Sonographic diagnosis of fetal growth disorders.

In summary, accurate identification of fetal growth disorders remains a difficult clinical challenge. Many diagnostic parameters have been devised to diagnose these conditions, however, no single test alone allows a confident antenatal diagnosis of IUGR or macrosomia to be established. Until new criteria or new methods such as Doppler analysis of umbilical artery flow permit a more accurate prediction of growth disturbances, multiple parameters should be monitored. Evaluation of the amniotic fluid volume, BPD, FL, AC, and EFW should be included in all studies. In high risk cases (unexplained oligohydramnios, previous history of growth retardation, poor nutritional status, abnormal sonographic parameters, maternal obesity, diabetes mellitus, etc.) additional measurements such as the HC/AC ratio and the FL/AC ratio should also be evaluated. Similarly, evaluation of suspected excessive fetal growth requires careful evaluation of AC measurements. Patients with suspected growth disorders should be reevaluated with serial scans at 2 to 3 weeks intervals. Careful monitoring of fetuses with suspected IUGR and macrosomia may decrease much of the morbidity and mortality associated with these conditions.