The Diagnostic Value of Applying Regional Ultrasound Fetometry Reference Standards for Confirming Intrauterine Growth Restriction in the Fetus

The aim is to assess the diagnostic value of applying regional ultrasound fetometry standards for verifying intrauterine growth restriction (IUGR) in the pregnant population of the Kirov region. Material and methods. The analysis included data from 320 full-term newborns diagnosed with IUGR, delivered at the Kirov Regional Clinical Perinatal Center between 2021 and 2023. Three IUGR subtypes were distinguished among the newborns: hypotrophic, hypoplastic, and dysplastic. The hypotrophic subtype is characterized by low birth weight with normal body length and head circumference, which corresponds to asymmetric fetal growth restriction on prenatal ultrasound fetometry. The hypoplastic subtype, consistent with symmetric fetal growth restriction on prenatal ultrasound, demonstrates proportionate deficits in birth weight, length, and head circumference compared to expected gestational age standards. The dysplastic subtype combines growth restriction with fetal malformations. We also performed a retrospective analysis of 374 maternal ultrasound scans, applying both national reference standards and our institutionally developed regional fetal growth parameters. Results. The sensitivity of ultrasound fetometry using regional norms reached 82.3% (asymmetric form) and 88.2% (symmetric form), substantially exceeding the sensitivity achieved with federal standards (30.9% and 71.1%, respectively). Meanwhile, the specificity of the method demonstrated a modest reduction with regional standards yet maintained high diagnostic performance. Conclusion. Regional ultrasound biometry standards significantly increase IUGR detection sensitivity by incorporating local population characteristics. Their clinical adoption in the Kirov region is recommended for improved fetal growth restriction diagnosis.

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