title: The utility of ultrasound in late pregnancy compared with clinical evaluation in detecting small and large for gestational age fetuses in low-risk pregnancies.
abstract: OBJECTIVE
  To determine the utility of ultrasound (US) in late pregnancy for identifying fetuses with growth disturbances.
  
  
  METHODS
  This study was designed as a retrospective study of birth weights over a 12-month period at the Royal Hobart Hospital (RHH) and Barwon Health (BH). Data were collected from the discharge summaries and medical records at both hospitals targeting abnormal fetal weight below 10th percentile (small for gestational age - SGA) and above 90th percentile (large for gestational age - LGA).
  
  
  RESULTS
  There were 4079 study patients from both hospitals. After weight adjustment by gender and gestational age, an abnormal fetal weight was detected in 741 cases (babies over the 90th percentile or below 10th percentile). One hundred and twenty-eight patients with high-risk pregnancies were excluded. Therefore, a total of 613 patients remained that were considered to be low-risk pregnancies with abnormal foetal growth; 305 patients from RHH and 308 from BH. The antenatal detection rate for LGA was 35.9%, at RHH by combination of US and clinical evaluation, while for BH it was 34.8% by clinical evaluation alone (p = 0.910). The antenatal detection rate for SGA was 36.8% via US and clinical evaluation at RHH and 54.5% by clinical evaluation alone at BH (p = 0.006).
  
  
  CONCLUSIONS
  This study shows no benefit in the use of routine US for the antenatal diagnosis of LGA compared with clinical evaluation in low-risk pregnancies. US evaluation was inferior to clinical evaluation in the antenatal diagnosis of SGA in low-risk pregnancies.
authors.affiliation: a Department of Perinatal Medicine , Royal Women's Hospital , Melbourne , Victoria , Australia .
authors.forename: Ahmed
authors.initials: A
authors.lastname: Al-Amin
authors.forename: Tania
authors.initials: T
authors.lastname: Hingston
authors.forename: Peter
authors.initials: P
authors.lastname: Mayall
authors.forename: Edward
authors.initials: E
authors.lastname: Araujo Júnior
authors.forename: Costa
authors.initials: C
authors.lastname: Fabrício Da Silva
authors.forename: Deborah
authors.initials: D
authors.lastname: Friedman
mesh_terms: D003955:Diagnostic Tests, Routine; D005260:Female; D005320:Fetal Macrosomia / Q000175:diagnosis / Q000000981:diagnostic imaging*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D011237:Predictive Value of Tests; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D012189:Retrospective Studies; D012307:Risk Factors; D016216:Ultrasonography, Prenatal / Q000379:methods
keywords: Clinical evaluation; large for gestational age; low-risk pregnancy; small for gestational age; ultrasound