Intrapartum fetal head circumference and estimated fetal weight as predictors of operative delivery

2017 ◽  
Vol 137 (1) ◽  
pp. 34-39 ◽  
Author(s):  
Noha H. Rabei ◽  
Amr M. El-Helaly ◽  
Amr H. Farag ◽  
Ahmed K. El-Naggar ◽  
Mohamed K. Etman ◽  
...  
Keyword(s):  
Head Circumference ◽  
Fetal Weight ◽  
Operative Delivery ◽  
Fetal Head ◽  
Estimated Fetal Weight

scholarly journals Accuracy of ultrasonic fetal weight estimation using head and abdominal circumference and femur length

2005 ◽  
Vol 58 (11-12) ◽  
pp. 548-552 ◽  
Author(s):  
Ljiljana Mladenovic-Segedi ◽  
Dimitrije Segedi
Keyword(s):  
Birth Weight ◽  
Head Circumference ◽  
Fetal Weight ◽  
Abdominal Circumference ◽  
Weight Estimation ◽  
Fetal Head ◽  
Total Body Mass ◽  
Femur Length ◽  
Fetal Weight Estimation ◽  
Gynecology And Obstetrics

Introduction Former investigations have shown that the accuracy of fetal weight estimation is significantly higher if several ultrasonic fe?tal parameters are measured, because the total body mass depends on the size of fetal head, abdominal circumference and femur length. The aim of this investigation was to establish the best regression model, that is a number of combinations of fetal parameters providing the most accurate fetal weight estimation in utero in our population. Material and methods This prospective study was carried out at the Gynecology and Obstetrics Clinic of the Clinical Center Novi Sad. It included 270 pregnant women with singleton pregnancies within 72 hours of delivery who underwent ultrasound measurements of the biparietal diameter (BPD), head circumference (HC), ab?dominal circumference (AC) and femur length (FL). Results In regard to fetal weight estimation formulas, the deviation was lowest using regression models that simultaneously analyzed four fetal parameters (0.55%) with SD ?7.61%. In these models the estimates of fetal weights were within ?5% of actual birth weight in 48.89%, and within ?10% of actual birth weight in 81.48%. Good results were also obtained using AC, FL measurements (0.92% ? 8.20) as well as using AC, HC, FL measurements (-1.45% ? 7.81). In our sample the combination of AC and FL model gave better results in fetal weight estimation (0.92 ? 8.20%) than the one using BPD and AC (2.97 ? 8.83%). Furthermore, the model using parameters AC, HC and FL showed a lower error in accuracy (-1.45 ? 7.81%) than the model using BPD, AC and FL (2.51 ? 7.82%). Conclusion This investigation has confirmed that the accuracy of fetal weight estimation increases with the number of measured ultra?sonic fetal parameters. In our population the greatest accuracy was obtained using BPD, HC, AC and FL model. In cases when fast estimation of fetal weight is needed, AC, HC, FL model may be appropriate, but if fetal head circumference cannot be measured (amnion rupture and/or fetal head already in the pelvis) the AC, FL model should be used.

Ultrasound assessment of fetal head circumference at the onset of labor as a predictor of operative delivery

2014 ◽  
Vol 28 (18) ◽  
pp. 2182-2186 ◽  
Author(s):  
Poh Vei Ooi ◽  
Meenakshi Ramphul ◽  
Soha Said ◽  
Gerard Burke ◽  
Mairead M. Kennelly ◽  
...  
Keyword(s):  
Head Circumference ◽  
Operative Delivery ◽  
Fetal Head ◽  
Ultrasound Assessment

scholarly journals Fetal head circumference versus fetal weight at term as a predictor of labour outcome

2021 ◽  
Vol 11 (1) ◽  
pp. 201
Author(s):  
Nishita Shettian ◽  
Nikita Pitty
Keyword(s):  
Head Circumference ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Fetal Weight ◽  
Fetal Head ◽  
Birth Canal ◽  
Second Stage Of Labour ◽  
Efficient Management ◽  
Electronic Delivery ◽  
The Impact

Background: Several models have been proposed to predict the need for an LSCS. With reference to this, the impact of the size of the fetal head traversing the birth canal is an important determinant of delivery outcomes. We examined the association between the head circumference and mode of delivery and perinatal outcomes, when compared to birth weight predicted by scan.Methods: This was a retrospective study, on 800 electronic delivery records between December 2019 and May 2021. Sociodemographic data, obstetrical parameter, term scan findings of head circumference and estimated fetal weight, and labour and perinatal outcomes were collected and analysed.Results: HC >95th centile was found to be comparatively more predictive and statistically significant compared to EFW >95th centile in the prediction of LSCS, with the most common indication being cephalopelvic disproportion. Prolonged second stage of labour was statistically significant in both cohort A and B, undergoing vaginal delivery. It was also noted that a significant number of newborns in cohort A required NICU admissions, while NICU admissions after emergency LSCS was significantly higher in the cohort B (p=0.0032) though the overall 5 and 10 minute APGAR scores and duration of stay were comparable in the groups classified on basis of EFW and HC.Conclusions: The above statistics observed on an Indian population may aid obstetricians in the planning of the mode of delivery, improve pre-labor counselling and efficient management of mothers of large babies. 

scholarly journals Sonographic Risk Assessment for An Unplanned Operative Delivery: A Prospective Study

2021 ◽  
Author(s):  
Sharon Perlman ◽  
Hanoch Schreiber ◽  
Zvi Kivilevitch ◽  
Ron Bardin ◽  
Eran Kassif ◽  
...  
Keyword(s):  
Prospective Study ◽  
Vaginal Delivery ◽  
Fetal Weight ◽  
Maximum Likelihood Estimates ◽  
Operative Delivery ◽  
Maternal Height ◽  
Spontaneous Vaginal Delivery ◽  
Pubic Arch ◽  
Estimated Fetal Weight ◽  
Angle Of Progression

Abstract Purpose: To assess the value of pre-labor maternal and fetal sonographic variables to predict an unplanned operative delivery.Methods: In this prospective study, nulliparous women were recruited at 37.0-42.0 weeks of gestation. Sonographic measurements included estimated fetal weight, maternal pubic arch angle, and the angle of progression. We performed a descriptive and comparative analysis between two outcome groups: spontaneous vaginal delivery (SVD) and unplanned operative delivery (UOD) (vacuum-assisted, forceps-assisted and cesarean deliveries). Multivariate logistic regression with ROC analysis was used to create discriminatory models for UOD. Results: Among 234 patients in the study group, 175 had a spontaneous vaginal delivery and 59 an unplanned operative delivery. Maternal height and pubic arch angle (PAA) significantly correlated with UOD. Analysis of Maximum Likelihood Estimates revealed a multivariate model for the prediction of UOD, including the parameters of maternal age, maternal height, sonographic PAA, angle of progression (AOP), and estimated fetal weight, with an area under the curve of 0.7118. Conclusion: Sonographic parameters representing maternal pelvic configuration (PAA) and maternal-fetal interface (AOP) improve the prediction ability of pre-labor models for a UOD. These data may aid the obstetrician in the counseling process before delivery.

scholarly journals Fetal head circumference and subpubic angle are independent risk factors for unplanned cesarean and operative delivery

2017 ◽  
Vol 96 (8) ◽  
pp. 1006-1011 ◽  
Author(s):  
Giuseppe Rizzo ◽  
Elisa Aiello ◽  
Costanza Bosi ◽  
Francesco D'Antonio ◽  
Domenico Arduini
Keyword(s):  
Risk Factors ◽  
Head Circumference ◽  
Operative Delivery ◽  
Fetal Head ◽  
Independent Risk Factors

Fetal growth and development disorders in smoking pregnant women

2021 ◽  
Vol 70 (3) ◽  
pp. 21-30
Author(s):  
Ekaterina M. Gryzunova ◽  
Alexey N. Baranov ◽  
Andrey G. Solovyov ◽  
Elena V. Kazakevich ◽  
Galina N. Chumakova ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Gestational Age ◽  
Head Circumference ◽  
Bone Growth ◽  
Growth Restriction ◽  
Fetal Weight ◽  
Ultrasound Screening ◽  
Pregnant Smokers ◽  
Tobacco Addiction ◽  
Estimated Fetal Weight

BACKGROUND: Due to the increased frequency of smoking in pregnant women, an interest in the study of the mechanisms of the fetoplacental unit in women with tobacco addiction has also been increased all over the world. The effect of low degrees of tobacco addiction of a pregnant woman on the fetus has not been studied in the available literature. AIM: The aim of this study was to identify the growth and developmental abnormalities of the fetus at 30-34 weeks of gestation in smoking pregnant women at the third-trimester ultrasound screening. MATERIALS AND METHODS: Pregnant women, who were observed in the Northern Medical Clinical Center named after N.A. Semashko, Arkhangelsk, Russia were examined during the ultrasound screening. A continuous examination of pregnant women with three ultrasound screenings was carried out, with the third screening performed in 1048 individuals. RESULTS: The survey cohort included 120 pregnant women using the inclusion criteria. Two groups were formed depending on the presence or absence of smoking during pregnancy. The first group contained non-smoking pregnant women (n = 40); the second group comprised smokers during pregnancy (n = 80). Comparison of fetal development parameters in the group of pregnant smokers was carried out in two subgroups: the second a subgroup only consisted of smokers in the first trimester (embryonic period) and the second b subgroup contained smokers throughout pregnancy. All pregnant women who took part in the study signed a Patient Informed Consent form. The study design was observational, cross-sectional (one-step). The main manifestations of fetal growth and development disorders at 30-34 weeks of gestation in pregnant smokers were low estimated fetal weight, low tubular bone length and low head circumference by the gestational age. Low (below the 10th percentile) estimated fetal weight by the gestational age was recorded only in the group of pregnant women who smoke (p = 0.001) and in 90.0% of cases even with a weak degree of tobacco addiction. It was accompanied by low bone sizes and was detected in 10.0% of cases among women who stopped smoking in the first trimester and in 15.0% of cases among those who continued to smoke throughout pregnancy. This result confirmed early symmetrical intrauterine growth restriction of the fetus. Pregnant smokers at 30-34 weeks of gestation had significantly more often low (below the 5th percentile) fetometric parameters characterizing bone growth: femur length (p = 0.01), shinbone length (p = 0.035), shoulder bone length (p = 0.004), biparietal head size (p = 0.006), and head circumference (p = 0.002). Low values of the fetal head circumference were found in 50.0% of cases among pregnant smokers. In the absence of signs of fetal bone growth restriction and the estimated fetal weight in P10-95 values in the group of smoking pregnant women, significantly more often (p = 0.027) than in non-smokers, low (below the 5th percentile) head circumference for gestational age was recorded in 29.8% of cases. In addition, in this group of fetuses of pregnant smokers, elevated ratios of abdominal circumference to head circumference were found, which indicated fetal head growth restriction. The fetometry data obtained were confirmed by anthropometric measurements in the newborns during term delivery, the length of full-term newborns in pregnant smokers being significantly lower (p = 0.040). CONCLUSIONS: Fetuses of pregnant smokers were more likely to have low fetometric parameters by gestational age. Low estimated weights of the fetuses were found in 90.0% of cases with a weak degree of tobacco addiction.

Discrepancy Analysis between Clinical Versus Ultrasound Estimated Fetal Weight and Actual Birth Weight at 3rd Trimester

2019 ◽  
Vol 11 (1) ◽  
pp. 32-38
Author(s):  
Naznin Rashid Shewly ◽  
Menoka Ferdous ◽  
Hasina Begum ◽  
Shahadat Hossain Khan ◽  
Sheema Rani Debee ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Fetal Weight ◽  
P Value ◽  
Weight Estimation ◽  
Third Trimester ◽  
Mortality And Morbidity ◽  
Fetal Weight Estimation ◽  
Obstetric Management ◽  
Estimated Fetal Weight

Background: In obstetric management fetal weight estimation is an important consideration when planning the mode of delivery in our day to day practice. In Bangladesh low birth weight is a major public health problem & incidence is 38% - 58%. Neonatal mortality and morbidity also yet high. So accurate antenatal estimation of fetal weight is a good way to detect macrosomia or small for date baby. Thus to improve the pregnancy outcome and neonatal outcome decreasing various chance of neonatal mortality and morbidity antenatal fetal weight prediction is an invaluable parameter in some situation where to identify the at risk pregnancy for low birth weight become necessary. Reliable method for prenatal estimation of fetal weight two modalities have got popularity - Clinical estimation and another one is ultrasonic estimation. This study was designed to determine the accuracy of clinical versus ultrasound estimated fetal weight detecting the discrepancy with actual birth weight at third trimester. So that we can verify more reliable and accurate method. Objectives: To find out more accurate and reliable modality of fetal weight estimation in antenatal period during obstetric management planning. To compare clinical versus ultrasound estimated fetal weight & to determine discrepancy of both variable with actual birth weight. Method: This prospective, cross sectional analytical study was carried out in Dhaka Medical College Hospital from January 2006 to December 2006. By purposive sampling 100 pregnant women fulfilling inclusion criteria were included in my study in third trimester (29wks-40wks). In clinical weight estimation procedure SFH (Symphysio Fundal Height) was measured in centimeter. On pervaginal finding whether vertex below or above the ischial spine was determined. By Johnson’s formula fetal weight in grams was estimated. Then by ultrasound scan different biometric measurements were taken and finally by Hadlock’s formula fetal weight was estimated. Eventually actual birth weight was taken after birth by Globe Brand weighing machine. Accuracy of both modalities were compared and which one was more reliable predictor was determined by statistical analysis. Results: After data collection were analyzed by computer based software (SPSS). There was gradual and positive relationship between symphysiofundal height and estimated birth weight. Discrepancy between clinical and actual birth weight at third trimester was statistically significant – Paired Student’s ‘t’ test was done where p value was <0.001. Whereas discrepancy between sonographically estimated fetal weight with actual birth weight was not statistically significant (by paired ‘t’ test where p value was >0.05). That implies discrepancy between ultrasound estimated fetal weight and actual birth weight was significantly less than that of clinically estimated fetal weight. 14% clinically and 46% sonographically estimated fetal weight were observed within £ 5% of actual birth weight. 31% clinical and 42% sonographically estimates observed within 6% to 10% of actual birth weight and 55% clinical and 12% sonographically estimate were >10% of actual birth weight. That is about 88% sonographical versus 45% clinical estimates were within 10% of actual birth weight. Conclusion: There is no doubt about importance of fetal weight in many obstetric situations. Clinical decisions at times depends on fetal weight. Whether to use oxytocin, to use forceps or vacuum for delivery or extend of trial or ended by Caesarian section immediately or no scope of trial to be largely depend on fetal size and weight. So more accurate modality for antenatal fetal weight estimation has paramount importance. In my study sonographically estimated weight have more accuracy than that of clinical estimate in predicting actual birth weight. Sonographically estimated fetal weight is more reliable, accurate and reproducible rather than other modality. J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 32-38

scholarly journals Swedish intrauterine growth reference ranges for estimated fetal weight

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Linda Lindström ◽  
Mårten Ageheim ◽  
Ove Axelsson ◽  
Laith Hussain-Alkhateeb ◽  
Alkistis Skalkidou ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Postnatal Growth ◽  
Fetal Weight ◽  
Hierarchical Regression ◽  
Reference Ranges ◽  
Hierarchical Regression Model ◽  
Gestational Week ◽  
Prospective Longitudinal ◽  
Estimate Fetal Weight ◽  
Estimated Fetal Weight

AbstractFetal growth restriction is a strong risk factor for perinatal morbidity and mortality. Reliable standards are indispensable, both to assess fetal growth and to evaluate birthweight and early postnatal growth in infants born preterm. The aim of this study was to create updated Swedish reference ranges for estimated fetal weight (EFW) from gestational week 12–42. This prospective longitudinal multicentre study included 583 women without known conditions causing aberrant fetal growth. Each woman was assigned a randomly selected protocol of five ultrasound scans from gestational week 12 + 3 to 41 + 6. Hadlock’s 3rd formula was used to estimate fetal weight. A two-level hierarchical regression model was employed to calculate the expected median and variance, expressed in standard deviations and percentiles, for EFW. EFW was higher for males than females. The reference ranges were compared with the presently used Swedish, and international reference ranges. Our reference ranges had higher EFW than the presently used Swedish reference ranges from gestational week 33, and higher median, 2.5th and 97.5th percentiles from gestational week 24 compared with INTERGROWTH-21st. The new reference ranges can be used both for assessment of intrauterine fetal weight and growth, and early postnatal growth in children born preterm.

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