Keywords
fetal growth retardation
hypoxia
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Abstract
Objective: To evaluate the pattern of fetal growth and validation of the fetal growth curve for the diagnosis of IUGR (intrauterine growth restriction). Methods: 120 pregnant women were studied, 55 with a diagnosis of IUGR and 65 with fetuses with a normal growth pattern. The diagnosis of IUGR was based on estimated fetal weight, fetal abdominal circumference, and Doppler of uterine, umbilical, and middle cerebral arteries. Results: 60.2% of patients with fetuses with adequate growth pattern (n=53) and 14.3% (n=13) with early IUGR and 25% (n=22) with late IUGR were identified. The average weight of newborns with early IUGR was 2038 + 843 g, for those with late IUGR it was 2408 + 416 g and for normal ones it was 3110 + 533 g (p<0.001). The curve performed in this service showed a sensitivity of 83% and specificity of 95% for the diagnosis of IUGR. Conclusions: Early IUGR determines lower birth weight, and the growth curve starts below the normal pattern. This curve can be an aid in the diagnosis of IUGR, especially in places where workup is restricted.
References
ACOG (AMERICAN COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS. Fetal Growth Restriction. ACOG Practice Bulletin, 2019; 204.
ALTMAN D, et al. Statistics with Confidence: Confidence Intervals and Statistical Guidelines. 2000; 254p.
AMORIM MAF. Indução de programação fetal pela desnutrição e pelo treinamento físico em ratos: estudo de parâmetros somáticos e bioquímicos em fêmeas e sua prole. 2010. Tese (Doutorado) - Universidade Federal de Pernambuco, Recife, 2010; 127p.
ANTONELLI JDS, et al. As consequências da restrição de crescimento intrauterino na estrutura e fluxo sanguíneo cerebral: uma revisão da literatura. Femina, 2018; 46(6): 352-59.
ASSIS GP, et al. Associação entre a altura uterina e o peso fetal nas gestantes de baixo risco. Revista Eletrônica Acervo Saúde, 2021; 13(6): e7848.
BERNACHI CF. O papel do doppler da artéria cerebral média nos fetos com crescimento restrito tardio. Femina, 2016; 44(4): 224-232.
CAMPOS CB e PALANCH AC. Nutrição materna e programação fetal: o papel dos hábitos alimentares no desenvolvimento embrionário e pós-natal. Saúde Rev., 2017; 17(45): 49-59.
CECCATI JC, et al. Curve of normal estimated fetal weight values by ultrasound according to gestation age. Cad. Saúde Pública, 2000; 16(4): 1083-90.
CLOPPER CJ e PEARSON ES. The Use of Confidence or Fiducial Limits Illustrated in the Case of the Binomial. Biometrika, 1934; 26(4): 404–13.
CROCKART IC, et al. Classification of intrauterine growth restriction at 34-38 weeks gestation with machine learning models. Inform Med Unlocked, 2021; 23: 100533.
DEEKS JJ e ALTMAN DG. Diagnostic tests 4: likelihood ratios. BMJ, 2004; 329(7458): 168-9.
DETER RL, et al. Third-trimester growth diversity in small fetuses classified as appropriate-for-gestational age or small-for-gestational age at birth. Ultrasound in Obstetrics and Gynecology, 2021; 58: 882–891.
FEBRASGO (FEDERAÇÃO BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA). Restrição de crescimento fetal. Protocolos Febrasgo, 2018; 35: 1-24.
FERNANDEZ-GONZALEZ S, et. al. Study of the fetal and maternal microbiota in pregnant women with intrauterine growth restriction and its relationship with inflammatory biomarkers: A case-control study protocol (SPIRIT compliant). Medicine (Baltimore). 2020; 13; 99(46): e22722.
FREITAS-SILVA LR, et al. A epigenética como nova hipótese etiológica no campo psiquiátrico contemporâneo. Physis Revista de Saúde Coletiva, 2014; 24(3): 765-86.
HE S, et al. Association between gestational weight gain and pregnancy outcomes in a Singaporean population: A prospective cohort study. Eur J Obstet Gynecol Reprod Biol., 2022; 272: 160-65.
LEES CC, et al. Clinical Opinion: The diagnosis and management of suspected fetal growth restriction: an evidence-based approach. Am J Obstet Gynecol., 2022; 226(3): 366-78.
MACEDO PC e NICOLAK DCK. Influência da hipertensão arterial crônica durante a gravidez no crescimento intrauterino restrito. Revista Científica Multidisciplinar Núcleo do Conhecimento, 2018; 8(12): 53-66.
MELLER TC e SANTOS LC. A Influência do Estado Nutricional da Gestante na Saúde do Recém-Nascido. R Bras Ci Saúde. 2009; 13(1): 33- 40.
MERCALDO ND, et al. Confidence Intervals for predictive values with an emphasis to case-control studies. Statistics in Medicine, 2007; 26(10): 2170-2183.
MOREIRA WB, et al. Leitura crítica de artigos científicos. Sociedade Brasileira de Oncologia Clínica. Disponível em: https://www.sboc.org.br/app/webroot/leitura-critica/LEITURA-CRITICA_EDITORIAL.pdf. Acessado em: 1 de fevereiro de 2023.
RAGONESI SMA, et. al. Crescimento intrauterino retardado: aspectos atuais. Rev. Assoc. Med. Bras., 1997; 43(2).
ROLNIK DL. ASPRE trial: performance of screening for preterm pre-eclampsia. Ultrasound in Obstetrics and Gynecology, 2017; 50(6): 807.
TELES LFS. Relação entre o ganho de peso gestacional e composição corporal do concepto. Universidade de São Paulo. Dissertação (Mestrado). Universidade de São Paulo, São Paulo, 2021; 294p.
PATTINO CM e FERREIRA JC. Entendendo os testes diagnósticos. Parte 1. J Bras Pneumol. 2017; 43(5): 330-330.
PATTINO CM e FERREIRA JC. Entendendo os testes diagnósticos. Parte 2. J Bras Pneumol. 2017; 43(6): 408-408.
PATTINO CM e FERREIRA JC. Entendendo os testes diagnósticos. Parte 3. J Bras Pneumol. 2018; 44(1): 4-4.
SIMUNDIC AM. Measures of Diagnostic Accuracy: Basic Definitions. EJIFCC, 2009; 20; 19(4): 203-11.
ZIMMERMMANN JB, et al. Gestação de alto risco: Do pré-natal ao puerpério. 2021; 880p.