الفهرس 
Fetal Growth and WeightOnly 14 pages are availabe for public view
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Abstract
Background: Intrauterine growth restriction represents pathological inhibition of fetal growth and failure of the fetus to attain its growth potential. There is a strong association between stillbirth and fetal growth restriction. A newborn infant is classified as growth restricted or small for gestational age, if his birth weight falls below the 10 percentile for his particular gestational age. Objective: The aim of the work is to evaluate the femur length / mid thigh circumference ratio in intrauterine growth restricted fetuses in comparison to small for gestational age but healthy fetuses. Subject and Methods: An observational case-control study was conducted at the department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, during the period from (June 2015 to May 2016), included 89 women pregnant ladies in third trimester with singleton pregnancy aged between 20 and 40 years old. They were diagnosed as having small for gestational age fetus and followed up for two weeks to differentiate their pregnancy into healthy small for gestational age fetus or intrauterine growth restricted fetus. They did not have medical disorders, the fetus did not have any congenital anomalies and is viable. Result: All women were either primigravida (45.5% vs. 11.8%) or multigravida (54.5% vs. 88.2%) with highly significant difference between both groups with more incidence of primigravida in SGA group than in IUGR group (P <0.001). But, there was no statistically significant difference between both groups regarding maternal age (29+/-4 vs. 31+/-5) (P> 0.05). Also there was statistically significant difference between both groups regarding gestational age being more in SGA group (34+/-1 week vs. 33+/-2 weeks) (P < 0.05). There was no statistically significant difference between both groups regarding BMI, blood pressure, history of CS or history of abortion (P>0.05). In IUGR group AFI was decreased (3.5 +/-1.4 vs. 8.4+/-4) with sensitivity 97.1% and specificity 89.1% and umbilical artery Doppler ultrasound (RI) significantly increased (0.8+/-0.08 vs. 0.61+/- 0.05) and when compared with the SGA this showed statistically highly significant difference (P<0.001) with sensitivity 87.1% and specificity 92.7%. In SGA group the BPD, HC was bigger (78.6mm+/-5.9mm vs. 74.7mm+/-8.9mm), (291.2mm+/-16.4 vs. 276.8mm+/-30mm) respectively, which indicate statistically significant difference between both groups (P<0.05). The FL also was longer in SGA group (60.2mm+/-4.7mm vs. 56mm+/-6.7mm) which indicate statistically significant difference between both groups (P<0.01). There was no statistically significant difference between both groups regarding FL/MCT ratio (P >0.05). Conclusion: Femur length / mid thigh circumference ratio cannot differentiate between small for gestational age but healthy fetuses and intrauterine growth restricted fetuses, but amniotic fluid index in case of intact membranes and umbilical artery resistance index can be used to differentiate between both groups.