Press release by the French National College of Obstetricians and Gynaecologists

Press release by the French National College of Obstetricians and Gynaecologists on New Recommendations for Fetal Growth Charts New recommendations concerning the choice of fetal growth charts from the CNGOF (French National College of Obstetricians and Gynaecologists) and the SFN (French Society of Neonatology) will be published in March-April. These will recommend the use of the 2017 World Health Organization (WHO) fetal growth charts for head circumference (HC), abdominal circumference (AC), femur length (FL) and estimated fetal weight (EFW).

This choice is based on a comprehensive analysis of the literature which shows that these charts offer the best option for antenatal screening of growth abnormalities in France (in terms of calibration with the French population, screening performance, consistency between the biometric measures and EFW, the possibility of using separate EFW charts for girls and boys and easy integration into ultrasound machines).

The CFEF (French College of Fetal Echography) made the unilateral decision to recommend the Intergrowth 21st charts. Because these charts are poorly calibrated to the French population, they run the risk of halving the detection rate of small for gestational age (SGA) and growth restricted fetuses, thereby increasing stillbirth risks. They are also expected to double the percentage of fetuses detected as large for gestational age (LGA), with potentially deleterious clinical consequences.

Probably because they are aware of these limits, the CFEF has proposed modifying the internationally recommended thresholds for detecting SGA and LGA fetuses (e.g. from the 10th and 90th percentiles for EFW to the 15th and 95th percentiles based on undefined risk criteria, and the 95th percentile). This proposition is arbitrary and, above all, has not been scientifically evaluated and therefore cannot be imposed as a recommendation for fetal ultrasounds in France.

The CNGOF recommends the use of the 2017 WHO fetal growth charts starting immediately and will focus in the coming weeks on generalizing their use in clinical practice and obstetrical decision-making in France.

Catégorie : Actualités

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