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PFM.64 Audit of Small for Gestational Age - Diagnosis and Clinical Outcomes
  1. CR Munyame1,
  2. S Salim2,
  3. S Kennedy2,
  4. L Vinayakarao2,
  5. P Eedarapalli1
  1. 1Royal Bournemouth and Christchurch Hospitals, Bournemouth, UK
  2. 2Poole General Hospital, Poole, UK

Abstract

Background Small for Gestational Age (SGA) is defined as babies with birth weights less than 10th centile. 50–70% of these are constitutionally small; the rest are due to intrauterine growth restriction (IUGR). West Midland’s evidence shows that customised growth charts combining symphysial height (SFH) measurements and ultrasound derived Estimated Fetal weight (EFW) can differentiate between constitutionally small and IUGR babies.

Aims

  1. Investigate and survey babies antenatally and perinatal outcomes.

  2. Assess the effectiveness of customised growth charts in selected cohorts for SGA.

  3. Ascertain the resource implications in terms of clinical workload and costs of implementing risk-based screening and customised growth charts locally.

Methods A retrospective analysis involving 82 SGA babies was conducted in Poole General Hospital between February and December 2013. One third of this cohort used GROW charts. Scan derived EFW was retrospectively plotted on customised growth charts to detect SGA.

Results Where GROW charts were used, 88% had serial measurement SFH, of which 35% were plotted resulting in 29% of the cohort being referred to have an ultrasound scan. Of those sent for scan, 63% correctly identified SGA (this corresponds to 16% of the total cohort).

Where GROW charts were not used, 62% had serial SFH measurements of which 18% were referred for an ultrasound. 80% of those sent for a scan identified SGA correctly (this corresponds to 9% of the total cohort).

Conclusions GROW charts helps to detect the majority of SGA antenatally. In the long term there is potential to improve the perinatal outcomes.

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