Improved fetal monitoring through individualized growth charts for ultrasound measurements
Objective: When monitoring pregnancies it is decisive to reduce unnecessary examinations. In particular, wrongfully assumed growth retardation might occur in cases with a small fetal growth potential [1–6]. It is further important to improve the detection of objectively retardated children who associate with a disproportionately high growth potential. It was the aim of this study to modify the standard growth charts for ultrasound parameters according to parental influences to better display the individual growth potential.
Material and methods: In a prospective trial 1390 ultrasound measurements of 174 completed pregnancies were observed. For all patients a standard questionnaire was conducted in which possible predictors for fetal growth were collected. Customizing the growth charts has been achieved by 1) calculating the general impact of parental factors on the ultrasound measurement values, 2) plotting the individual growth charts for each pregnancy and 3) analyzing the difference of every observed measurement from either unchanged normal values or customized growth charts [7, 8].
Results: The obtained biparietal diameter measurements all in all are 291mm closer to the individualized charts than to the unmodified charts. The total improvement of all measurements concerning thoracic diameter, abdomen circumference, and femur length was 294mm, 1005mm, and 296mm respectively. All results were statistically significant.
Conclusion: This is the first study to analyze the impact of several predictors on ultrasound growth charts. The feasibility and the statistical benefit of customizing ultrasound growth charts have been demonstrated in this work.