Antenatal detection and management of small for gestational age (SGA) is a wellknown strategy to prevent stillbirth. The Growth Assessment Protocol (GAP), an evidence-based antenatal intervention, was created to address the problem that most SGA fetuses are missed antenatally . GAP utilizes customized centile charts for fundal height and estimated fetal weight measurements.
It also involves training and accreditation of clinical staff, audit programs, and benchmarking of performance. 1 However, previous observational studies have provided conflicting results regarding the effect of GAP in detecting SGA antenatally and in reducing stillbirths. 2,3 Investigators from England have conducted an interventional DESiGN trial ( DEtection of Small for GestatioNal age fetus ) with a primary aim to determine if the implementation of GAP results in improved ultrasound detection of SGA compared to…
