A survey of policies for the monitoring of fetal growth in Australian and New Zealand hospitals

Aust N Z J Obstet Gynaecol. 2011 Dec;51(6):493-8. doi: 10.1111/j.1479-828X.2011.01354.x. Epub 2011 Sep 23.

Abstract

Background: Fetal growth restriction is associated with increased perinatal mortality and morbidity and adverse developmental outcome. However, evidence is lacking on optimal approaches to antenatal screening of fetal size and growth.

Aims: To determine the current policies and practices for assessment of fetal size and monitoring fetal growth with a view to informing future research in this area.

Methods: Web-based survey of Directors of Obstetrics and Gynaecology in maternity hospitals with over 1000 births per annum in Australia and New Zealand (ANZ). The survey focussed on the existence and details of guidelines for the clinical assessment of fetal size and growth in low- and high-risk pregnancies, techniques utilised for clinical assessment of fetal size and growth and the use of birthweight charts.

Results: Completed surveys were received from 49 (66%) of the 74 hospitals surveyed. Forty-four percent of hospitals have a fetal growth screening guideline, with abdominal palpation and symphysis fundal height (SFH) measurement the most common screening tools. Seventy-nine percent indicated that obstetric or birthweight charts were in use; 39% were unsure which chart/s were in use, and use differed by region. There was reasonable agreement regarding decision to take action following discrepancies between gestational age and SFH. Sixty-five percent of participants are interested in participating in a randomised controlled trial in this area.

Conclusions: The survey revealed that while there is some agreement with respect to methods used in the clinical assessment of fetal size and growth, there is interest in ANZ hospitals to pursue this area of research further.

MeSH terms

  • Australia
  • Birth Weight
  • Female
  • Fetal Development*
  • Fetal Growth Retardation / diagnosis*
  • Fetal Growth Retardation / diagnostic imaging
  • Fetal Monitoring / methods
  • Fetal Monitoring / standards*
  • Growth Charts
  • Health Care Surveys
  • Hospitals, Maternity / standards*
  • Humans
  • Mass Screening / standards
  • New Zealand
  • Organizational Policy*
  • Practice Guidelines as Topic
  • Pregnancy
  • Pregnancy, High-Risk
  • Ultrasonography, Prenatal