The physician can suspect IUGR based on lack of appropriate growth of the uterine fundus. Poor fundal growth with or without risk factors for IUGR should prompt ultrasound evaluation. Women at risk for IUGR should have early sonography to confirm their estimated day of delivery to aid in diagnosis. For example, a woman at 30 weeks' gestation has her first ultrasound for possible IUGR. The fetus is found to be 27 weeks by all parameters measured. It would be difficult to decide if the fetus is symmetrically growth-restricted or just due 3 weeks later. Overall, ultrasound for diagnosis of IUGR is 80% to 90% sensitive, depending on the measurements used. The abdominal circumference, a soft tissue measurement, is the first routinely measured parameter to fall behind normal growth in IUGR. Estimation of fetal weight, calculated using the abdominal circumference, can be plotted on fetal growth curves to evaluate its percentile for a specific gestational age.

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