Muhammad Wasim Awan, Fareeha Ahmed, maryam Amjad, sadaf Butt, maimoona shoukat, Col Mashkoor Ahmad, shaghaf Iqbal



Many  pregnancies     with intrauterine growth restricted (IUGR) fetuses remain

Aim:undiagnosed due to limited antenatal care. IUGR if identified before birth and delivered timely causes fourfold reduction in morbidity and mortality. Among the ultrasound parameters the transcerebellar diameter (TCD) is most reliable predictor of not only gestational age but also of normal or growth-retarded fetuses.

To determine the validity of TCD/AC ratio as an indicator of intrauterine growth restriction after 20 weeks gestation taking neonatal birth weight as gold standard.

Materials and methods:

A Cross sectional validation study, carried out in of Radiology Department of KRL hospital Islamabad from January 2018 to July 2018.

A total of 285 women fulfilling the selection criteria were included in the study. In addition to routine parameters, TCD and AC obtained at the time of scan was used to provide TCD/AC ratio. Neonatal birth weight was compared on standard gestational age growth chart keeping it as a gold standard.

Statistical analysis:

The TCD/AC ratios were correlated with Neonatal birth weight. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy (DA) for TCD/AC ratio in the prediction of IUGR fetuses were calculated


            Age range in this study was from 20 to 35 years with mean age of 28.000±2.89 years and mean gestational age was 29.547±3.41 weeks. TCD/AC ratio detected IUGR in 11.9% patients and at birth it was 12.3%. TCD/AC ratio has shown sensitivity of 77.1%, specificity 97.2%, diagnostic accuracy by 95%, PPV 79.41%, NPV 96.81%, LR positive 27.5 and LR negative was 0.23 (p=0.000) in diagnosis of IUGR.


In conclusion, TCD/AC ratio can be used in detecting IUGR with good diagnostic accuracy.

Full Text:



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