WHO Fetal Growth Charts

Study Overview
=================
Brief Summary
-----------------
Perinatal mortality and morbidity continue to be major global health challenges strongly associated with prematurity and reduced fetal growth, an issue of further interest given the mounting evidence that fetal growth in general is linked to degrees of risk of common noncommunicable diseases in adulthood. Ultrasound estimation of fetal weight before birth is today very widely used in clinical practice, and, while essential for the identification and management of high-risk pregnancies,the current reference ranges used worldwide are largely based on single populations from a few high-income countries and are therefore of uncertain general applicability.

Detailed Description
-----------------
Against this background, WHO made it a high priority to provide fetal growth charts for estimated fetal weight and common ultrasound biometric measurements intended for worldwide use. WHO study was conducted in 10 countries including Egypt (Assiut).The study showed that fetal growth differs significantly between countries. Growth was to a small extent influenced by maternal age, height, weight, and parity, and by fetal sex. The study suggested that these WHO charts for growth are more suitable for international use than those commonly applied today. However, the differences between countries, with maternal factors, and with fetal sex mean that these growth charts may need to be adjusted for local clinical use to increase their diagnostic and predictive performance. In our setting, we are using the charts built in the ultrasound machines based on studies done in western countries. So, it is prudent now to implement the WHO fetal growth charts in our setting

Official Title
-----------------
Implementation of WHO Fetal Growth Charts in Assiut,Egypt

Conditions
-----------------
Fetal Growth Complications

Intervention / Treatment
-----------------
* Device: ultrasound


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: They have body-mass index between 18-30; They have a singleton pregnancy; Their gestational age at entry is between 8+0 to 12+6 weeks based on last menstrual period. They have no history of health, environmental or economic constraints likely to impede fetal growth; need for long-term medication (including fertility treatment); smoking currently or in the previous 6 months; recurrent miscarriage; and any previous baby delivered pre-term (<37 weeks) or with a birth weight <2,500g b. Exclusion criteria: Multiple pregnancy Congenital fetal malformation (cardiac, cerebral, renal malformations, etc.)

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
-----------------
Female

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| normal group<br>fetuses with normal growth | Device: ultrasound<br>* The compulsory ultrasound measurements to be obtained at all visits include the following biometrical parameters: Biparietal diameter Head circumference Abdominal circumference Femur length Humerus length<br>|
| Growth retardation group<br>fetuses with retarded growth | Device: ultrasound<br>* The compulsory ultrasound measurements to be obtained at all visits include the following biometrical parameters: Biparietal diameter Head circumference Abdominal circumference Femur length Humerus length<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion of fetuses with abnormal fetal growth diagnosed using WHO fetal charts | correlation of fetal growth pattern with neonatal birth weight and outcome | 8 months |