detecting
SGA, but this approach is not
mentioned by ACOG.3
Because of the shortcomings of detecting
IUGR from clinical examination,
both ACOG and RCOG recommend
biometric measurements of the fetus and
EFW. Both guidelines agree that if the
abdominal circumference or EFW is less
than 10% for GA, abnormal growth
should be suspected. For detection of abnormal
growth, RCOG3 is specific about
which regression equations should be
utilized to derive the EFW, whereas
ACOG is not.8
Interestingly, ACOG considers amniotic
fluid (AF) an “important and prognostic
parameter in fetuses with IUGR,”
whereas RCOG notes that assessment of
AF has “minimal value in diagnosing”
inadequate growth. Both guidelines do
agree that umbilical artery Doppler is
not a reliable screening technique for
IUGR.3,8