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Poster Session 3

(813) Abdominal Circumference versus Estimated Fetal Weight in Fetal Growth Restriction Surveillance and Outcomes

Friday, January 31, 2025
10:30 AM – 12:30 PM  
Objective: To compare the incidence of abnormal umbilical artery Doppler (UAD), obstetric and neonatal outcomes in pregnancies affected by fetal growth restriction (FGR) when diagnosed by abdominal circumference (AC) and estimated fetal weight (EFW).

Study Design: This is a retrospective cohort study of patients with a singleton pregnancy with FGR who delivered at a tertiary urban academic center between January 2020 and December 2023.The primary outcome was abnormal UAD. Secondary outcomes were obstetric outcomes and Composite Neonatal Outcomes (CNO) including RDS, IVH, ROP, NEC, HIE, TTN, neonatal seizures, sepsis, hypoglycemia. Fisher’s exact, chi square, parametric and non-parametric tests were used.

Results: Among 178 patients, 104 (58%) were diagnosed by AC only (Group 1) and 74 (42%) by EFW (Group 2). Abnormal UAD was more frequent in patients with FGR diagnosed by EFW [3(3%) vs 11(15%) in Groups 1 and 2 respectively, p=0.004]. Gestational age at FGR diagnosis was significantly lower in Group 1 (32w4d vs 35w6d in Groups 1 and 2 respectively, p</span>=0.008). The incidence of cesarean delivery was similar between the groups[47(37%) vs 30(45%) in Groups 1 and 2 respectively, p=0.35]. The median GA at delivery was lower in Group 2 [39w0d in Group 1 vs 38w1d in Group 2, p< 0.0001]. Resolution of FGR was more likely when initially diagnosed by AC only [27 (21%) vs 1(1%) in Groups 1 and 2 respectively, p</span>< 0.0001]. Neonatal weight was lower in group 2 (median 2705g vs 2405g in Groups 1 and 2 respectively, p</span>< 0.0001); and incidence of small for gestational age (SGA) and low birth weight (LBW) were higher in group 2 [SGA: 41(39%) vs 51(69%), p=0.0001;  LBW: 27(26%) vs 50(68%), p</span>< 0.0001, respectively]. Incidence of CNO was higher in Group 2 [18(17%) vs 23(31%), p=0.04].  

Conclusion: Abnormal UAD was rarely seen in FGR fetuses diagnosed by AC and adverse neonatal outcomes were also seen less frequently in this group. FGR fetuses diagnosed by AC should be followed closely, although different surveillance frequency could be considered.