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J Perinatol. 2017 May;37(5):498-501. doi: 10.1038/jp.2016.275. Epub 2017 Jan 26.

Utility of third trimester sonographic measurements for predicting SGA in cases of fetal gastroschisis.

Author information

1
Department of Obstetrics & Gynecology, Stanford University School of Medicine, Stanford, CA, USA.
2
The Fetal and Pregnancy Health Program, Lucile Packard Children's Hospital Stanford, Palo Alto, CA, USA.
3
Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, CA, USA.
4
Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA, USA.
5
Department of Pediatrics, Division of Neonatology, Loma Linda University School of Medicine, Loma Linda, CA, USA.
6
Department of Obstetrics & Gynecology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.

Abstract

OBJECTIVE:

To assess the accuracy of different sonographic estimated fetal weight (EFW) cutoffs, and combinations of EFW and biometric measurements for predicting small for gestational age (SGA) in fetal gastroschisis.

STUDY DESIGN:

Gastroschisis cases from two centers were included. The sensitivity, specificity, positive and negative predictive values (PPV and NPV) were calculated for different EFW cutoffs, as well as EFW and biometric measurement combinations.

RESULTS:

Seventy gastroschisis cases were analyzed. An EFW<10% had 94% sensitivity, 43% specificity, 33% PPV and 96% NPV for SGA at delivery. Using an EFW cutoff of <5% improved the specificity to 63% and PPV to 41%, but decreased the sensitivity to 88%. Combining an abdominal circumference (AC) or femur length (FL) z-score less than -2 with the total EFW improved the specificity and PPV but decreased the sensitivity.

CONCLUSION:

A combination of a small AC or FL along with EFW increases the specificity and PPV, but decreases the sensitivity of predicting SGA.

PMID:
28125100
DOI:
10.1038/jp.2016.275
[Indexed for MEDLINE]

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