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.
An 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.
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.
Please contact us for more information on Gestation.net tools and services.
Customised assessment of birthweight and fetal growth has been recommended by the RCOG since 2002 and their use has been re-emphasised in the 2013 revision of the Green Top Guidelines.
NHS England has published guidance that aims to reduce stillbirths in England; the ‘Saving Babies’ Lives Care Bundle‘ was published in 2016 and Saving Babies Lives' version 2 was published in March 2019. We have worked with GAP leads and Trust clinicians to develop an adaptation of element 2 (Risk assessment, prevention and surveillance of pregnancies at risk of fetal growth restriction) into GAP.
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, 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.