20th World Congress on Ultrasound in Obstetrics and Gynecology
vs 11% in NA), in neonatal weight (1800gr in A vs 2500gr in
NA) and in IUGR/SGA (83% of IUGR/ 54% of SGA were A vs.
17% of IUGR/46% of SGA were NA). These differences were not
observed in maternal age, maternal parity, alterations of uterine
arteries Doppler, amniotic fluid, induction of delivery, gestational
age at diagnostic, neonatal gender, umbilical artery pH at birth or
Apgar score at 1 and 5 minutes. Important neonatal complications
were observed all in those newborn admitted to neonatal unit (16
respiratory distress syndromes, 9 pathological cerebral scans, 7 hya-
line membrane diseases, 7 mechanical ventilation, 5 inotropic drugs,
3 sepsis, 3 renal insufficiencies, 1 cerebral hemorrhage, 1 neonatal
death and 1 enterocolitis).
Conclusions: As our study corroborates, obstetrical complications
(hypertension, Doppler alterations, non-reassuring fetal heart rate
status during labor, Caesarean section, prematurity) in foetuses with
an EFW below 10th percentile are predictors of lower fetal weight, of
admission to neonatal unit at birth and of neonatal complications.
OP01.08
Neonatal outcome in intrauterine growth restricted and small
for gestational age fetuses
S. Visentin1 , F. Cavallin2,1 , V. Zanardo1 , E. Cosmi2
1
Obstetrics and Gynecology, University of Padua, Padua,
Italy; 2 Pediatrics, University of Padua, Padua, Italy
Objectives: To assess the neonatal outcome in intrauterine growth
restricted (IUGR) compared to small for gestational age (SGA)
fetuses.
Methods: A prospective study from January 2008 and March 2010
was performed in 24 IUGR, 47 SGA and 102 AGA fetuses. IUGR
were defined as fetuses with estimated fetal weight (EFW) < 10th
percentile with abnormal Doppler velocimetry and SGA fetuses with
EFW < 10th percentile and normal Doppler. IUGR fetuses were
followed by Doppler velocimetry of arterial and venous compart-
ment twice weekly and SGA once weekly. Biometry measurements
were performed fortnightly. Delivery in IUGR fetuses was based on
Doppler findings (late Doppler abnormalities) or on CTG abnor-
malities (at least 6 variable deceleration or 4 consecutive late
deceleration). SGA fetuses were delivered at term. Perinatal outcome,
pH and base excess at birth were available.
Results: Median gestational age at delivery and birth weight were
statistical different in IUGR respect to SGA and AGA, 34 weeks
(range 27–36), 1990 gr (range 1482–2273); 38 weeks (range 31–41),
2688 gr (range 2468–2853); 39 weeks (range 32–41), 3373 gr (range
2968–3698) (P < 0.0001), respectively. Perinatal outcome was sig-
nificantly different in IUGR fetuses compared to SGA and AGA
(P < 0.05). Mode of delivery of 20 IUGR fetuses was Cesarean
section for Doppler velocimetry abnormalities (10 with absent end
diastolic flow of umbilical artery) and 2 with ductus venosus absent
A-wave. In SGA and AGA there were twenty-four vaginal delivery
(54.5%,) and twenty Cesarean section (45.5%), 60% for previous
Cesarean section or breach presentation, 20% for CTG abnormali-
ties, and 20% for other indications.
Conclusions: IUGR fetuses show a significant difference in adverse
perinatal outcome respect SGA and AGA fetuses, while SGA and
AGA fetuses does not differ in term of mode of delivery, gestational
age at delivery and perinatal outcome.
OP01.09
Perinatal outcomes in gestations with intrauterine growth
restriction and small for gestational age foetuses, admitted to
neonatal unit
M. Gómez Roig1 , E. Mazarico1 , J. Sabrià1 , A. Martı́n Ancel2 ,
A. Vela1 , J. Lailla1
1
Obstetrics and Gynecology, Maternal-Fetal Medicine, Sant
Joan de Déu University Hospital, Barcelona, Spain;
2
Neonatology, Sant Joan de Déu University Hospital,
Barcelona, Spain
54
Short oral presentation abstracts
Objectives: To compare perinatal outcomes between those gestations
with intrauterine growth restriction or with small for gestational age
foetuses.
Methods: We included all foetuses with an estimated fetal weight
(EFW) below 10th percentile which needed to be admitted to
neonatal unit from January 2008 to December 2009 (87 foetuses).
71 of these 87 gestations were complicated with intrauterine
growth restricted (IUGR, EFW < 3rd percentile or < 10th percentile
with Doppler alterations) and 16 with small for gestational
age (SGA, EFW < 10th percentile but > 3rd percentile without
Doppler alterations). We followed up the immediate postnatal
complications.
Results: Almost significant differences (p:0.06) were found in
gestations complicated with hypertension (23% IUGR vs. 2%
SGA). We observed significant differences (p:0.04) in prenatal non-
reassuring fetal heart rate status (32% IUGR vs. 2% SGA) and
in Caesarean section rate (P < 0.05) (57% IUGR vs. 10% SGA).
We didn’t find significant differences referring to gestational age
at diagnostic (33 weeks for IUGR and SGA), to gestational age at
birth (35 weeks for IUGR and SGA), birth weight, Apgar score or
umbilical artery pH. In IUGR group the first cause of admission was
low weight (35% IUGR vs. 6% SGA), and the second prematurity
(27% IUGR vs. 6% SGA). Neonatal complications were observed
in some newborn admitted to neonatal unit: 16 respiratory distress
syndromes (12 IUGR vs. 4 SGA), 9 pathological cerebral scans (7
IUGR vs. 2 SGA), 7 hyaline membrane (4 IUGR vs. 3 SGA), 7
mechanical ventilation (4 IUGR vs. 3 SGA), 5 inotropic drugs (3
IUGR vs. 2 SGA), 3 sepsis (2 IUGR vs. 1 SGA), 3 renal insufficiency (3
IUGR), 1 cerebral hemorrhage (IUGR), 1 neonatal death (IUGR) and
1 enterocolitis (IUGR). We found significant differences (P < 0.05)
in these complications (72% IUGR vs. 28% SGA).
Conclusions: IUGR foetuses have more probability of admission to
neonatal unit, as well as obstetrical (hypertension, non-reassuring
foetal heart rate status, Caesarean section) and neonatal complica-
tions.
OP01.10
Intrauterine growth restriction (IUGR), small for gestational
age (SGA) and postnatal growth at twelve and twenty four
months of life
L. Garcı́a De Miguel1 , N. Rodriguez1 , G. Sebastiani2 ,
M. Dı́az2 , L. Ibáñez2 , M. Gómez Roig1
1
Obstetrics, Hospital Sant Joan de Déu, Barcelona, Spain;
2
Endocrinology, Hospital Sant Joan de Déu, Barcelona, Spain
Objectives: Study the influence of the prenatal growth and/or the
Doppler affection on postnatal anthropometric changes at ten days,
months fourth, twelfth and twenty-fourth.
Methods: Data for 285 gestations, of which 72 were IUGR, 46
SGA and 167 appropriate for gestational age (AGA) was collected
in our hospital. Prenatal assessment of the foetuses was carried
out through ultrasound scan check to determine the estimated foetal
weight (ESW) and a Doppler study. On the other hand, the postnatal
study evaluated several anthropometric parameters: weigh, length,
body mass index (BMI) and ponderal index (PI) up to twenty-four
months after birth.
Results: Comparison between IURG and SGA foetuses shows no
significant differences in their anthropometric variables at ten days,
four months, twelve or twenty four months of life. While significant
differences in all anthropometric variables, including evolution of
body mass over time, were observed between the < 10 percentile
weight at birth group and AGA subset at twelve months of age
(P 0.02). Interestingly, the greatest increase in BMI was observed in
the < 10 percentile weight. A pathologic uterine arteries or foetal
Doppler study shows no influence in the anthropometric variables
neither in their evolution at twelve and twenty-four months.
Conclusions: The foetuses with lesser prenatal growth (< 10
percentile) show greater postnatal retake of weigh and length, as the
BMI shows than AGA at twelve months postpartum. On the other
Ultrasound in Obstetrics & Gynecology 2010; 36 (Suppl. 1): 52–167