IUGR abdominal circumference

Is Abdominal Circumference Associated With Poor Outcomes

  1. al circumference (AC) has been shown to have high specificity and sensitivity for IUGR. We aim to deter
  2. al circumference is below the 2.5th percentile. At.
  3. al circumference (AC) at one point in time during pregnancy being below 3 rd percentile or EFW and/or AC below the 10 th percentile for gestational age with deranged Doppler parameters 14
  4. al circumference (AC)
  5. al circumference (AC) ratio. Tongsong T(1), Wanapirak C, Thongpadungroj T. Author information: (1)Department of Obstetrics and Gynecology, Chiang Mai University, Thailand
  6. al circumference AFV amniotic fluid volume BPP biophysical profile DV ductus venosus DVP deepest vertical pocket EFW estimated fetal weight IUGR intrauterine growth restriction MCA middle cerebral artery NST non-stress test SFH symphysis fundal heigh
  7. al circumference had dropped to 7.5%. Less than a month before, her AC was measuring at 13%. All of her other measurements, head circumference, femur length. etc. are in the 20s and 30s% so I'm concerned about her AC being so disproportionate and dropping so quickly. I have gestational diabetes and have only gained about 10 lbs overall (started out at 153.

Abdominal circumference (AC) Sensitivity, specificity, positive and negative predictive values of 61, 95, 86, and 83 percent, respectively More sensitive in asymmetric FGR More sensitive later in gestation More sensitive when the interval between measurements is more than two weeks Small AC also correlates with parameters of morbidit The following are Society for Maternal-Fetal Medicine (SMFM) recommendations: (1) we recommend that FGR be defined as a sonographic estimated fetal weight (EFW) or abdominal circumference (AC) below the 10th percentile for gestational age (GRADE 1B); (2) we recommend the use of population-based fetal growth references (such as Hadlock) in determining fetal weight percentiles (GRADE 1B); (3) we recommend against the use of low- molecular-weight heparin for the sole indication of prevention of. Prediction of intrauterine growth retardation via ultrasonically measured head/abdominal circumference ratios. Crane JP, Kopta MM. This prospective study examines the reliability of ultrasonically measured head/abdominal (H/A) ratios in detecting uteroplacental insufficiency (UPI)-related intrauterine growth retardation (IUGR) in 47 patients. Normal H/A ratios were found in 37 (79%) fetuses. None of these infants was classified as small for gestational age (SGA) on newborn pediatric.

Abdominal circumference/IUGR. m. mb33. I'm currently waiting for a call back from my providers but in the meantime I am curious to know if anyone has any information on IUGR and low abdominal circumferences. I'm 38 weeks tomorrow and yesterday I met with my MFM doctor who did a growth scan. He told me baby is just small (which has a what I've been told the past few weeks) and he was. IUGR may be clinically classified into two groups, based on sonographic measurement of the head-to-abdomen circumference ratio (HC/AC). Fetuses who are proportionately small (small head and abdomen) are considered to have symmetrical IUGR, whereas those with lagging abdominal growth relative to head size are labeled as having asymmetrical IUGR. These two types are theoretically caused by different mechanisms. In symmetrical IUGR, the pathogenesis is believed to occur in early development. Fetuses with FGR caused by placental insufficiency often develop asymmetrically, that is, the ratio of the fetal head circumference (HC) to abdominal circumference (AC) is increased (the head grows at the normal rate while the abdomen lags behind because the body organs, like the liver, grow slower). Asymmetrical growth also includes a short femur length (FL). This is because fetuses with FGR will usually prioritize which parts of their body most need to be supplied with blood Other definitions of IUGR include estimated weight less than 2 standard deviations below the mean weight, abdominal circumference <10 % for gestational age. Both ACOG and RCOG have adopted the definition of IUGR as estimated fetal weight is less than 10th percentile [ 1 , 2 ]

Methods: Prospective observational study of singletons with IUGR (abdominal circumference < 5 (th) percentile) who underwent serial standardized umbilical artery (UA), middle cerebral artery (MCA), ductus venosus (DV) and umbilical vein (UV) Doppler surveillance Ultrasound is used to confirm IUGR based on estimated fetal weight and measurements of head & abdominal circumference. Once IUGR has been identified, you can use the growth pattern can help to establish the cause. There are two main growth patterns seen in IUGR: symmetric and asymmetric. Symmetric : Asymmetric: 20-30% of IUGR: 70-80% of IUGR: Usually occurs early in pregnancy: Usually occurs.

Intrauterine Growth Restriction: Identification and

Intrauterine growth restriction Radiology Reference

Concern for a diagnosis of IUGR is traditionally raised when the estimated fetal weight or abdominal circumference is measured by ultrasound at <10th percentile. 11 However, these arbitrary parameters do not differentiate the constitutionally small fetus from the pathologically growth-restricted fetus unable to meet its true growth potential. 12 It has been reported that up to 70% of fetuses. The fetal abdominal circumference is a helpful indicator of fetal nutrition. Doppler flow. Another way to assess fetal well-being once IUGR has been diagnosed is Doppler flow, which uses sound waves to measure blood flow. The sound of moving blood produces wave-forms that reflect the speed and amount of the blood as it moves through a blood vessel. Blood flows through vessels in the both the.

Asymmetrical intrauterine growth restriction Radiology

Sonographic diagnosis of intrauterine growth restriction

IUGR leads to early depletion of hepatic glycogen and subcutaneous fat. This leads to early decrease in abdominal circumference. Hence, abdominal circumference is considered sensitive parameter for early detection of IUGR., However, accurate date of LMP or prior 1 st trimester dating scan is necessary for prediction of IUGR Intrauterine growth restriction (IUGR) or fetal growth restriction (FGR) is defined as an estimated fetal weight (EFW) / abdominal circumference (AC) at one point in time during pregnancy being below 3 percentile or EFW/AC below the 10 percentile for gestational age with deranged Doppler parameters . An IUGR can be broadly divided into two main types Early stage of IUGR. The growth impairment involves all body structures including the internal organs. It is usually due to chromosomal, genetic or infective causes. All ultrasound parameters (Head Circumference, Biparietal Diameter, Abdominal Circumference, Fetal diaphesis length) are smaller than expected. Workup should include detailed sonogram, karyotype, and screen for fetal infections. Abdominal circumference <2.5th percentile in IUGR has 95% sensitivity in asymmetric IUGR compared to head circumference ; Diagnosis . Estimating the fetal size prior to delivery is absolutely critical in diagnosing this condition early. Symphysis fundal height (SFH) Inexpensive way of estimating the gestational age ; Over 22 weeks of gestation the distance from the pubic symphysis to the top. Diagnosis intrauterine growth restriction (IUGR) dicurigai berdasarkan adanya faktor risiko dan hasil pemeriksaan fisik maternal. Diagnosis pasti dapat ditegakkan menggunakan berbagai modalitas USG untuk memperkirakan berat janin, misalnya abdominal circumference dan head circumference.. Anamnesis. Intrauterine growth restriction (IUGR) umumnya tidak menimbulkan gejala

Fetal Abdominal Circumference Reliably Predicts IUGR Risk. Sherry Boschert. SAN FRANCISCO — Ultrasound measurement of just the fetal abdominal circumference provides a reasonable estimate of the risk for intrauterine growth retardation among term babies when other measures are unavailable, Dr. Mark Williams said at the annual meeting of the American College of Obstetricians and Gynecologists Abdominal circumference has a specificity and negative predictive value close to 90% for diagnosing IUGR. 4 A decreased abdominal circumference reflects a small liver, and decreased hepatic glycogen stores and subcutaneous fat. Other useful measurements include head circumference, biparietal diameter, and femur length, along with specific ratios of these measurements. For example, an elevated. Transcerebellar diameter/Abdominal circumference ratio-A predictor of fetal growth restriction. Dr. Reena Mathur, Dr. Avinash Gupta, Dr. Namita Singh . Abstract : Objective: To evaluate the use of the transverse cerebellar diameter to abdominal circumference (TCD/AC) ratio in predicting intrauterine growth restriction (IUGR). Methods: A prospective study was conducted on 100 pregnant women. Abdominal circumference 4 weeks less than BPD; Early Delivery Indications. Doppler diastolic flow 0 mmHg in umbilical artery; VI. Complications: Peripartum Risks of IUGR . Meconium Aspiration; Intrauterine Asphyxia; Polycythemia; Hypoglycemia; VII. Causes: Intrauterine Growth Retardation (IUGR) Symmetric IUGR (Head and body growth retarded) Asymmetric IUGR (head growth spared) VIII. References. To screen for IUGR, ACOG recommends ultrasonography. ACOG describes 4 biometric measures to be used to generate an estimated fetal weight: biparietal diameter, head circumference, abdominal circumference, and femur length. If the estimated fetal weight is below the 10th percentile for gestational age, they suggest that further evaluation be considered, such as amniotic fluid assessment and.

My baby is having asymmetric IUGR. Abdominal circumference is lagging by 4 weeks.. Fetal weight 8%. My c section is scheduled on Tuesday. I will be 37 weeks then. I am very worried whether there will be any health issues for the baby. Will the baby catch up with the weight? Has anyone faced this situation. If so please share your story Symmetric IUGR: The baby's weight, head circumference, and abdominal circumference are all below the tenth percentile; usually attributable to an abnormality or infection. Asymmetric IUGR: The baby's weight is below the tenth percentile, but the head circumference and body length measure greater than the tenth percentile. It is usually caused by severe placental insufficiency. Combined type.

IUGR? AC measuring 7

An abdominal circumference within the normal range reliably excludes IUGR with a false negative rate of less than 10%, according to studies. Animal studies show that abdominal circumference at the liver is actually an indirect measure of the nutritional status of the fetus. The liver is the most affected organ in IUGR Intrauterine Growth Restriction (IUGR)/Small for Gestational Age (SGA) A primary goal of an obstetric care provider is the identification of pregnancies at risk for preventable perinatal morbidity and mortality. 1 The same principal is a central tenant of the practice of midwifery. Both physicians and midwifes are taught to collect all data necessary for a complete evaluation of the. ric IUGR based upon head/abdominal circumference ratio and femur length. J. Perinat. Med. 16 (1988) Cordano et al, Diagnosis and follow-up of IUGR 63 of retardation was made in 15 fetuses with a sensitivity of 53%. Of the 23 asymmetric fetuses a correct diagnosis was made in 19 with an 83% sensitivity (figure 1). The sensitivity of the femur method is similar to that of the HC/AC ratio. The results of this study showed that abdominal circumference was as the best single ultrasound parameter as an indicator of IUGR with a reasonably high sensitivity of around 88-94% in the Australian sample and 88-84% in the Iranian sample. However, the positive and negative predictive values for all of the proposed ultrasound parameters were low. This was shown by a high number of false.

Publications & Guidelines SMFM

C Biparietal diameter (BPD) and D abdominal circumference (AC), measured in vivo with ultrasound at both E19 and E20. *p < 0.05; **p < 0.01; ***p < 0.001. m F fetal weight, m p placental weight. IUGR. 53 Pages. IUGR. Monika Raghuwanshi. Download PDF. Download Full PDF Package. This paper. A short summary of this paper. 37 Full PDFs related to this paper. READ PAPER. IUGR . Download. IUGR. Monika Raghuwanshi. fetal head is larger than abdominal circumference head-sparing Placental dysfunction - common in htn moms. What is the Etiology of IUGR . many pathologies fetal cell restriction in size or (if early) number. maternal Risk factors for IUGR. 1) hx of IUGR!!! 2) htn 3) diabetes mellitus 4) elevated MSAFP (maternal serum alpha fetal protein) 5) Antiphospholipid syndrome 6) chronic medical. The estimated fetal weight at the time of the aIMT measurement was 1899 g, and the abdominal circumference was 278 mm. The AGA neonates had a mean gestational duration of 37 weeks and a mean birth.

abdominal circumference; BPO; Ans(3) 7. A lady of 150 cm height with Hb of 11gm%, BP of 160/110 mmHg and 12 kg gain during her pregnancy delivered in IUGR baby, the causes in this cases are: maternal infection ; short stature; HTN ↑ weight gain ↓ Hb% Ans(3) 8. Birth weight of a baby can be increased by a cessation of smoking: cessation of smoking; aspirin; Ca++ and vitamin D supplement. Diagnosis IUGR sangat bergantung pada pemeriksaan ultrasonografi (USG). Beberapa aspek dalam pemeriksaan USG yang dapat membantu diagnosis adalah estimasi berat janin, abdominal circumference (AC), rasio head circumference/abdominal circumference (HC/AC), rasio femur length/abdominal circumference (FL/AC), volume cairan amnion, dan doppler. Abdominal Circumference is the single most sensitive measurement. Other ratios and measurements habe many false positives. What measurements are indicative of asymmetric IUGR? Normal BPD and HC with disproportionately small AC. What is useful in differentiating symmetric to asymmetric IUGR? HC to AC ratio. What are maternal IUGR risk factors (4)? - prior IUGR pregnancy - significant HTN. Intrauterine growth restriction (IUGR), a condition that occurs due to various reasons, is an important cause of fetal and neonatal morbidity and mortality. It has been defined as a rate of fetal growth that is less than normal in light of the growt The prevalence of IUGR among the study group was 51.5%. The best cut‐off value of the TCD/AC ratio for predicting IUGR was 15.4%, giving the sensitivity, specificity, positive predictive value and negative predictive value of 73.26%, 80.25%, 79.75%, and 73.86%, respectively. Conclusion: The sonographic fetal TCD/AC ratio as a gestational age‐independent method can be helpful in antenatal.

abdominal circumference, head circumference and femur length are extracted from ultrasonography [4]. Gestational age (GA): One of the major requirements for an accurate diagnosis of IUGR is an accurate calculation of gestational age. It is assumed that the required date can be determined from LMP or early first trimester ultrasound scanning Abdominal circumference below the 10 th centile was diagnosed as IUGR. Clinical data was collected to EXCEL format from clinical files, and analyzed with PasW 18.0 software. Results Between February 2009 and September 2010, 2059 pregnant women were evaluated, mostly between 34 and 36 weeks (> 90%) with a prevalence of 4% of IUGR, considering the AC less than the 10 th centile the diagnostic. Many studies have compared the efficacy of several gestational age independent parameters and found that TCD/AC is a better predictor of asymmetric IUGR.To compare the accuracy of transcerebellar diameter/abdominal circumference with head circumference/abdominal circumference in predicting asymmetric intrauterine growth retardation after 20 weeks of gestation.The prospective study was. A prospective study was conducted to evaluate the ability of the transverse cerebellar diameter/abdominal circumference ratio to identify growth‐retarded fetuses. Of the cases analyzed, 48 of 87 (55%) were growth retarded by birth weight. The transverse cerebellar diameter/abdominal circumference ratio identified growth retardation with a sensitivity of 71%, specificity of 77%, positive. Learn Intrauterine Growth Restriction (IUGR) - Gestational Disorders for Medicine faster and easier with Picmonic's unforgettable videos, stories, and quizzes! Picmonic is research proven to increase your memory retention and test scores. Start learning today for free

Altered Fetal Growth | GLOWM

Prediction of intrauterine growth retardation via

IUGR from 74 Iranian pregnant women from May 1999 to July 1999 were used in the next stage of study to evaluate the validity of the developed index. V The results of this study showed that abdominal circumference was as the best single ultrasound parameter as an indicator of IUGR with a reasonably high sensitivity of around 88-94% in the Australian sample and 88-84% in the Iranian sample. His abdominal circumference is on the 10th percentile. He is 5 lbs 5 oz. they put me on bed rest and I wanna know if its IUGR or if the baby is just small?? I mean his weight is normal and he's growing. Couldn't he just be a small baby?? Thanks. Add Friend Ignore. kristyyt 1 child; Adelaide, Australia 2 posts. Apr 17th '12. I am 27 weeks, and at my 20 week ultrasound my bubs abdomen was. Intrauterine growth restriction (IUGR) is a condition in which the baby does not grow properly during its time in the mother's womb. It is due to a mix of factors including disease conditions in.

Abdominal circumference/IUGR - July 2020 Babies Forums

With IUGR, the growth of the baby's overall body and organs are limited, and tissue and organ cells may not grow as large or as numerous. When there is not enough blood flow through the placenta, the fetus may only receive low amounts of oxygen. This can cause the fetal heart rate to decrease placing the baby at great risk. Babies with IUGR may have problems at birth including: § decreased. This estimated fetal weight calculator will calculate percentiles as well as the estimated fetal weights based ultrasound data and on many published formulas.*. Calculations are based on the 4 common fetal measurements, biparietal diameter (BPD), head circumference (HC), femur length (FL), and abdominal circumference (AC) They repeated the growth scan at 34 weeks and the abdominal circumference is still measuring about 3 weeks behind, while the other measurements are about a week behind. The baby's estimated weight is about 4lbs 9oz although I know those are notoriously wrong). They're talking about inducing me after 37 weeks. I'd really prefer to wait until 39 or even 38 weeks but I don't know much about the. abdominal circumference) n Asymmetric n Head-sparing (abdominal circumference is reduced compared to head) IUGR: Pathologist's definition n Birthweight n (vs. weight at autopsy, usually lower) n Foot length n >2 week discrepancy between clinical and anatomically-determined gestational age may indicate symmetric IUGR n Brain:liver weight ratio n 3:1 indicates symmetric growth n >3:1 indicates. IUGR will be detected by ultrasound. If growth is found to be restricted, then repeated scans should be performed at fortnightly intervals. The biparietal diameter and abdominal circumference (between the liver and the kidneys) should be measured and plotted

Are all IUGR babies Small for gestation? | Pedchrome

Abdominal Circumference - an overview ScienceDirect Topic

Neonatal abdominal circumference has been shown to predict plasma cholesterol and fibrinogen levels in adults in later life, which are both risk factors for cardiovascular disease. Association between IUGR and raised blood pressure in childhood and adult life has been extensively demonstrated around the world. In 1996, a review based on 34. INTRAUTERINE GROWTH RESTRICTION (IUGR) Selçuk Özden MD, Pro Ø Asymmetrical IUGR: abdominal circumference is disproportionately reduced (starving) NB// babies with IUGR may not be small for gestational age • Epidemiology Ø The incidence of IUGR ~5% à ~1000 babies die in the UK every year as a result of IUGR Ø Incidence of live-born VLBW infants is 0.6%, but they make up 25% of neonatal mortalities • Causes Ø Physiological § Constitutionally.

Placenta Fetal / Intrauterine growth restriction (FGR

Abdominal Circumference (AC) - measures around the abdomen. Femur Length (FL) - measures the length of the thigh bone . An estimate of fetal weight (EFW) can be calculated by combining the above measurements. The EFW can be plotted on a graph to help determine whether the fetus is average, larger or smaller in size for its gestational age. If the fetal weight estimate is below the bottom. Fetal weight, head circumference and abdominal circumference measurements plotted against pre-existing standardized charts help to diagnose FGR. Usually, an ultrasound at 18 - 20 weeks of gestation is used to date the pregnancy and rule out any congenital malformations. Later, the findings are compared to another scan done at 28 - 32 weeks of gestation to assess growth, symmetry, and brain. IUGR with reduced HC (head circumference): Hi friends i had my ultrasound and appointment today.. I am 32 weeks, but baby's weight is just 1563 gm BPD = 29 weeks 3 days Head circumference(HC) = 28weeks 4days Abdominal circumference(AC) = 29weeks 2days Femur length(FL) = 32 weeks AFI is 9.5cm Gestational Age is lagging by 2 weeks IUGR Screen: 10-25% mid IUGR <10% moderate IURG <3% severe IUGR; Head Circumference / Abdominal Circumference; Until 34wks --> HC > AC; After 34wks --> AC > HC; First Trimester Scan - r/o viability, r/o ectopic, # of fetuses+chorionicity, nuchal translucency (NT) Complete Obstetrical Scan (18-20 week scan - anatomy) Third Trimester Scan - Some order, no proven benefit, identifies position. Answer: hi dear! with iugr you will have to take alot of proteins in your diet.Start having almonds, walnuts, raisins everyday.have sprouts, increase your milk intake.add protein powder in milk .you can try mamma's best with vanilla or chocolate flavour, have threptin biscuits 2 in the morning and two in the evening..if you eat eggs then start eating egg white everyday .you can also add soya.


Intrauterine Growth Restriction (IUGR): Etiology and

abdominal circumference on ultrasound that, because of a pathologic process, has not attained its growth potential.4 Fetal growth restriction (FGR) includes IUGR but can also be identified by deceleration of growth, i.e., falling off the growth curve, or absent/poor interval growth even when EFW and abdominal circumference (AC) remain above the 10th percentile.4 PRACTICE POINT Fetal. Asymmetrical intrauterine growth restriction is a type of intrauterine growth restriction (IUGR) where some fetal biometric parameters are disproportionately lower than others, as well as falling under the 10percentile. The parameter classically affected is the abdominal circumference (AC).. Please, refer to the article on symmetrical intrauterine growth restriction for a particular discussion.

Progression of Doppler abnormalities in intrauterine

A FGR or IUGR fetus is one that has not achieved its growth potential. The difficulty in determining growth potential means that it is difficult to reach a consensus regarding a clinically useful definition5. This condition can be associated with adverse perinatal and neurodevel-opmental outcomes. It has been classified into early-onse Patients presenting with IUGR must be monitored closely for increasing signs of fetal distress said Lee. Screening techniques include measuring fundal height, but this is less accurate in obese patients and those with leiomyomas, or fibroids. Ultrasounds can measure biparietal diameter, head circumference, abdominal circumference and femur. Asymmetrical IUGR is the most common type of IUGR and occurs in mostly in the third trimester. Uteroplacental insufficiency is usually the culprit; in hypoxic, hypertensive, or hypoglycemic conditions, the placenta cannot adequately provide what is necessary for continued growth of the child. The abdominal circumference is affecte Intrauterine growth restriction, or IUGR, simply means that a baby is not growing well in the womb. It is often defined as a fetal weight lower than the tenth percentile for a particular gestational age. IUGR is also sometimes referred to as small for gestational age, or SGA, or fetal growth restriction. There are many possible causes for this happening, and different risk factors as well. IUGR, the results have been encouraging as evidenced by better fetal abdominal circumference (AC), increased liquor volume and better Doppler changes with associated decreased NICU admissions and improvement in perinatal outcomes [1,10-12]. The present study was therefore embarked upon simultaneously in 3 different tertiary care centers of North India (2 in Haryana & 1 in UP) to evaluate the.

Approach to the Child with IUGR/SGA Learn Pediatric

women with IUGR. Ultrasound estimation of fetal parameters like BPD, FL, Abdominal circumference, Amniotic Fluid Index and estimated fetal weight were obtained. These parameters were reassessed at an interval of 4 weeks, or earlier, depending upon the clinical situation to assess the interval growth. BPD was measured a IUGR was defined as an abdominal circumference (AC) <5 th centile. Sixty controls were identified by selection of the next consecutive appropriately grown fetus of similar gestational age (± 1 week). To exclude fetal size effects, ratios between thymus perimeter and fetal biometry measurements including biparietal diameter (BPD), AC and femur length (FL), as well as estimated fetal weight. This study was undertaken to evaluate the role of umbilical artery flow velocimetry combined with sonographic estimation of fetal weight, head circumference to abdominal circumference ratio, femur length to abdominal circumference ratio, and qualitative determination of amniotic fluid volume as a comprehensive test for the detection of intrauterine growth retardation (IUGR) restriction (IUGR) by fetal transverse cerebellar diameter/ abdominal circumference (AC) ratio. Int J Gynecol Obstet 1999; 66: 1-5. 10. Smulian JC, Ananth CV, Vintzileos AM, Guzman ER. Revisiting sonographic abdominal circumference measurements. Ultrasound Obstet Gynecol 2001; 18: 237-43. 11. Reece EA, Goldstein I, Hobbins JC. Fundamentals o Abdominal Circumference • Circular transverse section of the fetal abdomen at the level of the liver. Visualising the whole circumference without indentation. • Short section of the of the intra hepatic umbilical vein - one third from the anterior abdominal wall • Stomach • Spine and descending Aorta • Short 'unbroken' rib ech

Welcome to your Third Trimester (part 9) - Doppler scansEstimation of Fetal Weight

Gynecologists, IUGR is one the most common and complex problems in modern obstetrics.[1] decrease or no increase in abdominal girth and decrease or no increase in fundal height). OR One of the following risk factors was present in the patient: -Known case of preeclampsia. -Gestational hypertension. OR -Maternal essential hypertension: This was diagnosed if a BP of 140/90 % mm Hg or more. Vergani et al. examined a cohort of IUGR fetuses delivered > =34 weeks and developed a probability formula for the prediction of adverse neonatal outcome using the variables of gestational age, abdominal circumference centile, and UA-PI centile . It was found that a score of > =25 was able to predict adverse neonatal outcome with a sensitivity of 75% and specificity of 82% IUGR was defined as an abdominal circumference (AC) 5 th centile. Sixty controls were identified by selection of the next consecutive appropriately grown fetus of similar gestational age (±1 week). To exclude fetal size effects, ratios between thymus perimeter and fetal biometry measurements including biparietal diameter (BPD), AC and femur length (FL), as well as estimated fetal weight (EFW.

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