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Re: ObsFrom: Terry J. DuBose (duboseterryj@uams.edu)Thu Aug 14 17:19:10 2003
Dr. Shazia, in a large study (10,000+) in the 1980's & 90's using up to 11 different fetal parameters for estimating fetal age we found that two standard deviations were just under +/- 10% of the average age. In the case you present here the average age of the head (34) and body (38) parameter ages would be 36 weeks; therefore, 2 SD would be 36 weeks +/- 3.6, or between about 32.4 to 39.6. Your parameters are within that range. (See DuBose, Fetal Sonography, W. B. Saunders 1996, p. 95-148) But to answer if there is IUGR, as Dr. Fougner said here recently, "High risk does not mean you have a problem. Low risk does not mean you have no problem." The same might be said about IUGR in this case, might be, might not. However with the head being behind the body in age (relative size), microcephaly is also a consideration, perhaps a greater probably than IUGR in this case. IUGR usually has the body behind the head (size/age), but not necessarily in all cases. Might be just a long, fat baby. An earlier, dating sonogram would help, because IUGR is generally progressive, and the growth between examinations will be less than expected. But if you only have one examination, then interpretation is more difficult. Growth disturbances are almost impossible to diagnose without at least two sonographic studies... an early "dating" sonogram, and a later one for growth analysis. For more on IUGR see: http://www.ohsu.edu/cliniweb/C16/C16.300.html http://chorus.rad.mcw.edu/doc/00943.html http://www.medical-library.org/journals2a/fetal_intrauterine_growth_retard.htm http://www.fpnotebook.com/OB39.htm Any good obstetrical sonography textbook should have femur and abdominal circumference age tables. I hope this helps. I realize this may raise more questions than answers… perhaps others here can give you more advice. Good luck, Terry J DuBose, M.S., RDMS Little Rock, Arkansas USA Q.1: What would be the gestational age of the faetus with measurement of B.P.D and H.C corresponding to 34 weeks and F.L and A.C corresponding to 38 weeks of gestation. Would the faetus be suffering from I.U.G.R? Q.2: What are the criteria of diagnosing IUGR? Q.3: Please provide a table of normal ratio of F.L and A.C at different gestational ages. What are the effects of abnormal ratios?
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-- Terry J. DuBose, M.S., RDMS, FSDMS, FAIUM Assistant Professor & Director, Diagnostic Medical Sonography Program University of Arkansas for Medical Sciences, CHRP 4301 West Markham St. Mail Slot #563 Little Rock, Arkansas, 72205 USA 501-686-6510 DuBoseTerryJ@UAMS.edu http://www.io.com/~dubose/ http://www.uams.edu/chrp/dms/default.asp http://www.obgyn.net/us/panel/panel.htm
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