Several methods used in the diagnosis of intrauterine growth retardation (IUGR) were evaluated with epidemiologic techniques. The strong effect of IUGR prevalence on the positive predictive and false-positive values of these methods is discussed. If correctly used, the combination of clinical measurements and perinatal risk factors can have a predictive power as high as any of the other more sophisticated techniques. The data reviewed show that at present biparietal diameter measurements, nonstress test/oxytocin challenge test or hormone values do not contribute to a better IUGR prediction than when the above mentioned methods are applied. For IUGR detection, ultrasound evaluation should include ratios of anthropometric measurements and may be complemented with amniotic fluid volume assessment. It is suggested that these procedures be reserved to a selected high risk population. Efforts should be made to evaluate new technologies through randomized controlled trials before they are introduced to the general population, particularly in developing countries.
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