A survey of current practice in reporting third trimester fetal biometry and Doppler in Australia and New Zealand

Introduction: Inconsistent reporting practices in third trimester ultrasound, the choice of reference charts in particular, have the potential to misdiagnose abnormal fetal growth. But this may lead to unnecessary anxiety and confusion amongst patients and clinicians and ultimately influence clinical management. Therefore, we sought to determine the extent of variability in choice of fetal biometry and Doppler reference charts and reporting practices in Australia and New Zealand.
Methods: Clinicians performing and/or reporting obstetric ultrasound were invited to answer questions about fetal biometry and Doppler charts in a web-based survey. Results: At least four population-based charts are in current use. The majority of respondents (78%) report the percentile for known gestational age (GA) alongside measurements and 63% using a cut-off of estimated fetal weight (EFW) < 10th percentile when reporting small for gestational age (SGA) and/or fetal growth restriction (FGR). The thresholds for the use of fetal and maternal Doppler in third trimester ultrasound varied in terms of the GA, EFW cut-off, and how measures were reported. The majority of respondents were not sure of which Doppler charts were used in their practice.
Conclusion: This survey revealed inconsistencies in choice of reference chart and reporting practices. The potential for misdiagnosis of abnormal fetal growth remains a significant issue. Introduction Abnormal fetal growth and fetal growth restriction (FGR), in particular, are associated with increased risk of adverse perinatal outcomes.1, 2 Prenatal identification allows for increased fetal monitoring to inform clinical decisions regarding delivery and has been shown to improve perinatal outcomes.