الفهرس 
Intrauterine growth restrictionOnly 14 pages are availabe for public view
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Abstract
The most widely used definition of IUGR is a fetus whose estimated weight is below the 10th percentile for its gestational age. At term, the cutoff birth weight for IUGR is 2,500 g. approximately 70 percent of fetuses with a birth weight below the 10th percentile for gestational age are constitutionally small; in the remaining 30 percent, the cause of IUGR is pathologic. Ultrasound biometry of the fetus is now the gold standard for assessing fetal growth. The measurements most commonly used by ultrasound are the biparietal diameter, abdominal circumference, and femur length. Diameter have been established for each of these parameters, and fetal weight can be calculated. The management of IUGR must be individualized for each patient. In addition to managing any maternal illness, a detailed sonogram should be performed to search for fetal anomalies, and karyotyping should be considered to rule out aneuploidy if suspected. The thymus is an organ that develops mainly from endoderm at the 3rd and 4th pharyngeal pouches during embryogenesis. It is composed of the inner medulla and peripheral cortex, and it is surrounded by an outer capsule. It starts to develop around the 9th week of human development, and it is fully developed by birth. So, the aim of this study is to evaluate a possible predictive role of sonographically estimated fetal thymus size in relation to fetal biometric measurements in pregnancies complicated by intrauterine growth restriction (IUGR). To elucidate our aim, this study was prospective controlled observational study was conducted on 40 pregnant women with IUGR and 40 normal pregnancy who attended to department of Obstetrics & Gynecology of Menoufia University Hospital, during a period time from Aprile 2022 to May 2023.
All the studied patients were undergoing the following: Complete history taking including Gestational age at enrollment, History of abortion, History of stillbirth, History of PTL and History of IUGR. Thorough examination: Fetal biometric indices include Head circumferences (HC), abdominal circumferences (AC), expected fetal weight (EFW), biparietal diameter (BPD) and femur length (FL) and Amniotic fluid volume assessment. Measurement of fetal thymus size the transverse diameter of the thymus is measured; the thymus is visualized on a transverse section of the fetal chest posterior to the sternum and anterior to great vessels of the heart (3-vessel view). The result of this study could be summarized as follow: - There was no significant different between cases and control regarding Gestational age at enrollment, history of abortion and history of still birth while history of preterm labor and history of intrauterine growth retardation showed significantly higher percent among cases than control (P <0.001). - The thymus diameter was of significantly higher value among control than cases (P= 0.001). - There was significant different between cases and control regarding BPD diameter, FL diameter, EFW and AF DVP (P <0.001). - ROC curve analysis demonstrated that thymus diameter has AUC was 0.75, 95% CI was 0.63-0.87, P value was <0.001, cutoff point was 25.5, sensitivity was 87.5%, Specificity was 75.0%, PPV was 77.8%, NPV was 85.7 % and accuracy was 81.25%.