Search

In this study, we tested the hypothesis that anomalous first trimester growth affects birth weight. Four hundred and fifteen women with viable singleton pregnancies at the primary transvaginal scan who had at least two crown rump length (CRL) and birth weight data were included. A linear mixed model was fitted to the Box-Cox transformed CRL values to evaluate the association between the GA and the embryonic growth. For multivariate analysis we included maternal age, height, weight, parity, number of miscarriages, vaginal bleeding, smoking, foetal gender, birth weight, small-for-gestation (SGA) and large-for gestation (LGA) categories at delivery. Smoking appeared to be significant for predicting the initial CRL from the beginning of the pregnancy (p value = 0.013). The SGA foetuses appeared to have slightly slower embryonic growth rates compared to non-SGA (p value = 0.045), after taking into account the effect of smoking on the initial CRL. None of the other variables including subsequent birth weight or LGA category have statistically significant effect on the first trimester embryonic growth curve when tested separately.

Links between low birth weight and tobacco exposure in utero are well established, as are associations between maternal body mass index (BMI) and birth weight. This study further develops those relationships. In particular, this article analyses whether high maternal weight acts to dampen the previously established link between tobacco exposure and low birth weight. A retrospective cohort study was undertaken, reviewing the birth weights of 13,473 live singleton pregnancies born at a Sydney regional hospital between 1998 and 2003. Results demonstrated a statistically significant decline in reduced birth weight as BMI increased. That is, as body weight increases, tobacco use has a smaller effect on reducing birth weight. Inversely, the effect on reducing birth weight for each cigarette smoked by leaner women was greater. In effect, the adverse influence of tobacco use on birth weight appears to be modulated by increasing maternal BMI.

Objective: To develop a simplified measure of intrauterine fetal growth velocity from birth weight and gestational age at term., Methods: This concept is based on the observation that intrauterine fetal growth in the third trimester is quasi-linear. The average fetal weekly weight gain (AWG) was calculated by dividing the difference between birth weight (in g) and the 24-week median weight by the difference between gestational age at birth and 24 weeks, as follows: [Formula: see text] An obstetric database of 12,425 term live singleton pregnancies was studied to validate this measure., Results: The mean AWG was 176.5 g/week, SD 29.1. There was a close correlation between birth weight z-scores and the AWG (R = 0.993). Pregnancy characteristics correlated with the AWG, the strongest being fetal gender and cigarette smoking (p < 0.0001). Females had an AWG 9 g lower than males; multiparae had an AWG 7 g higher. Other significant correlates include maternal weight, height and body mass index., Conclusions: The AWG is a novel estimate of intrauterine fetal growth velocity that is computationally simple, and could be used as an alternative to the birth weight z-score.

Objective: To test the hypothesis that small- or large-for-gestational-age (SGA or LGA) newborns have anomalous crown-rump length (CRL) growth rates in the first trimester., Methods: Prospective observational study. Women in the first trimester presenting to the Early Pregnancy Unit, between November 2006 and December 2010, underwent transvaginal scan. Women with viable singleton pregnancies in the first trimester who had at least two CRL measurements > 5 mm, recorded at least 2 weeks apart, and also had birth weight data available were included in the final analysis. Birth weight percentiles were calculated and adjusted for gestational age and gender. SGA was equivalent to < 10th centile and LGA was equivalent to > 90th centile. Correlation analysis was performed between birthweight percentiles and first-trimester CRL growth-rate coefficients. In addition, we estimated early fetal growth rates (EFGR) by calculating the Δ CRL/Δ time (mm/day) to see if these differed according to the birth-weight percentiles., Results: A total of 107 women had complete data. The mean maternal characteristics were age 27.5 ± 6 years, weight 87 ± 29 kg and height 163 ± 8 cm. The mean birth weight and gestational age at delivery were 3405 g (SD = 597) and 269 days (SD = 13), respectively. The proportions of SGA and LGA were 7.5% and 18.7%, respectively. There were no significant correlations between birth-weight percentiles and any of the CRL growth rates. There were also no significant differences in the mean CRL velocities when comparing the SGA and LGA newborns birth weights. EFGR for SGA and LGA newborns were 1.34 mm/day (SD = 0.17) and 1.32 mm/day (SD = 0.24), respectively (p > 0.05)., Conclusions: Newborns who are found to be SGA or LGA at delivery do not appear to have anomalous CRL growth patterns in the first trimester. The EFGR also did not correlate with birth-weight percentiles.

The purpose of this study was to estimate the frequency of post-caesarean section scar defects (PCSD) on transvaginal ultrasound and to correlate these with the presence of abnormal menstrual bleeding. We reviewed the pelvic ultrasound images of 318 women referred for a gynaecological scan in a private women's ultrasound clinic. The incidence of defects at the expected location of a caesarean scar was evaluated and then correlated with patient responses to a questionnaire on abnormal menstrual bleeding. Of the 318 patients, 71 had a history of caesarean section and technically adequate pelvic ultrasound images. Fluid-filled defects in the hysterotomy incision were noted in 29 (40%). The presence of a PCSD was significantly associated with patients reporting prolonged periods or post-menstrual spotting. The larger the defect, the higher was the incidence of abnormal vaginal bleeding.