title: Uncomplicated Pregnancies and Ultrasounds for Fetal Growth Restriction: A Pilot Randomized Clinical Trial.
abstract: Objective The purpose of this multicenter pilot study was to determine the feasibility of randomizing uncomplicated pregnancies (UPs) to have third trimester ultrasonographic exams (USE) versus routine prenatal care (RPNC) to improve the detection of small for gestational age (SGA; birth weight < 10% for GA). Material and Methods At three referral centers, 50 UPs were randomized after gestational diabetes was ruled out. Women needed to screen, consenting, and loss to follow-up was ascertained, as was the detection rate of SGA in the two groups. Results During the study period at the three centers, there were 7,680 births, of which 64% were uncomplicated. Of the 234 women approached for randomization, 36% declined. We recruited 149 women and had follow-up delivery data on 97%. The antenatal detection rate of SGA in the intervention group was 67% (95% confidence intervals 31-91%) and 9% (0.5-43%) in control. Conclusion The pilot study provides feasibility data for a multicenter randomized clinical trial to determine if third trimester USE, compared with RPNC, improves the detection of SGA and composite neonatal morbidity.
authors.affiliation: Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia.
authors.forename: Ibrahim A
authors.initials: IA
authors.lastname: Hammad
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, UT Health Science Center, Houston, Texas.
authors.forename: Suneet P
authors.initials: SP
authors.lastname: Chauhan
authors.affiliation: Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia.
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Mlynarczyk
authors.affiliation: Department of Obstetrics and Gynecology, University of Arkansas for the Medical Sciences, Little Rock, Arkansas.
authors.forename: Nader
authors.initials: N
authors.lastname: Rabie
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Chris
authors.initials: C
authors.lastname: Goodie
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Eugene
authors.initials: E
authors.lastname: Chang
authors.affiliation: Department of Obstetrics and Gynecology, University of Arkansas for the Medical Sciences, Little Rock, Arkansas.
authors.forename: Everett F
authors.initials: EF
authors.lastname: Magann
authors.affiliation: Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia.
authors.forename: Alfred Z
authors.initials: AZ
authors.lastname: Abuhamad
keywords: pilot study; screening; small for gestational age; third trimester ultrasound