Download International Fetal Growth Standards

PhenX Toolkit Supplemental Information
Domain: Pregnancy
Release Date: April 11, 2017
[International Fetal Growth Standards]
About the Measure
Domain
Pregnancy
Measure
International Fetal Growth Standards
Definition
This measure includes abstraction of fetal growth and ultrasound
information from a medical record.
About the Protocol
Description of
Protocol
Determination of fetal growth is a three-step process:
Step 1: Ascertainment of Estimated Fetal Weight (EFW)
Step 2: Verification of Gestational Age (GA) at which the EFW was
recorded
Step 3: Determination of EFW or biometry percentiles by plotting the
EFW or relevant biometric measures at the appropriate GA on a predefined fetal growth curve.
Protocol Text
1. Ascertainment of Estimated Fetal Weight (EFW)
The investigator is encouraged to utilize one of the following
approaches for documentation of EFW. Approach (a) is the preferred
approach for retrospective studies, although it is recognized that
biometric data may be less easily accessible in retrospective
investigations, and as such approach (b) is provided as an alternative.
(a) EFW (preferably in grams) derived by review of available
ultrasound reports to obtain relevant biometric measures (bi-parietal
diameter [BPD], head circumference [HC], abdominal circumference
[AC], and femur length [FL]), followed by calculation of EFW from
formula provided by Hadlock*.
Date of ultrasound: ____________________
(DD/MMM/YYYY)
Gestational Age: ________ weeks ________ days (as per
protocol for GA)
Biometric measures as they appear on the ultrasound report:
Bi-parietal diameter (BPD): __________ mm
Head circumference (HC): ___________ mm
Abdominal circumference (AC): ___________ mm
Femur length (FL): ___________ mm
Estimated Fetal Weight (EFW): ________________ grams
(b) EFW (preferably in grams) abstracted from ultrasound report
contained within the medical record:
PhenX Toolkit Supplemental Information
[International Fetal Growth Standards]
PhenX Toolkit Supplemental Information
Domain: Pregnancy
Release Date: April 11, 2017
[International Fetal Growth Standards]
Date of ultrasound: ____________________ (DD/MMM/YYYY)
Gestational Age: ________ weeks ________ days (as per
protocol for GA)
Estimated Fetal Weight: ________________ grams
2. Verification of Gestational Age (GA)
See the PhenX measure for Gestational Age – Medical Record
Abstraction. It is considered essential for interpretation of this
measure.
3. Plotting the EFW or Biometric Measures – International
standards
Determination of fetal growth should then be undertaken, by plotting
EFW or biometric measures on a growth curve, allowing for
determination of percentiles, by using the following protocol:
INTERGROWTH-21st – Fetal Growth Longitudinal Study (FGLS)
*An SR of 11 methods of EFW assessment did not identify a superior
formula; given that Hadlock (1985) is the most widely used formula, it may
provide the greatest degree of consistency across studies
Once biometric measures and gestational age have been
obtained using one of the approaches described, the investigator
should consult the EFW centiles in the INTERGROWTH-21st Fetal
Growth Standards Project.
Participant
Pregnant women
Rationale for
Inclusion in
Supplemental
Information
The INTERGROWTH 21st Project investigators conducted a
prospective population-based study in eight diverse locations to
develop international fetal growth standards that are endorsed by the
World Health Organization (WHO). The standards are based on the
pooled data from those eight populations and do not represent the
ethnic diversity of the U.S.
Source
Stirnemann, J., Villar, J., Salomon, L. J., Ohuma, E., Ruyan, P.,
Altman, D. G., Nosten, F., Craik, R., Munim, S., Cheikh Ismail, L.,
Barros, F. C., Lambert, A., Norris, S., Carvalho, M., Jaffer, Y. A.,
Noble, J. A., Bertino, E., Gravett, M. G., Purwar, M., Victora, C., Uauy,
R., Bhutta, Z., Kennedy, S., Papageorghiou, A. T. (2016).
International Estimated Fetal Weight Standards of the
INTERGROWTH-21st Project. Ultrasound Obstet Gynecol. doi:
10.1002/uog.17347
Hadlock FP, Harrist RB, Sharman RS, Deter RL, Park SK. (1985).
PhenX Toolkit Supplemental Information
[International Fetal Growth Standards]
PhenX Toolkit Supplemental Information
Domain: Pregnancy
Release Date: April 11, 2017
[International Fetal Growth Standards]
Estimation of fetal weight using head, body and femur measurements
- a prospective study. Am J Obstet Gynecol, 151:333-337.
Language of
Source
English
Personnel and
Training Required
Personnel who are trained in performing medical records review
Equipment Needs
None
Protocol Type
Medical Record Abstraction
General References
Anderson, N. H., et al. (2016). INTERGROWTH-21st vs customized
birthweight standards for identification of perinatal mortality and
morbidity. Am J Obstet Gynecol, 214(4): 509.e501-507.
Bricker L, Neilson JP, Dowswell T. (2008). Routine ultrasound in late
pregnancy (after 24 weeks’ gestation). Cochrane Database Syst Rev,
4: CD001451.
Conde-Agudelo A, Papageorghiou AT, Kennedy SH, Villar J. (2013).
Novel biomarkers for predicting intrauterine growth restriction: a
systematic review and meta-analysis. BJOG, 120:681–94.
Ioannou C, Talbot K, Ohuma E, et al. (2012). Systematic review of
methodology used in ultrasound studies aimed at creating charts of
fetal size. BJOG, 119:1425–39.
Malone FD, Canick JA, et al. (2005). First- and Second-Trimester
Evalution of Risk (FASTER) Research Consortium. First-trimester or
second-trimester screening, or both, for Down’s Syndrome. N Engl J
Med, 353(19):2001-11.
Sylvan K, Ryding EL, Rydhstroem H. (2005). Routine ultrasound
screening in the third trimester: a population-based study.
Acta Obstet Gynecol Scand, 84: 1154–58.
Process and
Review
The Expert Review Panel has not reviewed this measure yet.
PhenX Toolkit Supplemental Information
[International Fetal Growth Standards]