Pregnancy and Abortion

Good News for Pregnant Women — a Breakthrough in the Diagnosis of the Fetal Head

A new study conducted in the Afula Emek Hospital valley sheds light on the diagnosis of a fetus in pregnancy. It concludes that the criteria used to examine a fetal head so far was inaccurate, which often resulted in parents panicking and conducting a series of unnecessary tests.

The fetal head is measured by ultrasound. This inspection is done routinely during pregnancy, and it examines various parameters of the fetus’s condition, such as the scope of his stomach, the femur length, head circumference and the like. Measurement of fetal head circumference is one of the most pivotal tests, since it indicates the age of the fetus and how it is developing. For example, a smaller than normal head circumference usually indicates motor and mental retardation, language difficulties and more. Just to show the seriousness of the matter — in some, albeit rare, cases, a woman whose fetus was diagnosed with a too small head was pushed to have an abortion (!) instead of giving birth to a deformed baby, G-d forbid.

One such case happened to S. who received an incorrect diagnosis of the size of her baby’s head when she was pregnant with her first child: “When the doctor told us that the size of our son’s head was small compared to the rest of the body,” says S, “We panicked and asked what were the implications of such a situation for the future. The doctor explained to us in detail the various problematic syndromes that our son might suffer from after he is born. Over the next few weeks we went through another series of tests, which indicated the same finding, and we were frightened out of our wits. Only the third time that I did the ultrasound tests did the doctor assure me that the size of the head was normal.”

Prof. Eliezer Shalev, director of the Department of Obstetrics and Gynecology at the Emek Hospital, and Dean of the Faculty of Medicine at the Technion, and Dr. Etti Spiegel, Senior Physician of the Ultrasound Unit in the Department of Obstetrics and Gynecology at the hospital are behind the study and its findings. The study findings revealed that of 17,705 women who were studied (who were pregnant from week 12 to week 42) over 12 years, one-fifth received an incorrect diagnosis about the size of the fetal head, which was incorrectly diagnosed as being too small.

According to Dr. Spiegel, current criteria by which they measure fetal head today, were established in the 80’s in the United States, and they lack important adjustments for different populations.

“You can’t copy criteria of one population for another,” she explains. “If we apply the criteria for the Scandinavian population to the Chinese, the result will be that all Chinese fetuses will be predicted potential dwarfs. They are now implementing a reform in this matter throughout the whole world.”

The new growth curve developed in the study is adapted to the Israeli public, and now they expect that only in a tenth of the previous cases of incorrect diagnosis will women have to undergo additional tests to recheck the results.

So what happens when there is a suspicion that the head is too small, you ask? In this case, 30% of women will be sent to the ultrasound unit for monitoring. The doctors hope they will completely eliminate wrong diagnoses, but they are anyway cautious not to promise anything, for fear of being sued for falsely promising a healthy child.

“A doctor who is not familiar with the new curve will usually send a woman for genetic counseling, amniocentesis, etc.,” adds Dr. Spiegel, “when in fact, all he has to do is simply use the new curve to save a woman unnecessary stress and panic.”

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