ABSTRACT
Objective: Evaluation of fetal growth constitutes a core component of prenatal care. However, the limited accuracy of the sonographic examination complicates this task. In the present study, we assessed the diagnostic and prognostic power of the first biometric measurements and the three arterial Doppler indices in cases with suspected fetal growth restriction (FGR). Material and Methods: A retrospective, cross-sectional study was conducted between August 2016 and January 2019. Data on suspected FGR cases were obtained from consultations. Three biometric measurements, namely abdominal circumference (AC), estimated fetal weight (EFW), and femur length (FL); three arterial Doppler indices (umbilical, uterine, and middle cerebral) and one combinatory index; the cerebroplacental ratio (CPR) were analyzed to predict cases with neonatal birth weight (NBW) <10th centile. Results: In a sample of 352 pregnancies diagnosed as FGR, 246 (69.9%) cases reported NBW <10th centile (true positives). The AC <3rd centile had the highest sensitivity (81.9%), whereas EFW <3rd centile had the highest specificity (83.2%). For each biometric measurement, the addition of any Doppler index resulted in decreased sensitivity but increased specificity. The frequency of cases with at least one Doppler abnormality was significantly higher in true-positive cases than in false-positive cases (36.9% vs. 22.6%, respectively; p=0.008). In caseswith late-onset FGR, CPR <5th centile was associated with an increased risk of admission to neonatal intensive care unit (NICU) (odds ratio [OR]: 6.42; 95% confidence interval [CI]: 2.24-18.40; p=0.001). Conclusion: A high sensitivity was associated with the first biometric measurements for detecting FGR. The CPR < 5th centile could be useful in predicting cesarean delivery for fetal distress and NICU admissions in cases with late-onset FGR.