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Inability of relative fetal hepatic lobar size to diagnose intrauterine growth retardation.

It has been demonstrated by autopsy and by ultrasonography that the fetal left hepatic lobe is proportionately larger than that in the adult, probably because of increased supply of oxygenated blood from the umbilical vein. Intrauterine growth retardation (IUGR) is associated with impairment of the fetal blood supply, and might affect the left lobe disproportionately. The authors evaluated the relative size of the lateral segment of the fetal left lobe (L) compared with the remainder of the liver (R) in 88 obstetrical sonograms from 53 patients with IUGR. There was no statistically significant difference in the mean ratio of L/R between normal and IUGR fetuses. There was also no evidence of decreasing L/R in IUGR fetuses with serial examinations. The L/R ratio does not discriminate between normal fetuses and those with IUGR.