GAP India: 2023-2024

Module 1 - GAP Theory
Chapter 1 - Definitions
11 Topics
1.1 Contents
1.2 LBW, SGA, and FGR (1/3)
1.3 LBW, SGA, and FGR (2/3)
1.4 LBW, SGA, and FGR (3/3)
1.5 Fetal Growth Restriction (FGR) or Intrauterine Growth Restriction (IUGR)
1.6 The customised GROW chart 6
1.7 GROW
1.8 Causes of Fetal growth Restriction 3
1.9 Symmetrical and Asymmetrical FGR7
1.10 Early and late onset FGR (1/2)
1.11 Early and late onset FGR (2/2)
Chapter 2 - Fetal growth restriction and pregnancy outcome
5 Topics
2.1 Contents
2.2 FGR, perinatal morbidity and mortality
2.3 Stillbirth and FGR (1/3)
2.4 Stillbirth and FGR ctd (2/3)
2.5 Stillbirth and FGR ctd 16 (3/3)
Chapter 3 - Risk Assessment
14 Topics
3.1 Contents
3.2 Risk assessment and surveillance for fetal growth restriction (FGR)
3.3 Risk assessment in early pregnancy
3.4 GAP Care Pathway Phase I
3.5 GAP Care Pathway Phase II
3.6 Risk Assessment (1/3)
3.7 Risk Assessment (2/3)
3.8 Risk Assessment (3/3)
3.9 Fetal Growth Surveillance: Low risk
3.10 Fetal Growth Surveillance: assessing growth rate
3.11 Fetal Growth Surveillance (1/3)
3.12 Fetal Growth Surveillance (2/3)
3.13 Fetal Growth Surveillance (3/3)
3.14 Summary recommendations
Chapter 4 - Screening and Surveillance
6 Topics
4.1 Contents
4.2 Predictive tests
4.3 Surveillance in low risk pregnancies
4.4 Surveillance in increased risk pregnancies
4.5 Growth scans at term
4.6 Routine growth scans
Chapter 5 - Monitoring effect of implementation
9 Topics
5.1 Contents
5.2 Impact of training
5.3 Monitoring the effect of implementation
5.4 Antenatal detection of SGA
5.5 Effect on stillbirth rates
5.6 Stillbirths in England 2000-2019 (ONS)
5.7 Reduction of proportion of stillbirths that are SGA 35
5.8 Level of GAP implementation and effect on stillbirth rates
5.9 Key points – Module 1
Module 2 - GAP Practice
Chapter 1 - Generating and using customised growth charts
13 Topics
1.1 Abbreviations
1.2 Contents
1.3 How to generate a customised GROW chart
1.4 Generating a customised growth chart
1.5 Features of the chart
1.6 Generating a customised growth chart
1.7 Generating a customised growth chart
1.8 Features of the chart (1/2)
1.9 Features of the chart (2/2)
1.10 The Antenatal Chart
1.11 Plotting fundal height
1.12 Plotting estimated fetal weight (EFW)
1.13 Summary Points
Chapter 2 - Fetal growth surveillance in low-risk pregnancies
11 Topics
2.1 Contents
2.2 Fundal height measurements: Introduction
2.3 Fundal height measurements: misconceptions
2.4 Standardising fundal height measurements (1/5)
2.5 Standardising fundal height measurements (2/5)
2.6 Standardising fundal height measurements (3/5)
2.7 Standardising fundal height measurements (4/5)
2.8 Standardising fundal height measurements (5/5)
2.9 Additional Points
2.10 Serial standardised fundal height measurements
2.11 Fundal height measurement: contraindications 21:
Chapter 3 - Indications for Referral
8 Topics
3.1 Contents
3.2 Normal growth
3.3 First SFH below the 10th centile
3.4 Slow Growth (SFH)
3.5 First SFH plot above 90th centile
3.6 Serial plots above 90th centile
3.7 Accelerated or excessive growth
3.8 Summary Points
Chapter 4 - Fetal growth surveillance in increased risk pregnancies
8 Topics
4.1 Contents
4.2 Serial ultrasound biometry
4.3 GAP Care Pathway – Phase I: moderate and increased risk
4.4 Slow growth – EFW (1/2)
4.5 Slow growth – EFW (2/2)
4.6 Doppler
4.7 Risk assessment (1/2) (see also Module 1, Chapter 3)
4.8 Risk assessment (2/2)
Chapter 5 - Audit
32 Topics
5.1 Contents
5.2 Audit: Monitoring SGA/FGR and detection rates
5.3 Definitions for reporting
5.4 Data Collection Method
5.5 GROW-App (1/2)
5.6 GROW-App (2/2)
5.7 Retrieving the record
5.8 Confirm that retrieved chart is correct
5.9 Input the unit that was responsible for antenatal care
5.10 Birth details
5.11 Early pregnancy risk assessment
5.12 Birth weight centile (1/2)
5.13 Birth weight centile (2/2)
5.14 GROW-App Reports (1/16)
5.15 GROW-App Reports (2/16)
5.16 GROW-App Reports (3/16)
5.17 GROW-App Reports (4/16)
5.18 GROW-App Reports (5/16)
5.19 GROW-App Reports (6/16)
5.20 GROW-App Reports (7/16)
1 of 2
Previous Topic
Next Lesson

3.8 Summary Points

GAP India: 2023-2024 Chapter 3 – Indications for Referral 3.8 Summary Points
Lesson Progress
0% Complete
  • Low risk: SFH 2-3 weekly from 26-28 weeks until delivery  
  • High risk or SFH not possible (see chapter 4): EFW 3 weekly until delivery
  • If 1st fundal height measurement is below the 10th centile line, or sequential measurements show slow growth, refer directly for an ultrasound scan
  • The scan should be carried out as early as possible, as per unit protocol. 
  • Ideally, 2 scans 3 weeks apart should be undertaken to check growth rate
  • If growth rate on scan is reassuring, continue SFHs, using previous last SFH as baseline 
  • Fundal height measurements above 90th centile line do not require referral to scan unless they show accelerated growth. Consider also referral for diabetes screening. 
Previous Topic
Back to Lesson
Next Lesson