Early screening for IUGR: comparison of two related echographic markers.
BACKGROUND
Can ultrasonography be performed in pregnant women as a screening test to predict IUGR? To justify its use, it must have a high enough positive predictive value.


METHODS
This study addresses the concept of early prediction of IUGR using echographic measurements in the first trimester. We studied one traditional and one new marker, the crown-rump length (CRL) and the cerebro-corporal coefficient (CCC). We retrospectively reviewed the charts of 139 pregnancies that gave birth to babies with IUGR and 25 charts of normal pregnancies that made the control group. Screening in the first trimester of pregnancy was done in 125 (89.9%) pregnant women between 10 and 14 weeks. We calculated the diagnostic and predictive values of these two parameters in IUGR.


RESULTS
The sensitivity and specificity for reduced CRL were 29 and 100%, respectively, and for the CCC>0.6, 46 and 100%, respectively. Using IUGR prevalence (10%) and the Bayes equation we calculated the positive predictive value of reduced CRL and >0.6 CCC in general, moderate and severe IUGR and severe IUGR alone. They were 1, 1, 9%, 13, 19 and 29%, respectively.


CONCLUSIONS
The positive predictive value of the crown-rump length and the cerebro-corporal coefficient for IUGR in the general population increases with the severity of the disease. Using these two parameters, however, would be more useful in high-risk pregnancies.
Walid
Mohammad Sami
MS
Department of Obstetrics and Gynecology, Kuban State Medical University, Ulitsa Sedina 4, 350063 Krasnodar, Russia. mswalid@yahoo.com
Pomortsev
Alexei Victorovich
AV