Fetal Growth

Fetal growth restriction is associated with stillbirth, neonatal death and perinatal morbidity. Confidential enquiries have demonstrated that most stillbirths due to fetal growth restriction are associated with suboptimal care and are potentially avoidable.

A recent epidemiological analysis based on the comprehensive West Midlands database has underlined the impact that fetal growth restriction has on stillbirth rates, and the significant reduction which can be achieved through antenatal detection of pregnancies at risk.

Customised charts

The Perinatal Institute administers the Gestation Network www.gestation.net which provides tools for assessment of fetal growth and birthweight by defining each pregnancy’s growth potential through the Gestation Related Optimal Weight (GROW) software, including

GROW-Chart: customised antenatal charts for plotting fundal height and estimated fetal weight.

GROW-Centile: for calculation of customised birthweight centiles for each pregnancy, or a database of pregnancies (bulk centile calculator).

GROW-Service: GROW chart, centile and reporting via an API with Maternity Information systems.

GROW-Documentation: describes the GROW technique.

Customised assessment of birthweight and fetal growth has been recommended by the RCOG since 2002 and their use has been re-emphasised in the recently published 2013 revision of the Green Top Guidelines.

NHS England has published new guidance that aims to reduce stillbirths in England; the ‘Saving Babies’ Lives Care Bundle‘. The bundle includes an element on risk assessment and surveillance for fetal growth restriction.

The Perinatal Institute provides the customised growth chart software in a web based application or via APIs. Audits in the West Midlands have shown that antenatal detection of fetal growth restriction is directly related to the degree of training and implementation of standardised protocols. Therefore from 2013, continued provision of the software will include a requirement that staff are trained, and that the use of the charts is audited, through the Perinatal Institute's new Growth Assessment Protocol (GAP). For further details about GAP UK, please click here.

There are also similar projects planned or underway in other countries, including the Netherlands, New Zealand, Australia and India.

Gestation Network
Gestation Network Fundal Height Examples Growth Assessment Protocol (GAP)