A model for diagnosing fetal growth restriction using functional diagnostic methods
Volochaeva M.V., Timofeeva A.V., Fedorov I.S., Kan N.E., Tyutyunnik V.L., Ryzhova K.O., Gasymova Sh.R.
Objective: To enhance the differential diagnosis of fetal growth restriction (FGR) and small-for-gestational-age (SGA) fetuses using functional diagnostic methods.
Materials and methods: This case-control study included 13,232 patients who were divided into three groups. Group 1 comprised pregnant women with FGR (n=242), group 2 included pregnant women with SGA (n=395), and group 3 consisted of pregnant women without FGR and SGA (n=12,595). Postnatally, neonatal length and height indicators were assessed according to the INTERGROWTH-21 centile curve. The sample for model development and training consisted of 13,232 patients, while a test sample of 1,843 patients was used to evaluate the model's performance.
Results: The developed formula (1), which includes fetal abdominal circumference (mm) (AC), right uterine artery pulsatility index (RUtA-PI) (percentile), and cerebro-placental ratio (CPR) (percentile), enabled the diagnosis of FGR with a sensitivity of 84% and a specificity of 82%. To differentiate between SGA and FGR, a second formula (2) was created, incorporating AC (mm), uterine artery pulsatility index (UA PI) (percentile), and middle cerebral artery pulsatility index (MCA PI) (percentile). This formula allows for the diagnosis of SGA as distinct from FGR, with a sensitivity of 67% and specificity of 88%.
Conclusion: The developed formulas facilitate the diagnosis of FGR and SGA, enabling timely decision-making regarding pregnancy management strategies. This approach aims to reduce the incidence of iatrogenic interventions, neonatal morbidity, and mortality while improving the quality of medical care.
Authors' contributions: Volochaeva M.V., Timofeeva A.V., Fedorov I.S., Kan N.E., Tyutyunnik V.L., Ryzhova K.O.,
Gasymova Sh.R. – conception and design of the study, acquisition of data for analysis, review of relevant literature, material processing and analysis, statistical analysis, drafting of the manuscript, editing of the manuscript.
Conflicts of interest: The authors have no conflicts of interest to declare.
Funding: The study was conducted within the framework of the initiative project «Epigenetic Criteria for Diagnosing Fetal Growth Delay from the Perspective of Neurogenesis Dysfunction». Research Project No. 19-И23 dated December 8, 2022. Registration number in the EGISU NIOKTR system (state accounting) – 123060500032-8.
Ethical Approval: The study was reviewed and approved by the Research Ethics Committee of the V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia.
Patient Consent for Publication: All patients provided informed consent for the publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.
For citation: Volochaeva M.V., Timofeeva A.V., Fedorov I.S., Kan N.E., Tyutyunnik V.L., Ryzhova K.O.,
Gasymova Sh.R. A model for diagnosing fetal growth restriction using functional diagnostic methods.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (2): 31-39 (in Russian)
https://dx.doi.org/10.18565/aig.2025.15
Keywords
fetal growth restriction
small-for-gestational-age fetus
ultrasound diagnostics
Doppler ultrasound examination
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Received 27.01.2025
Accepted 13.02.2025
About the Authors
Maria V. Volochaeva, PhD, Senior Researcher at the Department of Regional Cooperation and Integration, Physician at 1 Maternity Department, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4,+7(919)968-72-98, volochaeva.m@yandex.ru, https://orcid.org/0000-0001-8953-7952
Angelika V. Timofeeva, PhD (Bio), Head of the Laboratory of Applied Transcriptomics, Academician V.I. Kulakov National Medical Research Center for Obstetrics,
Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, avtimofeeva28@gmail.com, https://orcid.org/0000-0003-2324-9653
Ivan S. Fedorov, Researcher at the Laboratory of Applied Transcriptomics, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, is_fedorov@oparina4.ru, https://orcid.org/0000-0002-2104-5887
Natalia E. Kan, Professor, Dr. Med. Sci., Deputy Director General for Research – Director of the Institute of Obstetrics, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, kan-med@mail.ru,
Researcher ID: B-2370-2015, SPIN: 5378-8437, Authors ID: 624900, Scopus Author ID: 57008835600, https://orcid.org/0000-0001-5087-5946
Victor L. Tyutyunnik, Professor, Dr. Med. Sci., Leading Researcher at the Center for Scientific and Clinical Research, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, tioutiounnik@mail.ru,
Researcher ID: B-2364-2015, SPIN: 1963-1359, Authors ID: 213217, Scopus Author ID: 56190621500, https://orcid.org/0000-0002-5830-5099
Kristina O. Ryzhova, Resident, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia,
117997, Russia, Moscow, Ac. Oparin str., 4, cr.yanina@gmail.com, https://orcid.org/0009-0007-8318-435X
Shagane R. Gasymova, Junior Researcher at the Department of Fetal Medicine, Institute of Obstetrics; Ultrasound diagnostics doctor, Department of Ultrasound and Functional Diagnostics, obstetrician-gynecologist, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology,
Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, shagane2501@mail.ru, https://orcid.org/0009-0001-2626-6670
Corresponding author: Maria V. Volochaeva, volochaeva.m@yandex.ru
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