Fifteen hundred patients were scanned to predict fetal age and weight by biparietal diameter measurement. three hundred eleven patients had more than one scan. Forty-three small for gestational age (SGA) babies were ultimately delivered in this population. Prenatal ultrasound screening criteria for grouping into appropriate for gestational age (AGA) or small for gestational age (SGA) categories were: a) only an absolute biparietal diameter below the third percentile for the reference Rochester region population; b) only delta BPD calculated as less than 50 percent of the mean growth rate for the reference population; and c) a combination of these two factors. Intrauterine growth retardation was most accurately determined when an absolutely small biparietal diameter was found (at the time of the last ultrasound examination) in a woman with accurate gestational age assessment. Least accurate was the prediction based on one biparietal diameter measurement in a woman with poor clinical dates. A 50 percent false positive detection rate and poor sensitivity to intrauterine growth retardation were found using ultrasound biparietal diameter measurements as a screening test in this manner.
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