Distinction between SGA and FGR by means of fetal umbilical vein flow and maternal hemodynamics

Abstract

Objectives

To improve identification of fetal growth restriction (FGR) by means of umbilical venous flow (QUV) and maternal hemodynamics, including systemic vascular resistance (SVR) and cardiac output (CO), in order to distinguish between FGR and SGA.

Methods

We enrolled 68 pregnancies (36 SGA, 8 early FGR and 24 late FGR) who underwent a complete fetal hemodynamic examination including QUV and a noninvasive maternal hemodynamics assessment by means of USCOM.

Results

In comparison with SGA, QUV and corrected for estimated fetal weight QUV (cQUV) were significantly lower in early and late-FGR. In addition, maternal CO was lower in early and late-FGR, while SVR was lower only in early-onset FGR. According to ROC analysis, cQUV centile (AUC 0.92, 0.72) was the best parameter for the prediction of SGA before and after 32 weeks, followed by SVR and CO. For all parameters, the prediction was always better in the case of early-onset FGR <32 weeks.

Conclusions

UV flow and maternal hemodynamics examination are useful tools to accurately discern between SGA and FGR.

Keywords:

• Fetal growth restriction
• small for gestational age
• umbilical vein blood flow
• maternal hemodynamics
• systemic vascular resistance
• cardiac output

Disclosure statement

No potential conflict of interest was reported by the author(s).