title: Assessment of fetal growth using the ratio of the transverse cerebellar diameter to abdominal circumference.
abstract: OBJECTIVE
  To evaluate use of the transverse cerebellar diameter to abdominal circumference (TCD/AC) ratio in predicting intrauterine growth restriction (IUGR).
  
  
  METHODS
  A prospective observational study was conducted at a prenatal clinic in Udaipur, India, between August 2011 and December 2012. Women with a singleton pregnancy and a confirmed gestational age of 20-36 weeks were enrolled. Transverse cerebellar diameter and abdominal circumference were measured by ultrasonography on two prenatal visits at early (20-28 weeks) and late (30-36 weeks) gestation. A TCD/AC ratio above the 90th percentile was considered to indicate IUGR. Birth weight was recorded.
  
  
  RESULTS
  Overall, 100 women completed the study. Among 15 neonates with IUGR, the mean TCD/AC ratio was 14.17 ± 0.89 at early gestation and 15.61 ± 1.18 at late gestation. The TCD/AC ratio for appropriate-for-gestational-age neonates was significantly lower: 13.50 ± 0.97 and 13.80 ± 0.97 at early and late gestation, respectively (P<0.05 for both). Among 14 fetuses with a TCD/AC ratio above the 90th percentile at early gestation, 9 (64%) were small for gestational age, 5 (36%) were appropriate for gestational age, and none was large for gestational age at the neonatal examination.
  
  
  CONCLUSIONS
  The TCD/AC ratio was fairly accurate in recognizing abnormal fetal growth at an early gestational age.
authors.affiliation: Department of Obstetrics and Gynaecology, SMS Medical College, Jaipur, India. Electronic address: drcharusmita@gmail.com.
authors.forename: Charusmita
authors.initials: C
authors.lastname: Agrawal
authors.affiliation: Department of Pediatrics, SMS Medical College, Jaipur, India.
authors.forename: Kamlesh K
authors.initials: KK
authors.lastname: Agrawal
authors.affiliation: Department of Obstetrics and Gynaecology, RNT Medical College, Udaipur, India.
authors.forename: Sudha
authors.initials: S
authors.lastname: Gandhi
mesh_terms: D000328:Adult; D000886:Anthropometry / Q000379:methods*; D005260:Female; D047109:Fetal Development; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging*; D005333:Fetus / Q000000981:diagnostic imaging; D005865:Gestational Age; D006784:Hospitals, Teaching; D006801:Humans; D007194:India; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D062606:Tertiary Care Centers; D016216:Ultrasonography, Prenatal; D055815:Young Adult
keywords: Abdominal circumference; Gestational age; Intrauterine growth restriction; Large for gestational age; Transverse cerebellar diameter