Intrauterine growth predictors.

The present study was conducted to construct standards for midarm circumference and midarm/head circumference ratio to identify neonates at risk for metabolic complications and to assess the anthropometric variable which could be used to substitute weight to identify low birth weight neonates. A study of 2925 consecutive live births showed significant correlation (p less than or equal to 0.001) between different anthropometric variables studied. Since midarm circumference (MAC), midarm circumference/head circumference ratio (MAC/HC) and ponderal index (PI) had the least correlation with gestation, these were used as independent markers for gestation. Among these three, MAC had the best correlation with birth weight (r = 0.808). A midarm circumference of less than or equal to 8.6 cm and less than or equal to 7.4 cm had the best sensitivity and specificity for identifying neonates with a birth weight of less than or equal to 2500 and less than or equal to 2000 g, respectively. All the anthropometric variable studied can rule out low birth weight with great accuracy (high negative predictive value greater than 90%).

Congenital syphilitic hepatitis.

Hepatitis is a known manifestation of congenital syphilis, however hepatitis developing during penicillin therapy is unknown. Ten patients of congenital syphilis were studied and serial liver enzymes were done before and after starting penicillin therapy. Eight of the ten patients developed hepatitis after initiating penicillin therapy. Whether hepatitis in these cases was secondary to toxic reaction to the products of treponemal lysis or an autoimmune reaction needs to be investigated.

Ultrasonic variables in the diagnosis of intrauterine growth retardation.

Ultrasonic biparietal diameter (BPD), femur length, abdominal circumference, femur length/abdominal circumference ratio, estimated fetal weight, ponderal index, estimated fetal length were measured within 72 h of delivery of 30 small-for-date (SFD) and 174 non-SFD newborns. Evaluation of each ultrasound variable in the antenatal diagnosis of SFD fetus was assessed. Abdominal circumference and estimated fetal weight were the best predictors in confirming SFD in 73.3 and 76.6 per cent respectively, followed by BPD (63.3%). Other variables (femur length, femur length/abdominal circumference ratio, estimated fetal length and ponderal index) were less accurate in diagnosis of SFD babies. For all variables studied negative predictive value was high (almost 90% or above). However, positive predictive value for abdominal circumference and estimated fetal weight were satisfactory. This study demonstrates the usefulness of abdominal circumference and estimated fetal weight in recognising SFD. It also shows that various growth variables could be used to rule out the diagnosis of IUGR with reasonable accuracy (negative predictive value greater than or equal to 90).

Fetal ponderal index in predicting growth retardation.

Fetal ponderal indices were calculated by ultrasound examination and compared with the neonatal ponderal indices in 154 pregnancies. No significant difference was found between the prenatal and postnatal values of weight, length and ponderal indices of the entire sample as well as in babies with intrauterine growth retardation (IUGR). The fetal ponderal index had a sensitivity and specificity of 56.7 and 84.6 per cent respectively. These data suggest that fetal ponderal index could be used to rule out IUGR with reasonable accuracy (negative predictive value: 86%).

Ultrasonic intrauterine growth curves.

Intrauterine growth was studied by serial ultrasonic measurements of biparietal diameter (BPD), femur length (FL) and abdominal circumference (AC) in 241 normal low risk obstetric patients. These measurements were used to construct normal ultrasonic fetal weight and length curve. The data correlate well with the already established, postnatal weight and length curves after 28 weeks of gestation. The fetal ponderal index curve was compared with postnatal ponderal index curves available. Antenatal recognition of fetal weight, length and ponderal index can be used to evaluate pregnancies at risk for altered fetal growth.

Intrauterine growth curves in north Indian babies: weight, length, head circumference and ponderal index.

Intrauterine growth (weight, length, head circumference, Ponderal index) was studied in 2875 consecutive live born babies. Weight, length and head circumference growth curves did not show any significant difference when compared to previous growth curves made 20 years back from this centre. Norms and curves for ponderal index are provided for the Indian babies and were comparable with figures from Western studies. However, the 90th centile values were found to be low between 32-38 weeks of gestation.