CLINICAL TOOL
WHO Growth Charts & Velocity
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 biometry (2014) and EFW (2017); Hadlock EFW (1985); ISUOG biometry (2019), FGR (2020), and twins (2025); SMFM #72 (2024); Delphi FGR (2016).
Limitations
Ultrasound EFW has measurement uncertainty, often around 10–15%, and errors can be larger. Chart-derived expected gain is not a validated normal-velocity interval. Interpret size and trajectory alongside dating, Dopplers, fluid and clinical context; this workbench does not replace clinical judgment.
FAQ
Which growth chart should I use: WHO or INTERGROWTH-21st?
Both are published international references with different populations and methods. WHO documents fetal-size variation across countries and by fetal sex; INTERGROWTH uses a prescriptive approach. Choose the department-approved standard, document it, and keep it consistent across serial scans. Do not switch charts to obtain a more favourable centile.
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.