Clinical and Ultrasound Predictors of Adverse Neonatal Outcome at Diagnosis of Late Onset Fetal Growth Restriction Low Resources Settings | ||
| Zagazig University Medical Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 03 March 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/zumj.2025.360617.3841 | ||
| Authors | ||
| Mohamed Ali; Gaser Elbishry; Mohamed Sweed; Radwa Ali* | ||
| Department of Obstetrics & Gynecology, Faculty of Medicine - Ain Shams University, Cairo, Egypt | ||
| Abstract | ||
| Background: Fetal growth restriction (FGR) is associated with high incidence of perinatal morbidity and mortality. Early diagnosis of fetuses at risk will allow for close monitor and timely delivery accordingly; which remains challenging mainly in late onset FGR where some cases remain unrecognized during pregnancy because of normal Doppler findings. The aim of this study was to determine different clinical and ultrasound predictors of adverse neonatal outcomes at the time of diagnosing late onset FGR. Methods: Analysis of medical records at Ain Shams University Maternity Hospital was conducted to evaluate singleton pregnancies complicated by late-onset FGR. Different clinical and sonographic parameters obtained at time of FGR diagnosis were evaluated as possible predictors of composite neonatal morbidity in low resources settings. Results: One hundred fifty one non-anomalous singleton pregnancies with late-onset FGR were evaluated, the composite neonatal morbidity were significantly associated with hypertensive disorders. The estimated fetal weight ≤3 percentile at the time of late-onset FGR diagnosis had a sensitivity of 87.7% and specificity of 51.06 % in predicting composite neonatal morbidity. Amniotic fluid index to head-to-abdomen circumference ratio (AHC/AC) had the highest area under the ROC curve (AUC) of 0.727; p-value <0.0001. At the cut-off ≤0.06, AHC/AC was 77.19 % sensitive and 62.77% specific in predicting composite neonatal morbidity. Conclusion: The findings of the current study suggest that EFW and AC percentiles, AFI, and AHC/AC ratios at the time of late onset FGR diagnosis have acceptable predictive value for composite neonatal morbidity. | ||
| Keywords | ||
| Amniotic fluid index; fetal growth restriction; low resources; neonatal outcomes; neonatal morbidity | ||
|
Statistics Article View: 76 |
||
