Document Type

Conference Paper

Department

Obstetrics and Gynaecology (East Africa)

Abstract

Objectives: To compare the proportion of small-for-gestational-age and fetal growth-restricted fetuses detected in women offered a routine growth ultrasound to those either offered selective or no ultrasound in the third trimester.

Methods: An open-label randomised control trial was conducted at the Aga Khan University Hospital, Nairobi. Eligible women were randomised into either the intervention or control group. Women in the intervention arm had a mandatory third trimester ultrasound for fetal growth performed between 36 weeks 0 days to 37 weeks 6 days. Those in the control group had a selective growth scan done if the clinician suspected abnormal fetal growth. The women were then followed up for delivery outcomes. Analysis was on an intention to treat basis.

Results: A total of 278 women were recruited into the study with an overall completion rate of 88%. A majority of the women (67.8%) were primiparous. The overall detection rate of small-for-gestational-age and fetal growth-restricted fetus in the intervention groups was 10.9% (95%CI 4.9-16.9) with numbers needed to treat (NNT) of 9. The detection rate for fetal growth restriction was 3.6 (95%CI -0.28-7.5) and for small for gestational age was 4.5 (95% CI 0.29-8.8). The perinatal outcomes were similar between the two study groups.

Conclusions: Compared to selective third-trimester ultrasound, rou-tine growth ultrasound for all low-risk women increased the detection rate of small-for-gestational-age and growth-restricted fetuses.

Publication

Ultrasound in Obstetrics & Gynecology

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