Early identification of fetal growth restriction using ultrasound biometrics and biochemical markers: a comprehensive diagnostic approach.

OBJECTIVE

To evaluate whether ultrasound biometrics improve the identification and early treatment of fetal growth restriction (FGR).

METHODS

This retrospective study analyzed 240 pregnant women admitted to a Ji'nan Maternity and Child Care Hospital over a five-year period starting from January 2021. The study population comprised 120 women with fetal growth restriction (FGR group) and 120 women with normal pregnancies (Control group). The diagnosis of FGR was based on ultrasound measurements, with estimated fetal weight (EFW) and abdominal circumference (AC) both below the 10th percentile. Clinical data on, including maternal risk factors, ultrasound scans, and fetal data (e.g., weight, health status, ultrasound measurements such as weight estimates, skull size, bone development, and head size), were analyzed.

RESULTS

The FGR group exhibited significantly lower EFW (P < 0.001), smaller AC (P < 0.001), shorter femur length (FL) (P < 0.001), and smaller biparietal diameter (BPD) (P < 0.001) compared to the control group. The head circumference to abdominal circumference ratio (HC/AC) was significantly higher in the FGR group (P < 0.001), reflecting abnormal growth patterns. Doppler ultrasound revealed significantly lower velocities and higher resistance indices in both the middle cerebral artery (MCA) and umbilical artery (UA) in the FGR group (P < 0.001). Additionally, biochemical markers such as beta-hCG were significantly higher (P < 0.001), while AFP and PAPP-A were significantly lower in the FGR group (P < 0.001). These findings highlight the importance of using ultrasound and specific biomarkers for effective detection of FGR.

CONCLUSION

Early identification of fetal growth restriction (FGR) using a combination of ultrasound biometric indicators, Doppler blood flow measurements, and biochemical markers significantly enhances diagnostic accuracy, facilitates timely interventions, and enhances both maternal and fetal outcomes.