CLINICAL TOOL
Fetal Growth, EFW & FGR Workbench
Clinical fetal growth workbench with WHO and INTERGROWTH-21st centiles, EFW formula comparison, serial growth velocity, singleton FGR (Delphi/ISUOG) management, twin sFGR/TTTS tools, and EMR-ready output.
Clinical Purpose
To evaluate fetal growth by calculating estimated fetal weight (EFW) centiles, plotting growth trajectories, calculating growth velocity, and diagnosing/staging Fetal Growth Restriction (FGR) in singletons and twins based on international consensus guidelines.
Inputs
- Gestational Age (Days/Weeks) or EDD
- Biometric Measurements (BPD, HC, AC, FL)
- Fetal Doppler values (Umbilical Artery, Middle Cerebral Artery, Ductus Venosus, Uterine Artery) - Optional
- Amniotic Fluid Index (AFI) or Deepest Vertical Pocket (DVP) - Optional
Formula & Guideline Source
WHO Fetal Growth Charts (2017), INTERGROWTH-21st (2014), Hadlock (1991), ISUOG Practice Guidelines (2020), Delphi Consensus for FGR (2016).
Limitations
EFW formulas have inherent error margins (up to 15%). Centile calculators are population-dependent. The diagnosis of FGR should combine biometry with functional parameters (Dopplers/fluid) and clinical context. This tool is for educational and supportive purposes and does not replace clinical judgment.
FAQ
Which growth chart should I use: WHO or INTERGROWTH-21st?
Both are robust international standards. WHO curves provide specific centiles optimized for varying maternal environments, while INTERGROWTH-21st provides prescriptive standards describing how fetuses should grow under optimal conditions. The choice depends on local/national guidelines.
How is Fetal Growth Restriction (FGR) defined in this tool?
The tool incorporates the Delphi consensus criteria (2016), differentiating between early (<32 weeks) and late (≥32 weeks) FGR, utilizing a combination of EFW/AC centiles, growth velocity, and Doppler abnormalities.
References
- Kiserud T, et al. The World Health Organization Fetal Growth Charts: A Multinational Longitudinal Study of Ultrasound Biometric Measurements and Estimated Fetal Weight. PLoS Med. 2017.
- Papageorghiou AT, et al. International standards for fetal growth based on serial ultrasound measurements: the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project. Lancet. 2014.
- Gordijn SJ, et al. Consensus definition of fetal growth restriction: a Delphi procedure. Ultrasound Obstet Gynecol. 2016.
- Lees CC, et al. ISUOG Practice Guidelines: diagnosis and management of small-for-gestational-age fetus and fetal growth restriction. Ultrasound Obstet Gynecol. 2020.