EP08.05: Evaluating an algorithm to enable a consistent approach to manage fetal growth

Current proposals to manage fetal growth restriction do not achieve intended aims of preventing many stillbirths and result in unnecessary interventions with associated harm. The aim is to evaluate an algorithm enabling a consistent approach for health professionals to manage fetal growth parameters >34 weeks. A retrospective cohort in a UK tertiary maternity unit (March-August 2019). Inclusion criteria: singleton pregnancies, morphologically normal fetuses >34 weeks. The input to the tool was estimated fetal weight (EFW) centile, and cerebroplacental ratio (CPR) which was converted into multiples of the median (MoM). CPR MoM<5th centile (0.67) was used as a threshold for failing to reach growth potential and termed, ‘non-reassuring’ (NRCPR) as opposed to ‘reassuring’ (RCPR). A decision algorithm was then applied to quantify the groups into high/moderate/low risk and provide a time for repeat scan or delivery. 959 ultrasounds were analysed. Mean EFW centile was greater in the RCPR (n = 893) compared with the NRCPR (n = 66) group (61.8 ± 26.6 vs 51.6 ± 31.0, p < 0.01) as was birthweight (3358.6 ± 16.8 vs 2998.9 ± 64.0, p < 0.01). The mean gestation at birth was greater in the RCPR group (39.6 ± 1.4 vs 38.7 ± 1.5). In babies with a RCPR compared with those with a NRCPR, birthweight centile was overestimated (see table 1). There was no difference in the number of babies with a pH below 7.2 at birth (25.9% RCPR; 36.7% NRCPR, p = 0.32). There was one stillbirth in the RCPR group (0.1%) (placental abruption at 37 weeks). There is a need to follow clearer protocols to improve outcomes. The proposed tool appears to provide a consistent safe approach for health professionals. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.