The RCOG Green-Top Guideline for the Investigation and Management of the Small-for-Gestational- Age Fetus is available here:

The guideline reviews the available evidence and recommends

  • the use of standardised fundal height measurement
  • use of customised growth charts to plot fundal height and estimated fetal weight
  • reviews risk factors for fetal growth restriction and makes recommendations for surveillance by serial scans
  • outlines management protocols for the SGA fetus in early and late pregnancy

NHS England have since issued recommendations for risk assessment in the Saving Babies Lives Care Bundle which includes a simplified fetal growth surveillance algorithm (page 19)  

In response to requests from many units concerned about the cost implications of serial scanning for high risk pregnancy, the Perinatal Institute has prepared a cost-benefit analysis which is available here:


Information about Birmingham City University's focussed courses for third trimester fetal growth scanning by midwives is available here:


Presentations from Lorraine Walsh and David Cole at the recent masterclass for ultrasonographers:

Fetal biometry review (FMMR, 2002):

For further references and the rationale for the GAP Programme, see here.