Neonatal outcome-based performance of the recent International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) definition of fetal growth restriction: retrospective study

Abstract

Objective. to evaluate the performance of ISUOG definition for placenta- mediated fetal growth restriction (FGR) in predicting fetuses at risk of adverse neonatal outcomes. The definition is based on a combination of measures of fetal size percentile and Doppler abnormalities. Material and Methods. this retrospective study included medical records of 55 singleton pregnancies with FGR who were admitted in Ain Shams University Maternity Hospital. FGR was defined as EFW and /or AC below the10th percentile using Hadlock’s fetal growth standard. These criteria were reevaluated in accordance to the ISUOG definition for placenta- mediated fetal growth restriction in predicting adverse outcomes. Our primary outcome was to assess the accuracy of the ISUOG definition in predicting the composite adverse neonatal outcome (ANO) including one or more of the following parameters: neonatal intensive care unit (NICU) admission, 5-min Apgar score < 7, respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), necrotizing enterocolitis, periventricular leukomalacia, neonatal anemia, pulmonary hypertension, seizures and/or death. Results. Of the 245 pregnancies that were evaluated, only 55 records fulfilled the parameters needed to evaluate the performance of the ISUOG definition. The current study revealed that the ISUOG criteria for the diagnosis of FGR identified all pregnancies that were significantly at risk for composite adverse neonatal outcome. Conclusions. According to the current study, the ISUOG criteria for fetal growth restriction can accurately identify fetuses at risk of adverse perinatal outcomes.