Clinical monitoring of foetal growth:-What to asses periodically in Pre sonography era??

Serial Biometric Growth Pattern.

1.                      Mat Wt gain	First trimester at least 1 kg. From 32 W to 36 W =27 Gm /day. &	Second tri=5 Kg.  Usual wt gain is 0.5 Kg/week, per day 24 Gm F. Wt gain 36-40 weeks.	Total gain by 3rd Tri=11 Kg. Usual wt gain in > 2Kg /month.
2.                      SFH	If clinically SFH lags 4 cm then possible FGR.		Apply Johnsons Formula.
3.                      Mat AC	Standard rise of AC of mother 2.5 cm /weekly after 30 week.	At term mat AC is inches means gest age in weeks.
4.Clinical assess of LA
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Apply Johnsons Formula & in calculation of foetal wt.:- Ht of fundus in Cm -12 ÷  12 × 155 + wt of foetus as calculated clinically. This is true if vertex is above I spines.

Relevance of measuring Maternal AC in unbooked cases where pregnancy dating has not been done due to late attendance?:- upto 20-30 weeks:- Ht in cm is equal to week in gestation. After 20 weeks of gest. The SFH should grow by 1 cm/week. If less then close follow up mandated. It can pick up as many as 40% of FGR cases by clinical means alone. If seriously measured then such clinical serial biometry can pick up as many as 70-85% specific in the of FGR cases. , 96% specific.

Relevance of measuring SFH at 32-36 weeks: - If the pregnancy is well dated & later if one notices that there is growth lag> 3 cm during the gest period of 32 to 36 Weeks-> if Fundal lengths less 3 cm then FGR suspected on clinical biometry. Relevance of measuring SFH at 36 weeks & later: - If there is well dated pregnancy then if Fundal lengths less 2 cm then F