The use of ultrasound to detect small-for-gestational-age infants in patients with elevated human chorionic gonadotropin on maternal serum screening

Tamera Hatfield, Aaron B. Caughey, David C. Lagrew, Ryan Heintz, Judith H. Chung

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

We evaluated serial sonography for the antenatal detection of small-for-gestational-age (SGA) infants in pregnancies with elevated human chorionic gonadotropin (hCG) levels on midtrimester triple-marker screen. A retrospective cohort study was performed at Saddleback Memorial Medical Center where serial ultrasounds from 26 weeks to delivery are generally recommended for patients with hCG levels >2.0 Multiple of the Median (MoM). From 1999 to 2007, 659 subjects were identified for analysis. The incidence of intrauterine growth restriction (IUGR) and SGA were 5.2% and 7.3%, respectively. Antenatal ultrasound identified 31.3% of SGA infants. Compared with estimated fetal weight (EFW) <10th percentile alone, abdominal circumference (AC) <10th percentile improved the detection of SGA from 31.3% (95% confidence interval [CI], 18.7 to 46.3) to 35.4% (95% CI, 22.2 to 50.5). Using either EFW or AC further increased the sensitivity to 45.8% (95% CI, 31.4 to 60.8). The sensitivity for the detection of SGA was 100% when an EFW cutoff of 75% was used. Ultrasound can be used to detect SGA infants in patients with elevated hCG levels on midtrimester serum screening. A sonographic estimated fetal weight 75th percentile appears to be a safe cutoff to rule out all fetuses at risk for SGA.

Original languageEnglish (US)
Pages (from-to)173-180
Number of pages8
JournalAmerican journal of perinatology
Volume27
Issue number2
DOIs
StatePublished - Feb 15 2010
Externally publishedYes

Keywords

  • Human chorionic gonadotropin
  • Intrauterine growth restriction
  • Small for gestational age
  • Ultrasound

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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