fetal & neonatal medicine, 26, 62–5, 2013 [PubMed: 23043627] | Assessed accuracy of birthweight charts. |
| Goto, E., Symphysis-fundal height to identify large-for-gestational-age and macrosomia: a meta-analysis, Journal of Obstetrics & GynaecologyJ Obstet Gynaecol, 1–7, 2019 [PubMed: 31814480] | Systematic review, references checked |
| Goto, E., Ultrasound fetal anthropometry to identify large-for-gestational-age: a meta-analysis, Minerva Ginecologica, 71, 467–474, 2019 [PubMed: 31741367] | Systematic review, references checked |
| Grover, V., Usha, R., Kalra, S., Sachdeva, S., Altered fetal growth: antenatal diagnosis by symphysis-fundal height in India and comparison with western charts, Int J Gynaecol ObstetInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 35, 231–4, 1991 [PubMed: 1677627] | Country not of interest for review: India (not high income country) |
| Hansen, D. N., Odgaard, H. S., Uldbjerg, N., Sinding, M., Sorensen, A., Screening for small-for-gestational-age fetuses, Acta Obstetricia et Gynecologica Scandinavica, 99, 503–509, 2020 [PubMed: 31670396] | Reports accuracy of screening program as a whole but not US specifically |
| Haragan, A. F., Hulsey, T. C., Hawk, A. F., Newman, R. B., Chang, E. Y., Diagnostic accuracy of fundal height and handheld ultrasound-measured abdominal circumference to screen for fetal growth abnormalities, American Journal of Obstetrics and Gynecology, 212, 820.e1–820.e8, 2015 [PMC free article: PMC4465094] [PubMed: 25818672] | Testing began before third trimester. |
| Hargreaves,K., Cameron,M., Edwards,H., Gray,R., Deane,K., Is the use of symphysis-fundal height measurement and ultrasound examination effective in detecting small or large fetuses?, Journal of Obstetrics and Gynaecology, 31, 380–383, 2011 [PubMed: 21627417] | Insufficient data provided for calculation of accuracy outcomes. |
| Hedriana, H. L., Moore, T. R., A comparison of single versus multiple growth ultrasonographic examinations in predicting birth weight, American Journal of Obstetrics & Gynecology, 170, 1600–4; discussion 1604-6, 1994 [PubMed: 8203416] | Outcomes not reported as pert protocol (index test measurements in standard deviation) |
| Hoftiezer, L., Hof, M. H. P., Dijs-Elsinga, J., Hogeveen, M., Hukkelhoven, Cwpm, van Lingen, R. A., From population reference to national standard: new and improved birthweight charts, American Journal of Obstetrics & GynecologyAm J Obstet Gynecol, 220, 383.e1–383.e17, 2019 [PubMed: 30576661] | Assessed accuracy of birthweight charts. |
| Indraccolo,U., Chiocci,L., Rosenberg,P., Nappi,L., Greco,P., Usefulness of symphysis-fundal height in predicting fetal weight in healthy term pregnant women, Clinical and Experimental Obstetrics and Gynecology, 35, 205–207, 2008 [PubMed: 18754294] | Incorrect index tests (US results use 50th percentile). |
| Kase,B.A., Carreno,C.A., Blackwell,S.C., Customized estimated fetal weight: a novel antenatal tool to diagnose abnormal fetal growth, American Journal of Obstetrics and Gynecology, 207, 218–5, 2012 [PubMed: 22835492] | Testing began before third trimester. |
| Kayem,G., Grange,G., Breart,G., Goffinet,F., Comparison of fundal height measurement and sonographically measured fetal abdominal circumference in the prediction of high and low birth weight at term, Ultrasound in Obstetrics and Gynecology, 34, 566–571, 2009 [PubMed: 19582801] | Thresholds not chosen prospectively to identify SGA/LGA but picked to optimise sensitivity from ROC curve. |
| Khalifa, E. A., Hassanein, S. A., Eid, H. H., Ultrasound measurement of fetal abdominal subcutaneous tissue thickness as a predictor of large versus small fetuses for gestational age, Egyptian Journal of Radiology and Nuclear Medicine, 50 (1) (no pagination), 2019 | Not in high income country |
| Kim, M. A., Han, G. H., Kim, Y. H., Prediction of small-for-gestational age by fetal growth rate according to gestational age, 14, e0215737, 2019 [PMC free article: PMC6485641] [PubMed: 31026299] | Thresholds not chosen prospectively to identify SGA/LGA but picked to optimise sensitivity from ROC curve. |
| Lalys,L., Pineau,J.C., Guihard-Costa,A.M., Small and large foetuses: Identification and estimation of foetal weight at delivery from third-trimester ultrasound data, Early Human Development, 86, 753–757, 2010 [PubMed: 20826073] | Insufficient data to construct 2 × 2 table and calculate diagnostic outcome accuracy measures |
| Lindell,G., Marsal,K., Kallen,K., Predicting risk for large-for-gestational age neonates at term: a population-based Bayesian theorem study, Ultrasound in Obstetrics and Gynecology, 41, 398–405, 2013 [PubMed: 23505150] | Threshold not of interest for review: z score |
| McCowan, L. M. E., Thompson, J. M. D., Taylor, R. S., Baker, P. N., North, R. A., Poston, L., Roberts, C. T., Simpson, N. A. B., Walker, J. J., Myers, J., Kenny, L. C., Healy, D., Briley, A., Murphy, N., Snapes, E., Chan, E., Black, M., Prediction of small for gestational age infants in healthy nulliparous women using clinical and ultrasound risk factors combined with early pregnancy biomarkers, PLoS ONE, 12 (1) (no pagination), 2017 [PMC free article: PMC5221822] [PubMed: 28068394] | Not third trimester ultrasound |
| Miranda, J., Rodriguez-Lopez, M., Triunfo, S., Sairanen, M., Kouru, H., Parra-Saavedra, M., Crovetto, F., Figueras, F., Crispi, F., Gratacos, E., Prediction of fetal growth restriction using estimated fetal weight vs a combined screening model in the third trimester, Ultrasound in obstetrics & gynecology, 50, 603–611, 2017 [PubMed: 28004439] | Insufficient data provided for calculation of accuracy outcomes. |
|
Najafzadeh, A., Graves, A., Re: Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: A prospective cohort study. Lancet2015; 386:2089–97. [PMC free article: PMC4655320] [PubMed: 26360240] SovioU, WhiteIR, DaceyA, PasupathyD, SmithGC, Sonography, 3, 70–71, 2016 | Commentary. |
| Newnham,J.P., Patterson,L.L., James,I.R., Diepeveen,D.A., Reid,S.E., An evaluation of the efficacy of Doppler flow velocity waveform analysis as a screening test in pregnancy, American Journal of Obstetrics and Gynecology, 162, 403–410, 1990 [PubMed: 2178428] | Cut off for index test US AC <5th percentile with the reference standard set at birth weight <10th percentile |
| Okonofua, F. E., Ayangade, S. O., Chan, R. C., O’Brien, P. M., A prospective comparison of clinical and ultrasonic methods of predicting normal and abnormal fetal growth, Int J Gynaecol ObstetInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 24, 447–51, 1986 [PubMed: 20419909] | Outcomes not reported as pert protocol (insufficient information for calculation of accuracy outcomes) |
| Ott, W. J., Doyle, S., Ultrasonic diagnosis of altered fetal growth by use of a normal ultrasonic fetal weight curve, Obstetrics and Gynecology, 63, 201–204, 1984 [PubMed: 6694813] | Outcomes not reported as pert protocol (index test measurements in standard deviation) |
| Papastefanou, I., Pilalis, A., Chrelias, C., Kassanos, D., Souka, A. P., Screening for birth weight deviations by second and third trimester ultrasound scan, Prenatal diagnosis, 34, 759–64, 2014 [PubMed: 24659438] | Did not report results of third trimester scans separately. |
| Pay, A. S. D., Froen, J. F., Staff, A. C., Jacobsson, B., Gjessing, H. K., Symphysis-fundus measurement - the predictive value of a new reference curve, Tidsskrift for Den Norske LaegeforeningTidsskr Nor Laegeforen, 137, 717–720, 2017 [PubMed: 28551970] | Not in English. |
| Pay, A., Froen, J. F., Staff, A. C., Jacobsson, B., Gjessing, H. K., Prediction of small-for-gestational-age status by symphysis-fundus height: a registry-based population cohort study, BJOG: An International Journal of Obstetrics & GynaecologyBjog, 123, 1167–73, 2016 [PubMed: 26644370] | Accuracy data not reported for specific SFH measurements/strategies |
| Persson, B., Stangenberg, M., Lunell, N. O., Brodin, U., Holmberg, N. G., Vaclavinkova, V., Prediction of size of infants at birth by measurement of symphysis fundus height, Br J Obstet GynaecolBritish journal of obstetrics and gynaecology, 93, 206–11, 1986 [PubMed: 3964594] | Outcomes not reported as pert protocol (index test measurements in standard deviation) |
| Pilalis, A., Souka, A. P., Papastefanou, I., Michalitsi, V., Panagopoulos, P., Chrelias, C., Kassanos, D., Third trimester ultrasound for the prediction of the large for gestational age fetus in low-risk population and evaluation of contingency strategies, Prenatal Diagnosis, 32, 846–853, 2012 [PubMed: 22729391] | Insufficient data provided for calculation of accuracy outcomes. |
| Poljak, B., Agarwal, U., Jackson, R., Alfirevic, Z., Sharp, A., Diagnostic accuracy of individual antenatal tools for prediction of small-for-gestational age at birth, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 49, 493–499, 2017 [PubMed: 27486031] | Majority of population suspected SGA on inclusion. |
| Pritchard, N., Lindquist, A., Siqueira, I. D. A., Walker, S. P., Permezel, M., INTERGROWTH-21st compared with GROW customized centiles in the detection of adverse perinatal outcomes at term, Journal of Maternal-Fetal and Neonatal Medicine, 33, 961–966, 2020 [PubMed: 30372647] | Did not report accuracy outcomes |
| Reboul, Q., Delabaere, A., Luo, Z. C., Nuyt, A. M., Wu, Y., Chauleur, C., Fraser, W., Audibert, F., Prediction of small-for-gestational-age neonate by third-trimester fetal biometry and impact of ultrasound-delivery interval, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 49, 372–378, 2017 [PubMed: 27153518] | Thresholds not chosen for prediction but selected without detail on index test intention. |
| Rial-Crestelo, M., Martinez-Portilla, R. J., Cancemi, A., Caradeux, J., Fernandez, L., Peguero, A., Gratacos, E., Figueras, F., Added value of cerebro-placental ratio and uterine artery Doppler at routine third trimester screening as a predictor of SGA and FGR in non-selected pregnancies, Journal of maternal-fetal & neonatal medicine, 32, 2554–2560, 2019 [PubMed: 29447050] | No outcomes on accuracy of US alone. |
| Ricchi, A., Pignatti, L., Bufalo, E., De Salvatore, C., Banchelli, F., Neri, I., Estimation of fetal weight near term: comparison between ultrasound and symphysis-fundus evaluation by Johnson’s rule, Journal of maternal-fetal & neonatal medicine, 1–5, 2019 [PubMed: 31122147] | Insufficient data provided for calculation of accuracy outcomes. |
| Roeckner, J. T., Odibo, L., Odibo, A. O., The value of fetal growth biometry velocities to predict large for gestational age (LGA) infants, Journal of Maternal Fetal and Neonatal Medicine., 2020 [PubMed: 32546027] | Population only women referred for US for clinical suspicion of growth abnormality |
| Rogers, M. S., Needham, P. G., Evaluation of fundal height measurement in antenatal care, Aust N Z J Obstet GynaecolThe Australian & New Zealand journal of obstetrics & gynaecology, 25, 87–90, 1985 [PubMed: 3901997] | Outcomes not reported as pert protocol (index test measurements in standard deviation) |
| Rosenberg, K., Grant, J. M., Tweedie, I., Aitchison, T., Gallagher, F., Measurement of fundal height as a screening test for fetal growth retardation, Br J Obstet GynaecolBritish journal of obstetrics and gynaecology, 89, 447–50, 1982 [PubMed: 7082601] | Included 2nd trimester measurements |
| Sananes, N., Guigue, V., Kohler, M., Bouffet, N., Cancellier, M., Hornecker, F., Hunsinger, M. C., Kohler, A., Mager, C., Neumann, M., Schmerber, E., Tanghe, M., Nisand, I., Favre, R., Use of Z-scores to select a fetal biometric reference curve, Ultrasound in Obstetrics and Gynecology, 34, 404–409, 2009 [PubMed: 19731264] | Assessed accuracy of reference curves and included second trimester measurements. |
| Secher, N. J., Lundbye-Christensen, S., Qvist, I., Bagger, P., An evaluation of clinical estimation of fetal weight and symphysis fundal distance for detection of SGA infants, European Journal of Obstetrics, Gynecology, & Reproductive Biology, 38, 91–6, 1991 [PubMed: 1995388] | Index test not of interest for review: clinical examination/abdominal palpitation only |
| Sijmons, E. A., Reuwer, P. J., van Beek, E., Bruinse, H. W., The validity of screening for small-for-gestational-age and low-weight-for-length infants by Doppler ultrasound, Br J Obstet GynaecolBritish journal of obstetrics and gynaecology, 96, 557–61, 1989 [PubMed: 2667630] | Index test not of interest for review: doppler ultrasound (umbilical artery) |
| Souka, A. P., Papastefanou, I., Michalitsi, V., Pilalis, A., Kassanos, D., Specific formulas improve the estimation of fetal weight by ultrasound scan, Journal of Maternal-Fetal and Neonatal Medicine, 27, 737–742, 2014 [PubMed: 23981185] | Assessed overall accuracy of multiple formulae but without specific cut-off outcomes. |
| Souka, A. P., Papastefanou, I., Pilalis, A., Michalitsi, V., Kassanos, D., Performance of third-trimester ultrasound for prediction of small-for-gestational-age neonates and evaluation of contingency screening policies, Ultrasound in Obstetrics & GynecologyUltrasound Obstet Gynecol, 39, 535–42, 2012 [PubMed: 21858886] | Thresholds not chosen for prediction but selected without detail on index test intention. |
| Souka, A. P., Papastefanou, I., Pilalis, A., Michalitsi, V., Panagopoulos, P., Kassanos, D., Performance of the ultrasound examination in the early and late third trimester for the prediction of birth weight deviations, Prenatal diagnosis, 33, 915–20, 2013 [PubMed: 23703542] | Thresholds not chosen for prediction but selected without detail on index test intention. |
| Sovio, U., Smith, G. C. S., Comparison of estimated fetal weight percentiles near term for predicting extremes of birth weight percentile, American journal of obstetrics and gynecology., 21, 2020 [PubMed: 32835717] | Outcomes on this cohort already included from Sovio 2015 |
| Sparks,T.N., Cheng,Y.W., McLaughlin,B., Esakoff,T.F., Caughey,A.B., Fundal height: a useful screening tool for fetal growth?, Journal of Maternal-Fetal and Neonatal Medicine, 24, 708–712, 2011 [PubMed: 20849205] | Majority of population suspected SGA/LGA on inclusion. |
| Todros, T., Ferrazzi, E., Arduini, D., Bastonero, S., Bezzeccheri, V., Biolcati, M., Bonazzi, B., Gabrielli, S., Pilu, G. L., Rizzo, G., et al.,, Performance of Doppler ultrasonography as a screening test in low risk pregnancies: results of a multicentric study, J Ultrasound MedJournal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 14, 343–8, 1995 [PubMed: 7609011] | Index test not of interest for review: doppler ultrasound (umbilical artery) |
| Warsof, S. L., Cooper, D. J., Little, D., Campbell, S., Routine ultrasound screening for antenatal detection of intrauterine growth retardation, Obstetrics and Gynecology, 67, 33–39, 1986 [PubMed: 3510015] | Index tests done before the third trimester |
Economic studies
A single economic search was undertaken for all topics included in the scope of this guideline. No economic studies were identified which were applicable to this review question. See supplementary material 2 for details.
Appendix L. Research recommendations
Research recommendations for review question: What is the best method using third trimester measurements to predict birth weight?
No research recommendations were made for this review question.
Appendix M. Additional studies in update searches
Table 6. Summary of studies identified but not extracted (PDF, 105K)
Final
Evidence reviews underpinning recommendations 1.2.31 to 1.2.34
These evidence reviews were developed by the National Guideline Alliance, which is a part of the Royal College of Obstetricians and Gynaecologists
Disclaimer: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.
NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the Welsh Government, Scottish Government, and Northern Ireland Executive. All NICE guidance is subject to regular review and may be updated or withdrawn.
- Usefulness of symphysis-fundal height in predicting fetal weight in healthy term pregnant women.[Clin Exp Obstet Gynecol. 2008]Usefulness of symphysis-fundal height in predicting fetal weight in healthy term pregnant women.Indraccolo U, Chiocci L, Rosenberg P, Nappi L, Greco P. Clin Exp Obstet Gynecol. 2008; 35(3):205-7.
- Review Routine third-trimester ultrasound in low-risk pregnancies and perinatal death: a systematic review and meta-analysis.[Am J Obstet Gynecol MFM. 2020]Review Routine third-trimester ultrasound in low-risk pregnancies and perinatal death: a systematic review and meta-analysis.Al-Hafez L, Chauhan SP, Riegel M, Balogun OA, Hammad IA, Berghella V. Am J Obstet Gynecol MFM. 2020 Nov; 2(4):100242. Epub 2020 Oct 3.
- A survey of methods used to measure symphysis fundal height.[J Obstet Gynaecol. 2008]A survey of methods used to measure symphysis fundal height.Griffiths A, Pinto A, Margarit L. J Obstet Gynaecol. 2008 Oct; 28(7):692-4.
- International standards for symphysis-fundal height based on serial measurements from the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project: prospective cohort study in eight countries.[BMJ. 2016]International standards for symphysis-fundal height based on serial measurements from the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project: prospective cohort study in eight countries.Papageorghiou AT, Ohuma EO, Gravett MG, Hirst J, da Silveira MF, Lambert A, Carvalho M, Jaffer YA, Altman DG, Noble JA, et al. BMJ. 2016 Nov 7; 355:i5662. Epub 2016 Nov 7.
- Review Symphysial fundal height (SFH) measurement in pregnancy for detecting abnormal fetal growth.[Cochrane Database Syst Rev. 2015]Review Symphysial fundal height (SFH) measurement in pregnancy for detecting abnormal fetal growth.Robert Peter J, Ho JJ, Valliapan J, Sivasangari S. Cochrane Database Syst Rev. 2015 Sep 8; 2015(9):CD008136. Epub 2015 Sep 8.
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