Role of fetal abdominal circumference as a prognostic parameter of perinatal complications

Objective: To evaluate the potential of fetal abdominal circumference (AC) measurement as predictor of perinatal complications in term newborns. Materials and methods: This prospective study included 324 consecutive term pregnancies within a 6-month period between February and August 2009. Inclusion criteria were a singleton pregnancy with at least 37 weeks of gestation, vertex presentation, absence of structural or chromosomal disorders and complete ultrasound examination within 3 days of delivery. Patients with elective caesarean sections were excluded. Vaginal deliveries were assessed with regard to the impact of fetal AC on the mode of delivery, the neonatal outcome (pH, base excess, APGAR score at 5 min) and the incidence of perineal injuries. When appropriate, U tests and χ ² tests were performed for group comparisons. Results: Complete data were obtained for 258 patients. Sixty-six patients were excluded because they underwent elective caesarean section. Only 12 of the 30 fetuses with an AC ≤36.0 cm weighed more than 4,000 g. There was no significant difference in relation to incidence of surgical delivery (instrumental delivery, P = 0.754 and caesarean section, P = 0.405), the neonatal outcome (pH, P = 0.527; base excess, P = 0.146; APGAR score at 5 min, P = 0.552), and the occurrence of perineal injuries (2nd and 3rd degree, P = 0.951). Conclusion: The results of the study could not demonstrate a significant relationship between AC ≤36.0 cm and perinatal complications. For this, measuring the fetal AC is of no help in finding the correct clinical management.