Gestational age- and estimated fetal weight-adjusted reference ranges for myocardial tissue Doppler indices at 24-41 weeks' gestation

Abstract Purpose This study investigated the correlation between the umbilical artery (UA) pulsatility index (PI) and the estimated fetal weight percentile and birthweight (BW) percentile, respectively. Materials and Methods We included low-risk pregnancies, in which UA Doppler investigations after 28 weeks were performed. Cases were allocated according to BW percentiles: small for gestational age (SGA) with BW < 10th percentile; appropriate for gestational age (AGA) and large for gestational age (LGA) with BW > 90th percentile. We analyzed differences in the mean UA-PI and UA-PI z-score for gestational age according to the three groups. Linear regression was performed to evaluate any relationship between Doppler indices and BW percentiles. Multiple logistic regression analysis was performed to determine the independent association of UA-PI with LGA babies. In a second step, we considered data on estimated fetal weight (EFW) percentiles and performed the same analysis. Results We analyzed 14 554 pregnancies from 2004 to 2015. The mean UA-PI and mean UA-PI z-scores in the LGA group were lower than in the AGA and SGA groups (p < 0.001). UA-PI and UA-PI z-scores were linearly related to birthweight percentiles (p < 0.001) and to EFW percentiles (p < 0.001). Logistic regression analysis showed that low UA-PI was independently associated with neonatal LGA (p < 0.001). Conclusion The higher the EFW and BW percentiles, the lower the UA-PI. However, reference ranges for UA Doppler are only based on gestation weeks. Further studies are needed to clarify whether customized reference ranges based on EFW percentiles are more appropriate for the evaluation of fetal wellbeing in the third trimester.

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P08.07: Associations between perinatal outcome and Doppler indices of ductus venosus and aortic isthmus in term small-for-gestational age fetuses with both an estimated fetal weight below the 3rd percentile and normal umbilical arterial Doppler: 5 case re

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.13016 ◽

2013 ◽

Vol 42 (s1) ◽

pp. 142-143

Author(s):

T. Mishima ◽

M. Matsushita ◽

T. Murakoshi ◽

M. Ohashi ◽

T. Shinno ◽

...

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Perinatal Outcome ◽

Fetal Weight ◽

Ductus Venosus ◽

Aortic Isthmus ◽

Doppler Indices ◽

Estimated Fetal Weight

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Swedish intrauterine growth reference ranges for estimated fetal weight

Scientific Reports ◽

10.1038/s41598-021-92032-2 ◽

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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