SGA/FGR assessment

Referral/follow-up review

Maternal age:

Parity:

BMI:

Medical history:

Medications:

Previous SGA/FGR:

Smoking:

Diabetes:

Hypertension:

CST:

PAPP-A:

PET risk:

Combined uterine artery PI at anomaly scan:

AC centile at anomaly scan:

EFW centile at anomaly scan:

Today:

Blood pressure:

Urinalysis:

EFW (centile):

AC (centile):

AC velocity (centile change since anomaly scan):

Umbilical artery PI:

CPR:

DV a-wave:

Combined uterine artery PI:

Impression:

Plan: