An ultrasonographic estimated fetal weight reference for Japanese twin pregnancies

Abstract Purpose: The aim of this study was to determine the relationships between the estimated fetal weight discordancy, which was measured by ultrasound during pregnancy, and maternal pregnancy complications and neonatal outcomes in dichorionic diamniotic twin pregnancies.Methods: We conducted a retrospective review of the medical records of 320 twin pregnancies delivered at Chilgok Kyungpook National University Hospital between January 2011 and February 2020. This study included dichorionic diamniotic twin mothers who delivered between 32+1 and 38+0 weeks of gestation. Mothers who had one fetal demise, a major anomaly, or twin-specific complications were excluded. At 20–24 weeks and 28–32 weeks of gestation, participants were divided into 2 groups: discordant twins with an estimated fetal weight difference of more than 20% and concordant twins with a weight difference of less than 20%. The maternal complications and neonatal outcomes were compared between the two groups. Results: The incidences of preeclampsia and placenta previa were significantly higher in discordant twins measured between 20 and 24 weeks compared with concordant twins, but no statistical significance was found in the neonatal outcomes between the two groups. Delivery times were earlier and neonatal weights were lower in discordant twins measured between 28 and 32 weeks. Neonatal outcomes such as ventilator use and neurodevelopment were also significantly different. Conclusion: Discordance in estimated fetal weight measured by ultrasound between 20 and 24 weeks is a risk factor for maternal preeclampsia and placenta previa, whereas discordancy at 28–32 weeks can predict poor neonatal outcomes.

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New reference values for biometrical measurements and sonographic estimated fetal weight in twin gestations and comparison to previous normograms

Journal of Perinatal Medicine ◽

10.1515/jpm-2019-0207 ◽

2019 ◽

Vol 47 (7) ◽

pp. 757-764

Author(s):

Renana Wilkof Segev ◽

Milana Gelman ◽

Esther Maor-Sagie ◽

Alon Shrim ◽

Mordechai Hallak ◽

...

Keyword(s):

Reference Values ◽

Medical Center ◽

Normal Growth ◽

Fetal Weight ◽

Primary Analysis ◽

Monochorionic Twins ◽

Equal Distribution ◽

Wide Variability ◽

Twin Pregnancies ◽

Estimated Fetal Weight

Abstract Objective To construct new reference values for biometrical measurements and sonographic estimated fetal weight (sEFW) in twin gestations and compare them to previously published normograms. Methods A retrospective analysis of sEFW evaluations of twin gestations was performed between 2011 and 2016 in a single university-affiliated medical center. sEFW was calculated using the Hadlock 1985 formula. To avoid selection bias, one evaluation per pregnancy was randomly selected. Following mathematical transformation to obtain normality of values, normograms were constructed using a best-fit regression model for estimation of mean and standard deviation at each gestational age (GA). Normograms were validated by applying all observations to ensure equal distribution at parallel percentiles. Our normograms were then compared to previously published sEFW normograms for twin gestations. Results A total of 864 sEFW evaluations were performed on 195 twin pregnancies at 22–39 gestational weeks. Of them, 390 entered the primary analysis. The rest were left for validation. Seventy percent of the cohort were dichorionic-diamniotic twins (136/195), 16% (32/195) were monochorionic-diamniotic twins and three (1.5%) were monochorionic-monoamniotic twins. Twenty-four fetuses lacked data on chorionicity. The rest were monochorionic twins or were of unknown chorionicity. Values corresponding to the 2.5th, 10th, 50th, 90th and 97.5th percentiles for sEFW are presented for every GA. Validation by applying all 864 evaluations on constructed normograms was achieved. Comparison to previously published twins’ sEFW normograms demonstrated wide variation between curves. Conclusion New reference values for biometrical measurements and sEFW in twin gestations are presented for clinical and research use. Comparison to other curves demonstrates the wide variability and need for further investigation on twin’s normal growth.

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Second-Trimester Estimated Fetal Weight and Discordance in Twin Pregnancies

Journal of Ultrasound in Medicine ◽

10.7863/jum.2011.30.8.1095 ◽

2011 ◽

Vol 30 (8) ◽

pp. 1095-1101 ◽

Cited By ~ 8

Author(s):

Nathan S. Fox ◽

Daniel H. Saltzman ◽

Rachel Schwartz ◽

Ashley S. Roman ◽

Chad K. Klauser ◽

...

Keyword(s):

Fetal Weight ◽

Second Trimester ◽

Twin Pregnancies ◽

Estimated Fetal Weight

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EP12.08: A reference for the ultrasonographic estimated fetal weight in Japanese twin pregnancies

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.19990 ◽

2018 ◽

Vol 52 ◽

pp. 251-252

Author(s):

M. Sekiguchi ◽

C. Nakagawa ◽

M. Muramoto ◽

J. Muromoto ◽

K. Ogawa ◽

...

Keyword(s):

Fetal Weight ◽

Twin Pregnancies ◽

Estimated Fetal Weight

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Estimated Fetal Weight in Twin Pregnancy: How Good Are We?

Acta geneticae medicae et gemellologiae twin research ◽

10.1017/s000156600000533x ◽

1990 ◽

Vol 39 (3) ◽

pp. 395-399 ◽

Cited By ~ 6

Author(s):

D.M. Campbell ◽

A.P. Smith ◽

A.W. Wilson

Keyword(s):

Multiple Pregnancy ◽

Fetal Weight ◽

Singleton Pregnancy ◽

Femur Length ◽

Biparietal Diameter ◽

Multiple Measurements ◽

Ultrasonic Assessment ◽

Twin Pregnancies ◽

Estimated Fetal Weight ◽

Singleton Pregnancies

AbstractUltrasonic assessment of fetal weight derived from multiple measurements of the fetus has become accepted in clinical practice as being useful in singleton pregnancies. Several different formulae for estimating fetal weight have been derived from differing measurements of the fetus, such as biparietal diameter, trunk circumference, and femur length. To date, there has been no attempt to evaluate such a technique in multiple pregnancy. This study aims to see whether the formulae derived for singleton pregnancy are applicable to twin pregnancies. Estimated fetal weight will be derived by mathematical modelling from ultrasonic measurements made within a week of delivery and the results compared with the actual birthweight to give an indication of how good such estimated fetal weights are. Factors to be considered in the analysis include whether there are differences between Twin I and Twin II, differences of presentation with twins and differences by gestation at delivery.

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

Journal of Shaheed Suhrawardy Medical College ◽

10.3329/jssmc.v11i1.43176 ◽

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

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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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