Fetal Growth Examples

The following examples illustrate some of the main concepts in the use of customised charts.

For further information, please see our GAP Guidance, attend one of our workshops, listed on the diary page or contact us

Abbreviations:
SGA – small for gestational age ​
FGR – fetal growth restriction
​SFH – standardised fundal height (measured from fundus to symphysis)​
EFW – estimated fetal weight, by ultrasound ​
GROW – gestation related optimal weight (customised charts) ​
GAP – growth assessment protocol

Normal Growth

Flexible Image

The chart above demonstrates normal growth by serial standardised fundal height (SFH) measurements.

More information can be obtained by clicking on the relevant plot which will in turn open the tooltip. This will allow you to review the findings to create a plan of care for the mother.

In the absence of any additional concerns, a referral for scan would not be indicated in this example.

Slow Growth - SFH

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Slow growth is highlighted to the user in GROW 2.0 with a red plot. By opening the tooltip, you can review the findings to support with creation of your plan of care.

If using a printed chart, growth velocity assessments can be calculated using the growth rate calculator: https://growthrate2.perinatal.org.uk

Slow Growth - EFW


Slow growth is highlighted to the user in GROW 2.0 with a red plot. By opening the tooltip, you can review the findings to support with creation of your plan of care.

If using a printed chart, growth velocity assessments can be calculated using the growth rate calculator: https://growthrate2.perinatal.org.uk/

First SFH plot above 90th Centile

A first SFH measurement above the 90th centile itself is not an indication for referral, as it usually does not reflect a large baby. The most important indicator is whether subsequent measurements will show normal accelerated growth (see next).

Serial plots above 90th centile

This chart demonstrates a normal pattern of growth. Women should be reassured that fundal height measurements are of the uterus and all its contents. They are not intended to predict the fetal size but to assess with serial measurements that the growth velocity is normal. Serial SFH plots above the 90th centile do not require referral for scan, unless there are other concerns e.g. polyhydramnios, or accelerated growth (see next example).

Accelerated or excessive growth

This chart demonstrated accelerated / excessive growth. Additional information can be reviewed within the tooltip by clicking on the relevant plot. Further tests including an USS and a GTT may be indicated, according to your local protocol.

If using a printed chart, growth velocity assessments can be calculated using the growth rate calculator: https://growthrate2.perinatal.org.uk/