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PubMed2001

Biomicroscopic measurement of the optic disc with a high-power positive lens.

PURPOSE: To compare the magnification properties of four different indirect double aspheric fundus examination lenses for clinical disc biometry. METHODS: Experimental study in a model eye. The relationship between the true size of a fundus object and its image was calculated for each fundus lens for an ametropic range between -12.5 and +12.6 D using a slit lamp biomicroscope with adjustable beam length. RESULTS: Equations for determining the correction factor p (degrees per millimeter) were calculated for each fundus lens. The factor can be used in calculations to determine true optic disc size. The total change in magnification of the system from myopia to hyperopia was -21.1% to +24.0% (60-D lens; Volk Opticals, Mentor, OH), -12.9% to +16.2% (Volk super 66 stereo fundus lens), -13.2% to +13.9% (Volk 78-D lens), and -13.3% to +14.0% (Volk super-field NC lens). When the fundus lens position was altered im relation to the model eye by +/-2 mm under myopic conditions, the change in magnification of the system was -4.3% to +5.7% (60-D lens), -4.6% to +6.1% (66 stereo fundus lens), -4.9% to +6.3% (78-D lens), and -5.9% to +7.8% (super-field NC lens). In the hyperopic condition the change was -2.7% to +3.6%, -3.4% to +4.5%, -3.6% to +4.8%, and -4.5% to +6.0%. CONCLUSIONS: The study has shown that the use of a single magnification correction value for each fundus lens may not be appropriate. These findings have important implications for the way in which calculations for determining the true optic disc size and other structures of the posterior pole are performed using indirect biomicroscopy.

Diagnostic Techniques, Ophthalmological↗
PubMed2000

Use of linear mixed models to detect irregular fetal growth.

Ultrasonographic fetal biometry data can be used to estimate fetal weights repeatedly over time. Different types of reference bands have been presented to judge such data. But relevant aspects of an individual growth curve are not taken in to account. How can individual growth curves be used efficiently to detect irregular fetal growth? Linear mixed model analysis of a sample of 167 uncomplicated pregnancies with 304 ultrasonic measurements revealed that a random intercept model is sufficient and heterogeneity in slopes is negligible. Hence irregularity of a sequence of weights can be captured by three quantities' residual level, trend and mean squared error' for which reference ranges are derived from the fitted model. After standardization they are independently normal and chi-square distributed in the reference population. Regularity of fetal growth may then be reported in terms of level and trend either in the form of Z-scores or as percentile indices. A sample of 97 pregnancies diagnosed as cases of chronic placental insufficiency postnatally is analysed to validate the ability to detected abnormal growth. Only the mean level and slope revealed to be able to detect IUGR. MSE was not discriminative. The sensitivity of the method depends on the number and placement of observation times, which opens the possibility of a model-based cost-effectiveness analysis. The derived scores make efficient use of available information and are easily implementable into any computer based monitoring device.

Decision Making, Computer-Assisted↗
PubMed1997

Quantitative real time measurement of iris configuration in human eyes.

PURPOSE: To evaluate intraobserver and interobserver reproducibility of real time measurement of iris morphology in living human eyes. METHODS: Based on the platform of software (Autocad, version 12), we developed an ultrasound biomicroscopy (UBM) image assistant measuring system. By using the system, we can perform the iris configuration quantitative measurement in living eyes. The measuring parameters including: iris rest length, radius of iris curvature, and the thickness in different parts of iris. Ten anterior segment images of one normal individual were obtained by a single operator to evaluate the intraobserver reproducibility of image capture, and ten times measurement of one image were performed by a single operator to assess the reproducibility of image measurement. The measurement of three independent observers were compared to investigate interobserver reproducibility in quantitative measurement. Intraobserver and interobserver reproducibility of measurement were assessed by calculating the coefficient of variation for each individual observer and by using the F test to detect a difference among observers. The iris configuration of 96 subjects (192 eyes) were measured. RESULTS: Intraobserver reproducibility was ranged from 0.9-4.9% in all measured parameters. Interobserver reproducibility for some of measured parameters varied considerably and was affected by subjective interpretative of visualized anatomic landmarks. The preliminary measured parameters in Chinese Show that iris rest length is 3.699 +/- 0.397 mm, radius of iris curvature is 9.101 +/- 1.408 mm, the average thickness of iris is 0.406 +/- 0.042 mm. CONCLUSION: The intraobserver reproducibility and the measured accuracy can fit the requisition of the ocular biometry and of the ocular physiology, pathophysiology, and pharmacology study. The method supply a new assistance for UBM image measurement.

Adult↗
PubMed2000

[Risk assessment of vertical transmission of Toxoplasma infections].

BACKGROUND: It is important to estimate the risk of congenital toxoplasmosis infection and its clinical sequelae. This information will assist the clinical counselling of pregnant women with acute toxoplasmosis and may guide individual decisions on investigative and therapeutic options. METHODS AND PATIENTS: Since January 1998 to July 2000 we collected data on 63 pregnant women referred to our Prenatal Diagnosis Centre for suspicion of acute maternal toxoplasmosis. In case of positive screening tests for IgG and IgM or documented seroconversion, we sent samples of maternal serum to a reference laboratory to detect specific IgM, IgG, IgA antibodies and IgG avidity. We estimated the risk of mother-to-child transmission as high or low in relation to gestational age at the time of maternal seroconversion. Antiparasitic treatment with spiramycin since before confirmation of infection and evaluation of fetal biometry were done. In high risk women we advised amniocentesis for polymerase chain reaction (PCR). If infection was diagnosed in the fetus, the regimen of treatment was changed. Live-born children of all these mothers were followed up serologically for at least 1 year. RESULTS: In 13/63 cases (20%) we excluded maternal infection. Thirty-six out of 63 cases (57%) with high transmission risk underwent an amniocentesis, except one case requesting termination of pregnancy. Four out of the remaining 14 cases estimated at low risk had an amniocentesis for maternal anxiety. Among high risk women, PCR on amniotic fluid was positive in 4 cases (10%): 2 of these requested pregnancy termination, while the other 2 decided to proceed with the pregnancy and the therapy was shifted to 3 weeks courses of pyrimethamine and sulphadiazine with folinic acid alternating with spiramycin. Five infants were lost at follow-up, 20 babies resulted not infected and the remaining 21 are still followed-up. CONCLUSION: It is possible to select by specific serological tests, high risk cases for mother-to-child transmission of infection and to decide a specific approach.

Female↗
PubMed1975

[Acoustic investigations in orbital tumor diagnosis (author's transl)].

360 patients with unilateral exophthalmos were examined with echoophthalmograph to study the diagnostical possibilities of a method of echography in orbital tumors. The findings of para- and transbulbal methodics were checked in 140 patients. The tonometry of tumors and soft orbital tissues was performed. The methodics of acoustic orbitonometry based on the measurement of retrobulbal neoplasms at the moment of their step-by-step compression was worked out. The echographic symptoms of different orbital neoplasms is described as well as those of pseudotumor and tireotropic exophthalmos. The possibility of acoustic measurement of orbital neoplasms is shown. The dependence between the extent and progress of deformation in the exophthalmed eye on one hand-nature of exophthalmos, character and localization of the tumor on the other was revealed. The quantitative data about the compression of different orbital tumors were obtained. It was shown that the surveying echography, biometry and acoustic orbitonometry facilitate the task of differential diagnosis, allow the localization and size of the tumor to be detected and help to control the results of the treatment.

Anthropometry↗
PubMed2001

[Ultrasonographic assessment of pregnancy development after endometriosis treatment].

Investigated group comprised pregnant women after sterility treatment, which underwent obstetrical care in Institute of Obstetrics and Gynaecology Medical Academy of Łódź in years 1998-2000. In the first group were 25 pregnant women after endometriosis treatment, the second one 23 healthy pregnant women. At term were performed ultrasound examinations (biometry and estimated fetal weight) than were assessed neonatal weight in both groups. There were found the similar mean age in both groups, but in the group after treatment more women in age over 30 years were observed (not significant). The higher weights were observed in the group of healthy pregnant women in ultrasound fetal estimation before delivery (about 343.5 g) and neonatal weight after delivery (about 407 g) but without significance. There is possibility of the better vascular development in the feto-maternal circulation in the course of pregnancy in healthy women than after endometriosis treatment, but for the correct conclusions should be made further research on larger collectives. Ultrasound assessment is a useful method in prenatal diagnostic with possibility of precise analysis of the fetal development.

Adult↗
PubMed2001

[Risks associated with exposure to cytostatics in health care personnel].

RISKS RELATED TO HANDLING: Cytostatic drugs (CS) destroy malignant cells. However, they also have deleterious effects on healthy cells. Manufacturing staff and nurses may suffer from side effects when handling these molecules. WHAT TYPE OF RISKS?: Laboratory staff and nurses handling these molecules are exposed to sub-therapeutic concentrations of these products, which induce little known biological effects. Cytostatics can provoke allergies, mutations and probably have carcinogenic and teratogenic effects. ASSESSMENT OF EXPOSURE: Exposure can be assessed by calculating the index of cytostatic contact. Medical surveillance includes measurement of he surrounding metrology and specific biometry. PREVENTION: Basic preventive measures include the wearing of masks, gloves and overalls and the installation of vertical laminar flow hoods.

Antineoplastic Agents↗
PubMed1998

[Quantitative real time measurement of iris configuration in living human eyes].

OBJECTIVE: To evaluate the intraobserver and interobserver reproducibility of real time measurement of iris morphology in living human eyes. METHODS: Based on the platform of software (Autocad, version 12), we developed an ultrasound biomicroscopy (UBM) image assistant measuring system. Using the system, we can perform the iris configuration quantitative measurement in living eyes. The measuring parameters include: iris rest length, radius of iris curvature and the thickness of different part of iris. Ten anterior segment images of one normal individual were obtained by a single operator to evaluate the intraobserver reproducibility of image capture, and ten times of measurement of one image were performed by a single operator to assess the reproducibility of image measurement. The measurements of three independent observers were compared to investigate interobserver reproducibility in quantitative measurement. Intraobserver and interobserver reproducibility of measurement were assessed by calculating the coefficient of variation for each individual observer and by using F test to detect a difference among the observers. The iris configurations of 96 subjects (192 eyes) were measured. RESULTS: Intraobserver reproducibility ranged from 0.9 - 4.9% in all measured parameters. Interobserver reproducibility for some of the measured parameters varied considerably and was affect by subjective interpretation of visualized anatomic landmarks. The preliminary measured parameters in Chinese show that iris rest length is 3.699 +/- 0.397 mm, radius of iris curvature is 9.101 plus minus 1.408 mm, the average thickness of iris is 0.406 +/- 0.042 mm. CONCLUSIONS: The intraobserver reproducibility and the measured accuracy can fit the requisition of the ocular biometry, physiology and pharmacology studies. The method supplies a new assistance for UBM image measurement.

Female↗
PubMed2002

Mechanisms of myopia in Cohen syndrome mapped to chromosome 8q22.

PURPOSE: To analyze the mechanisms of myopia in Cohen syndrome (Mendelian Inheritance in Man [MIM] no. 216550). METHODS: A cross-sectional study of 22 Finnish patients (age range, 2-57 years) with Cohen syndrome, which maps to chromosome 8q22, was undertaken to record cycloplegic refraction, keratometry (corneal power and radius of curvature), biometry (anterior chamber depth [ACD], lens thickness [LT], axial [AL] and vitreal length [VL]), and Hoffer Q-modeled lens power. These components of refraction were correlated to age and spherical equivalent (SE) at the corneal plane. Contribution to total myopia of refractive (corneal and lenticular) and axial components was modeled by multiple linear regression and by estimating the effect of deviation from population mean values. RESULTS: The mean SE in patients with Cohen syndrome older than 10 years was -9.35 D; the mean cylinder power, +1.70 D; and the mean anisometropia, 0.53 D. Relative to the emmetropic eye of a young adult, the AL and VL (mean, 23.9 and 16.6 mm, respectively) and lens power (mean, 30.30 D) were higher in 74% and 93% of patients, respectively, and the ACD (mean, 2.5 mm) was smaller and the LT (mean, 4.9 mm) and corneal power (mean, 45.63 D) higher than average in all patients. Corneal power (r = 0.513, P = 0.021) increased with age, but AL and VL (P = 0.46 and 0.54, respectively) and lens power (P = 0.89) did not correlate with age. The lens power decreased with AL (r = -0.564, P = 0.029) and tended to increase with corneal power (r = 0.475, P = 0.074). Multiple linear regression identified AL and corneal power as independent predictors of SE. Based on deviation from population means, the lens power explained 55%, corneal power 23%, and AL 22% of total myopia. ACD decreased and LT increased markedly with age, rendering angle-closure glaucoma a possibility. CONCLUSIONS: Myopia in Cohen syndrome is mainly refractive in type and is due to high corneal and lenticular power, which is otherwise rare in young patients. It may be superimposed on axial myopia, probably related to polygenic factors that determine myopia in the general population. The refractive myopia in Cohen syndrome may result from dysgenesis and atrophy of the cornea, ciliary body, and iris, which in turn cause iridial and zonular laxity and spherophakia.

Abnormalities, Multiple↗
PubMedDate not supplied

[Calculation of gestational age. Methods and problems].

Gestational age assignment is one of the most important issues in perinatal medicine. Nowadays, the first day of the last menstrual period, when available, is still used as the basis for calculation of gestational age and expected day of confinement. However, most frequently this date is uncertain or even unknown, and thereby gestational age can be confidently estimated by ultrasonographic biometry until 22 weeks of gestation. There is no uniform dating policy when both a valid last menstrual period and ultrasonographic dates are available in determining the date of confinement. When both methods are compared, there are obvious advantages of routine scanning in the first half of pregnancy.

Female↗
PubMed2002

Magnification characteristic of a +90-diopter double-aspheric fundus examination lens.

PURPOSE: To investigate the magnification characteristic of the +90-D double-aspheric fundus examination lens for biomicroscopic measurement of the optic disc. METHODS: A calibrated Gullstrand-type model eye adjusted for axial ametropia between -12.5 and +12.6 D was used to measure the change in magnification of the system with refractive error and variation in fundus lens position. A correction factor p (in degrees per millimeter) at different axial ametropias was also calculated. RESULTS: The total change in magnification of the system from myopia to hyperopia was -15.1% to +13.7%. When the fundus lens position was altered with respect to the model eye by +/-2 mm under myopic conditions, the change in magnification of the system was -4.8% to +8.1%. In the hyperopic condition the change was -4.8% to +6.0%. The fundus lens exhibited a linear relationship between p and the degree of ametropia of the model eye and a constant relationship between p and ametropia of -5 to +5 D. CONCLUSIONS: Axial ametropia has a significant effect on biomicroscopic measurement of the optic disc with the +90-D lens. Therefore, a correction factor (p) was calculated that can be used in calculations for determining true optic disc size. These findings may be important for improving clinical disc biometry.

Fundus Oculi↗
PubMed2002

[Morphology and distribution of Thysanophora crinita (Stylommatophora: Thysanophoridae) in Nicaragua].

A morphological characterization of Thysanophora crinita (Fulton, 1916-1917), including a redescription of the shell and the first description of the genital system, the radula and the jaw, are made based on 58 living individuals and 1378 empty shells; the sample considered for biometry was of 81 specimens. Means and ranges were 3.51 mm (2.6-4.9) diameter and 2 mm (1.5-2.5) height. This species exhibits a discoidal-depressed shell, with an opaque hairy periostracum as its most remarkable feature. The genital system is typical of the genus, with a well developed penis and a pear-shaped bursa copulatrix. Jaw: 16 to 18 narrow plates and radula with 72 transversal rows, formula: (C/3 + 5L/2 + 6M/2) x 2. The Nicaraguan populations of T. crinita are very similar to T. crinita from Cartagena and T.c. arubana, and show dimensions intermediate between both. This species was previously known from Carthagena, Colombia and is reported from Nicaragua for the first time. A distribution map is included.

Animals↗
PubMed2002

Validation of a birth weight prediction equation based on maternal characteristics.

OBJECTIVE: To validate the accuracy of a birth weight prediction equation based on maternal and pregnancy-specific characteristics and to assess its value in predicting fetal macrosomia. STUDY DESIGN: A previously published birth weight prediction equation based on maternal and pregnancy-specific characteristics was used to predict birth weight in 244 Caucasian gravidas with uncomplicated, singleton, term pregnancies. Results were assessed by calculating the mean absolute error, the mean absolute percentage error and the percentage of birth weights correctly predicted to within +/- 10% and +/- 15% of actual birth weight. The sensitivity, specificity and positive and negative predictive value for predicting fetal weight > 4,000 g were calculated. RESULTS: Birth weight was accurately predicted to within an average of +/- 8.1% (+/- 280 g). The percentage of weights accurately predicted to within 15% of actual birth weight was 87%, and the percentage predicted to within +/- 10% was 68%. The sensitivity for predicting fetal weight > 4,000 g was 52%, specificity 90%, positive predictive value 42% and negative predictive value 93%. The area under the receiver operating characteristic curve for predicting fetal macrosomia was 0.83. CONCLUSION: An equation using maternal and pregnancy-specific characteristics can predict term birth weight in gravidas with uncomplicated singleton pregnancies to within +/- 8.1% (+/- 280 g). The accuracy of the method for predicting birth weight > 4,000 g is comparable to that obtained using ultrasonic fetal biometry.

Adult↗
PubMed2002

Increasing trend of illicit drug abuse in Thai parturient at Siriraj Hospital.

OBJECTIVE: To report the magnitude of the problem and to evaluate the outcome of maternal illicit drug use in Thai parturients. DESIGN: Retrospective case-control study. SETTING: Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University. SUBJECT: The subjects were 44,640 parturients who had deliveries at Siriraj Hospital from January 1998 to December 2001 and were divided into two groups. The study group consisted of 66 parturients with a history of illicit drug use and the control group consisted of 44,574 parturients without a history of illicit drug use. INTERVENTION: Medical records of 66 parturients with a history of illicit drug use were reviewed. Obstetric statistics of the department were retrieved from the computerized database in the Division of Obstetric and Gynecologic Registry. The data were analyzed using descriptive statistics. MAIN OUTCOME MEASURE: Characteristics of parturients, pregnancy outcome, type and incidence of illicit drug. RESULTS: Within the study period, 66 cases of maternal illicit drug use were identifiable during the intrapartum period; 65 cases used amphetamine or derivatives and 1 case used an opioid derivative. The number had risen from 1 case in 1998 to 58 cases in 2001. Mean age of the patients was 23.30 +/- 6.04 years. Compared to the control group which included 44,574 parturients, the patients had a lower incidence of antenatal care (ANC rate = 21.21% vs 94.35%; RR = 0.23, 95% CI = 0.14-0.26), a higher incidence of HIV infection (10% vs 2%; RR = 6.09, 95% CI = 2.83-13.12), a higher incidence of birth before arrival (BBA rate = 9.09% vs 1.06%; RR = 8.59, 95% CI = 3.98-18.51), and a lower cesarean section rate (10.60% vs 26.36%; RR = 0.40, 95% CI = 0.20-0.81). There were no serious intrapartum, immediate postpartum and neonatal complication. Fetal outcome included a higher incidence of low birth weight infants (22.73% vs 10.23%; RR = 2.22, 95% CI = 1.42-3.46) and a smaller head circumference than the normal range of Thai fetal biometry (31.85 +/- 1.47 cm). CONCLUSION: There is an increasing trend of illicit drug use in Thai parturients. Although the present case series of drug abuse in Thai parturients cannot give the whole picture of maternal drug abuse in the Thai population, the dramatic increase in the identifiable cases during the past 4 years is very alarming. Currently, the outcome of pregnancy in case detected during intrapartum is not much different from that in the general population. However, there are potential risks for the patients and their babies. All medical staffs should be aware of this condition. Careful clinical data gathering and laboratory testing are suggested for prevention of complications and the potential hazards of this problem.

Adolescent↗
PubMed2000

[Ocular axial length and refractive changes in pediatric pseudophakia].

PURPOSE: To evaluate the ocular axial length and refractive changes that occured in children who had cataract extraction with intraocular lens implantation and to investigate the factors that influenced the pseudophakic refraction. METHODS: A review of 12 eyes in 10 children (mean age 7.16 years, range 3.83 to 10.16 years) who had cataract extraction with intraocular lens implantation was undertaken. Patients were followed for an average of 35.8 months. The preoperative and the last postoperative axial length and corneal curvature (K readings) in both operated and unoperated eyes were measured. The distance from the vertex of the cornea to the anterior vertex of intraocular lens (AVpc) was measured in the final follw-up. The initial (in two weeks) and the last refractive status of pseudophakia were examined. Overall age at surgery averaged 7.16 years (range 3.83 to 10.16 years), with followed up of 35.8 months. RESULTS: In the 12 operated eyes, the mean axial growth was 0.39 mm, whereas in the other eight unoperated eyes it was 0.66 mm. Though the axial length of both eyes increased significantly after surgery (P < 0.05), there was no significant difference in the postoperative increase of axial length between the two groups(P > 0.05). In K readings, there was no significant difference between the operated and unoperated eyes before surgery and in the last follow-up respectively. There was no significant difference between the preoperation and the last follow-up in the operated and the unoperated eyes respectively. The average calculated AVpc (AVpc2) was 4.66 30 mm, but the average objective AVpc (AVpc1) measured with ultrasonic biometry was 3.83 mm. The average difference between them was 0.8320 mm and was significant (P < 0.01). According to SRK formula, using preoperative and the last postoperative axial length and corneal curvature to predict refractive changes, the myopic shift was -1.53 D, but the average objective refractive difference between the last and initial examination after surgery was -3.86 D. The average difference between the predicted and actual postoperative refractive changes was significant (P < 0.05). CONCLUSION: Our study suggests that there may be no effect on ocular growth in children (3 to 10 years) followed cataract extraction and intraocular lens implantation. Increasing of axial length and moving forward of intraocular lens induced by complication may result in myopic shift in pseudophakia of children. Slightly undercorrected eyes with intraocular lens in children after cataract extraction will gradually move to emmetropia or moderate myopia in adulthood.

Adolescent↗
PubMed2002

[Doppler monitoring of fetal circulation from multiple arteries over several days to improve evaluation of fetal prognosis].

Intrauterine growth retardation and fetal hypoxia are currently related to placental insufficiency. Fetal biometry assessed by echography is entirely adapted to follow the growth and integrity of the principal fetal organs. Hypoxia induces an hemodynamic adaptation which can be detected and quantified by Doppler. The objective of this article is to review the evolution of the fetal Doppler practice for the last 20 years and especially to show that isolated Doppler measurement and only from one site (umbilical or cerebral or aortic) have a moderate negative predictive value of fetal outcome, compared to the study of the fetal hemodynamic evolution (degradation) from several sites and during several days. We will insist on the fact that (a) umbilical Doppler only gives information on placental blood flow and this information does not reflect neither the adaptation to hypoxia nor the consequences of this adaptation, (b) cerebral Doppler accounts for the vascular response to the pO(2) reduction but it does not allow to predict the consequences of this response, (c) the simultaneous study of the placental hemodynamic time course degradation and the cerebral vascular response to hypoxia allows quantification of the cumulative deficit of fetal oxygenation during this period and evaluation the adverse consequences of a sustained flow redistribution toward the brain. Finally, if cerebral vasodilation in response to hypoxia can be considered as a physiological compensatory mechanism, it is associated after several days to the appearance of irreversible fonctional (abnormal fetal heart rate) or organic (cerebral lesions) abnormalities. Adverse effects of this process are illustrated during episodes of acute hypoxia (malaria crisis of several days) or during sustained exposure of the fetus to hypoxia (pregnancy-induced hypertension).

Cerebrovascular Circulation↗
PubMed2003

Prediction of intrauterine growth restriction with customised estimated fetal weight centiles.

OBJECTIVES: 1. To determine the value of third trimester customized estimated fetal weight centile ranking in the prediction of infants born with anthropometric features of intrauterine growth restriction (IUGR). 2. To compare the performance of customized centiles with fetal growth velocity in the prediction of IUGR. DESIGN: Prospective, observational study. SETTING: Department of Obstetric Ultrasound. POPULATION: Two hundred and seventy-four women with low risk pregnancies who were participants in a previously published longitudinal study of fetal biometry. METHODS: Third trimester estimated fetal weight customized centiles were obtained after adjustment for gestational age at the time of ultrasound, birth order and gender, maternal weight, height and ethnic origin. Fetal growth velocity was calculated using the increment in the fetal abdominal area over a mean 28-day interval. Fetal abdominal area growth velocity was expressed as a standard deviation (Z score). Three neonatal anthropometric measures were used to define IUGR: subscapular or triceps skinfold thickness <10th centile, ponderal index <25th centile, mid-arm circumference to occipito-frontal circumference <-1 SD. The ability of estimated fetal weight customized centiles <5th centile and <10th centile to identify growth restriction was determined by calculating likelihood ratios. MAIN OUTCOME MEASURE: Likelihood ratios for the prediction of neonatal anthropometric features of IUGR. RESULTS: Two hundred and fifty-eight infants had an estimated fetal weight customized centile calculated and one or more anthropometric measurements. The mean customized estimated fetal weight centile for cases with and without a low skinfold thickness were 16.4 vs 41.7 (P < 0.01); the mean values of customized estimated fetal weight centile for cases with and without ponderal index <25th centile were 22.8 vs 42.7 (P < 0.01); mean estimated fetal weight customized centiles for cases with and without mid-arm circumference to occipito-frontal circumference <-1 SD were 26.3 vs 40.5 (P > 0.05). A customized estimated fetal weight centile of 5 or less had likelihood ratios (95% CI) of 4.9 (2.7-6.3), 6.8 (4.5-10.6) and 6.3 (3.7-14) for skinfold thickness <10th centile, ponderal index <25th centile and mid-arm circumference to occipito-frontal circumference <-1 SD, respectively. An estimated fetal weight customized centile of 10 or less had likelihood ratios of 4.5 (2.6-8.6), 4.1 (2.5-7.2) and 7.1 (3.5-24) for skinfold thickness <10th centile, ponderal index <25th centile and mid-arm circumference to occipito-frontal circumference <-1 SD, respectively. In the prediction of a ponderal index <25th centile, the fetal abdominal area velocity likelihood ratio for a positive test is higher than the likelihood ratio for the 10th estimated fetal weight customized centile (P = 0.04) but is not significantly higher for the other outcomes. The fetal abdominal area velocity likelihood ratio is not significantly higher than the likelihood ratios for the fifth estimated fetal weight customized centile for any of the three outcomes. CONCLUSION: Customized estimated fetal weight centiles in the late third trimester are moderately useful in the identification of infants with IUGR but are less accurate than calculated growth velocity in the prediction of an infant with a low ponderal index.

Female↗