ULTRASONOGRAPHIC MEASUREMENT OF CHEEK-TO-CHEEK DIAMETER IN FETAL GROWTH DISTURBANCES

OBJECTIVE: Our purpose was to assess the value of the cheek-to-cheek diameter and the cheek-to-cheek diameter/biparietal diameter ratio in the ultrasonographic detection of abnormal fetal growth. STUDY DESIGN: The cheek-to-cheek diameter and cheek-to-cheek diameter/biparietal diameter ratio were examined in 21 small-for-gestational-age (< 10th percentile for estimated weight) and 87 large-for-gestational-age (> 90th percentile) fetuses. Statistical analysis consisted of Student's t test comparison between means and analysis of covariance for comparison of regression lines slope between these 108 fetuses and previously published nomograms of appropriate-for-gestational-age fetuses. RESULTS: The mean cheek-to-cheek diameters in small-for-gestational-age fetuses were significantly smaller than in appropriate-for-gestational-age fetuses (p < 0.0001). In large-for-gestational-age fetuses the mean cheek-to-cheek diameters were significantly larger (p < 0.005). Although large-for-gestational-age fetuses of diabetic mothers exhibited higher cheek-to-cheek diameter/biparietal diameter ratios than did appropriate-for-gestational-age fetuses (p < 0.0001), in fetuses of nondiabetic mothers this ratio was only minimally larger (p < 0.05). CONCLUSION: The cheek-to-cheek diameter and cheek-to-cheek diameter/biparietal diameter ratio are innovative ultrasonographic parameters for detecting abnormal fetal growth. Futhermore, the cheek-to-cheek diameter/biparietal diameter ratio permits insight into the possible underlying pathophysiologic mechanisms of fetal macrosomia.