What should be the management plan if EFW is below the 10th percentile on the customized growth chart?

When estimated fetal weight (EFW) is below the 10th percentile on a customized growth chart, it is indicative of potential intrauterine growth restriction (IUGR). The management plan typically involves transferring care to ensure that the pregnancy is monitored closely and that appropriate interventions can be made for the health of the fetus.

Transferring care allows for specialized assessment and planning with an obstetrician, who can monitor the situation with greater resources, including advanced imaging and potential delivery management strategies. The concern is not just the fetal weight itself but the implications it may have for the fetus’s well-being and the likelihood of adverse outcomes if the situation is not addressed.

While consultation with an obstetrician may also be a critical part of the management plan, transferring care emphasizes a shift to a higher level of oversight to mitigate risks associated with IUGR. Frequent growth scans are usually part of monitoring, but they are not sufficient alone without the appropriate oversight and management strategy that a transfer of care would facilitate.

Thus, in this context, transferring care is the correct approach when the EFW is below the 10th percentile, ensuring that the fetus receives the best possible attention and intervention if necessary.