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Pregnant. Sonography showing FL and HL growth is lagging. What impact will it have on the growth of the child?

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35 weeks and 5 days pregnant.Gestational age 34 weeks and 3 days.Sonogrpahy for the first time has revealed that FL and HL growth is lagging behind.Foetal parameters are:BD : 8.5 cm, AC:31.5 cm, HC: 32 cm; FL: 6.42cm; HL: 5.56cm
The FL and HL growth was always earlier.The Double Test in 1st Tri-mester was also negative.Estimated foetal weight is : 2626 gms and Amniotic fluid index is 7.6 CMS. What is the impact these readings have on the growth of the child?
Also Umbilical artery shows reduced diastolic flow with raised RI value(RI: 0.94, SD: 4.38).What is the interpretation of all this and does this impact the foetal growth
Posted Wed, 30 Oct 2013 in Pregnancy
Answered by Dr. Shanti Vennam 57 minutes later
Brief Answer:
Surveillance needed; borderline defect.

Detailed Answer:

Thanks for your query.

At the outset, it appears that your dates and the sonogram dates are differing by about a week. This can happen with wrong dates or delayed ovulation in normal circumstances; it may also occur with IUGR.

The fetal parameters suggest a slight variation, which is quite normal, but the head circumference suggests a higher gestation age. This, in view of Down's syndrome being ruled out, has to be monitored closely and causes deciphered.

Estimated fetal weight corresponds with your dates. growth of the child can be deduced at a later sonogram and further management decided by your consultant. With these findings, one does not usually see any harmful effects.

Impaired umbilical artery flow with a slightly raised Resistance Index indicates IUGR or a fetus at risk. Disproportional growth retardation should be thought of. Most likely cause could be the reduced utero-placental blood flow.

Please contact an expert in high risk pregnancies. You may need protein infusions, ultrasound scans, CTG and Doppler, proper surveillance. Role of aspirin is controversial. Early induction on reaching maturity may be needed in some.

Please take rest in left lateral position to improve uterine blood supply. Take a healthy diet XXXXXXX in all nutrients. Try to avoid stress.

Hope your query is clarified. Please feel free to contact for further clarifications. I will be happy to help.

Above answer was peer-reviewed by
Follow-up: Pregnant. Sonography showing FL and HL growth is lagging. What impact will it have on the growth of the child? 25 minutes later
As the FL is 2 weeks behind and HL is 3 weeks behind gestational maturity (34 weeks).Is there any evidence of achondroplasia.Also does the raised resistance index have a impact on the growth of the fetal long bones which are currently lagging behind.
Are the fetal biometry readings provided more or less normal reading when compared with other pregnancy cases
Answered by Dr. Shanti Vennam 6 hours later
Brief Answer:
Not likely to be achondroplasia.

Detailed Answer:

Thanks for writing back.

Achondroplasia is usually observed as early as the first trimester when there is a lag of growth falling below the third percentile. Also, there are some certain diagnostic criteria like early shortening of long bones, FL/AC ratio < 0.16, hypoplastic thorax etc. that point to lethal cases.

As the growth chart of your baby was normal until now, a single ultrasound is not enough. It is possible to have a variation of 2 weeks in the findings and this is why a sonologist usually reports the findings as + or - 2 weeks. The other possibility is a hereditary shortening of long bones. Repeat sonograms, preferably 3D, can provide a better idea.

Umbilical artery resistance is noted and this can affect the growth of the baby. Though, as the baby is nearing maturity, early delivery can be planned by monitoring regularly.

The fetal biometry readings, as mentioned earlier, are within normal limits except the head circumference, which is on the higher side and this can be confirmed by a repeat sonogram. Isolated abnormal reading has to be confirmed before coming to a conclusion.

Hope your query is answered. Please contact for further information. I will be ready to help.

Above answer was peer-reviewed by
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