Bibliographic Details
| Title: |
CustOmized versus standard fundal‐height measuREments for the detection of small‐for‐gestational age fetuses in low‐risk women (CORE study): A randomized controlled trial. |
| Authors: |
Ahmed, Farhat ul Ain1 (AUTHOR) farhatulainahmed@yahoo.com, Hanook, Sharoon2 (AUTHOR), Ismail, Fatima1 (AUTHOR), Shah, Fatima1 (AUTHOR), Arsalan, Maaz1 (AUTHOR), Lopez Garcia‐Tinajero, Maria F.3 (AUTHOR), Martinez‐Egea, Judit3 (AUTHOR), Figueras, Francesc3 (AUTHOR) |
| Source: |
International Journal of Gynecology & Obstetrics. Dec2024, p1. 10p. 4 Illustrations. |
| Subject Terms: |
*FETAL growth retardation, *PREGNANT women, *GESTATIONAL age, *UNITS of measurement, *RANDOMIZED controlled trials |
| Abstract: |
Objective Methods Results Conclusion To compare the proportion of small‐for‐gestational age (SGA) infants detected by routine care versus a growth assessment protocol using customized fundal‐height charts in low‐risk pregnancies of a developing country.An open label randomized controlled trial was conducted at the Fatima Memorial Hospital (NUR International University, Pakistan). Low‐risk pregnant women were randomly allocated to routine care (Mcdonald's rule for fundal height measurements followed by referral for scan with discrepancy of 3 cm from gestational age and a contingency third trimester scan) or the growth assessment protocol (GAP) developed by the Perinatal Institute (UK), which consists of the use of gestation‐related optimal weight (GROW) customized charts, alongside management protocols for suspected SGA fetuses, audit tools and training. The primary prespecified outcome was the detection of SGA (defined as a birthweight <10th centile).Of the 2535 eligible women, 1884 (74%) were randomized (942 to standard care and 942 to GAP). After loss‐to‐follow‐up, 1755 women were analyzed (874 in the standard measurement group and 881 in the GAP group). The detection rate of SGA infants was higher in the GAP group (83.2% [95% CI: 74.4%–89.9%] vs. 29% [95% CI: 20.4%–38.9%], P < 0.001), at the cost of an increased false positive rate (10.4% [95% CI: 8.3%–12.7%] vs. 1.4% [95% CI: 0.7%–2.5%], P < 0.001). The diagnostic odds ratio (positive likelihood ratio/negative likelihood ratio) was 42.6 (95% CI: 24.1–75.4) in the GAP group and 28.3 (95% CI:13.6–59.1) in the standard care group.In low‐risk pregnant women of a developing country, a growth assessment protocol based on customized fundal‐height charts is superior to standard measurements for the antenatal detection of SGA in newborns. [ABSTRACT FROM AUTHOR] |
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| Database: |
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