The purpose of this review article was
to ascertain the similarities and differences,
if any, in national guidelines on a
specific topic. Because ACOG characterizes
intrauterine growth restriction
(IUGR) as “one of the most common
and complex problems in modern obstetrics,”
3 we chose this topic to compare
guidelines from other countries. The review
started with accessing the ACOG,
RCOG, SOGC and RANZCOG web
sites4-7 and determining whether they
have any publications on IUGR. As of
March 2008, neither SOGC nor RANZCOG
had published national guidelines
on this topic. Thus, this review focused
on ACOG and RCOG guidelines
on IUGR,3,8 which were published in
2000 and 2002, respectively.
Terminology and definition
ACOG notes that the terms IUGR and
small for gestational age (SGA) have
been used interchangeably, creating confusion
on the topic. SGA, according to
American guidelines, is a newborn with
an actual birthweight below 10th percentile
for gestational age (GA), whereas
IUGR is estimated fetal weight (EFW)
below this threshold.3 RCOG does not
differentiate between IUGR and SGA.8
Regardless of what the national
guidelines call suboptimal growth,
both acknowledge that there are multiple
definitions. Estimated or actual
weight below the third or fifth percentiles,
for example, are 2 common criteria
that both guidelines acknowledge.
Despite the various criteria, ACOG and
RCOG consider the abnormal condition
to be estimated or actual weight
below 10%. For RCOG, abdominal cir-