Screening and diagnosis of small for gestational age fetuses

Objective. - Define the mode of screening and diagnosis of fetal small for gestational age (SGA). Methods. - Bibliographic research by consulting Pubmed database and guidelines of the international professional societies. Keywords used: Intra uterine growth retardation or restriction, small for gestational age, curve, chart, fetal biometry, screening, velocity, fundal height measurement. Results. - The performance of ultrasound to detect SGA is low. The mode of screening and diagnosis of SGA must be well defined to be consensual. The fundal height measurement keeps its place in the screening from 22 SA (grade C). The criteria for measuring ultrasound parameters defined by the comite technique d'echographie are recommended (professional agreement). They allow the calculation of the estimated fetal weight (EFW). That must be transferred to the reference curve adopted (professional agreement). The introduction of audit on techniques for measuring ultrasound parameters should be encouraged (grade B). Conclusion. - Fetal biometry must be interpreted according to the clinical context and ultrasound including Doppler (grade C). To improve the performance of ultrasound, there is no need to another ultrasound examination in late pregnancy (grade A) except after a clinical suspicion (grade C). The minimum interval between two biometric tests is 3 weeks (grade B). This interval may be lower if the EFW is important in the decision of any fetal extraction (professional consensus). (C) 2013 Elsevier Masson SAS. All rights reserved.