223: Fetal abdominal circumference (AC) of 35cm or greater predicts shoulder dystocia in fetuses presumed to have estimated fetal weight (EFW) appropriate for gestational age (AGA)

2014 ◽  
Vol 210 (1) ◽  
pp. S119 ◽  
Author(s):  
Tovah Buikema ◽  
June Murphy ◽  
George Kazzi
2017 ◽  
Vol 34 (11) ◽  
pp. 1115-1124 ◽  
Author(s):  
José Yordan ◽  
Bradley Holbrook ◽  
Pranita Nirgudkar ◽  
Ellen Mozurkewich ◽  
Nathan Blue

Objective We compared the sensitivity and specificity of abdominal circumference (AC) alone versus estimated fetal weight (EFW) to predict small for gestational age (SGA) or large for gestational age (LGA) at birth. Study Design We searched the literature for studies assessing an ultrasonographic AC or EFW after 24 weeks to predict SGA or LGA at birth. Case series or studies including anomalous fetuses or multiple gestations were excluded. We computed the sensitivity, specificity, and positive and negative predictive values of any AC or EFW cutoff analyzed by at least two studies. Results We identified 2,460 studies, of which 40 met inclusion criteria (n = 36,519). Four studies assessed AC alone to predict SGA (n = 5,119), and six assessed AC to predict LGA (n = 6,110). Sixteen assessed EFW to predict SGA (n = 13,825), and 22 evaluated EFW to predict LGA (n = 18,896). To predict SGA, AC and EFW < 10th percentile have similar ability to predict SGA. To predict LGA, AC cutoffs were comparable to all EFW cutoffs, except that AC > 35 cm had better sensitivity. Conclusion After 24 weeks, AC is comparable to EFW to predict both SGA and LGA. In settings where serial EFWs are inaccessible, a simpler screening method with AC alone may suffice.


2015 ◽  
Vol 43 (5) ◽  
Author(s):  
Fadi G. Mirza ◽  
Samuel T. Bauer ◽  
Anne Van der Veer ◽  
Lynn L. Simpson

AbstractFetuses with gastroschisis are at increased risk of intrauterine growth restriction (IUGR). However, there is a tendency for underestimation of fetal abdominal circumference and hence fetal weight, leading to overdiagnosis of IUGR. Our objective was to evaluate the accuracy of ultrasound for the prediction of being small for gestational age (SGA) at birth in these cases.A retrospective study of prenatally diagnosed cases of gastroschisis was conducted at a tertiary center. Fetal weight was estimated using the formula of Hadlock. IUGR was defined as an estimated fetal weight ≤10th percentile for gestational age. SGA at the time of birth was defined as a birth weight ≤10th percentile for gestational age. The incidence of IUGR on last ultrasound and that of SGA at birth were calculated, and the precision of ultrasound in predicting SGA was determined.IUGR was reported on the last ultrasound prior to delivery in 9/25 cases (36%). Postnatally, 13/25 newborns (52%) were SGA. All sonographically suspected cases of IUGR based on the last ultrasound were SGA at birth. The positive predictive value of the last ultrasound in identifying SGA was 100%.At least half of the infants affected by gastroschisis were SGA at birth. Sonographic estimation of fetal weight within 1 month of birth reliably predicted SGA in infants with gastroschisis.


2017 ◽  
Vol 35 (08) ◽  
pp. 703-706
Author(s):  
Katherine Himes ◽  
Adriane Haragan

Objective Clinicians use estimated fetal weight (EFW) as a proxy for birth weight (BW) in the antenatal period. Our objective was to compare the accuracy of EFW obtained by ultrasound to BW among infants born during the periviable period and determine if accuracy of EFW varied among small for gestational age (SGA) versus appropriate for gestational age (AGA) grown neonates. Study Design We included women who delivered between 230/7 and 256/7 weeks' gestation and had an EFW within 7 days of delivery. Mean percentage difference and median absolute percentage difference between EFW and BW were calculated. Results Our cohort included 226 neonates with a mean gestational age of 241/7 ± 0.8 weeks and median BW of 653 g (interquartile range [IQR]: 580–750 g). The median absolute percentage difference between EFW and BW of fetal weight estimates was 9.2% (IQR: 3.6–17.2). EFW overestimated BW for 75% (n = 171) of the cohort. Among SGA infants, the mean percentage difference in EFW and BW was 16.2 ± 19.4% versus 6.9% ± 13.1% in AGA infants (p = 0.019). Conclusion EFW overestimated BW in this cohort. In addition, ultrasound was less accurate among infants born SGA. These data are important to consider when counseling families facing periviable delivery.


2014 ◽  
Vol 32 (1) ◽  
pp. 21-25
Author(s):  
NR Shapla ◽  
MA Aleem ◽  
E Jesmin ◽  
H Ahmed ◽  
YS Lepe

The estimation of foetal birth weight is an important factor in the management of high risk pregnancies. Estimated foetal weight is calculated in the standard routine antepartum evaluation of high risk pregnancies and deliveries. This prospective observational study was done at the Department of Obstetrics and Gynecology in Border Guard Hospital, Peelkhana, Dhaka over a period of 6 months from January 2012 to June 2012. The present study was carried out to compare the accuracy of actual and ultrasonographic estimation of foetal weight at term. Hundred pregnant women at different gestational age from 37 weeks to 40 weeks were selected by simple random sampling. Ultrasonography was done for determination of estimated foetal weight (EFW) at term by using Hadlock method and birth weight was measured just after delivery. Data analysis was done by percentage and paired ‘t’ test. The age range of patients were 18-37 years with mean ±SD is 25.13±4.46. Among 100 study patients 33% were nuliparous and 67% were multiparous. The mean ±SD of gestational age and actual birth weight is 38.76±1.09 and 3.11±0.391 respectively. Ultrasound biometric data that includes mean ±SD biparietal diameter (BPD) in mm, abdominal circumference (AC) in mm and femur length (FL) in cm were 90.21±3.52, 327.67±20.75 and 7.45±1.43 respectively. Mean ±SD of estimated foetal weight (EFW) Kg was 2.97±0.53. Actual birth weight is correlated with the estimated foetal weight and the result was not statistically significant (P >.05). Calculation of estimated fetal weight by ultrasonography is recommended to make decision about mode of delivery, so that an obstetrician can plan early in high risk cases. DOI: http://dx.doi.org/10.3329/jbcps.v32i1.21032 J Bangladesh Coll Phys Surg 2014; 32: 21-25


2018 ◽  
Vol 36 (06) ◽  
pp. 594-599 ◽  
Author(s):  
Tara Lynch ◽  
J. Glantz ◽  
Kathryn Drennan

Objective To assess whether standard fetal biometric parameters can be used to predict difficult intubations in periviable neonates undergoing resuscitation. Study Design This is a retrospective case–control study of periviable neonates delivered at 23 to 256/7 weeks at an academic hospital during a 5-year period in whom intubation was attempted. Standard fetal biometric measurements were included if they were taken within 7 days of delivery. Primary outcome was intubation in one attempt and was compared with more than one attempt. Data were also collected for fetal gestational age at delivery, neonatal birth weight, estimated fetal weight, head circumference, biparietal diameter, and abdominal circumference. Parametric and nonparametric statistical tests used p < 0.05 as significant. Results In total, 93 neonates met the inclusion criteria. The mean estimated fetal weight was 675 g (standard deviation [SD] ± 140), and the mean neonatal birth weight was 706 g (SD ± 151). The median interval between fetal ultrasound and delivery was 3 days (range: 0–7 days). A total of 45 neonates (48.3%) required more than one intubation attempt. The median number of intubation attempts was 1 (range: 1–10). There was no association between intubation difficulty and fetal abdominal circumference, biparietal diameter, head circumference, gestational age, estimated fetal weight, and neonatal birth weight (all p > 0.05). Conclusion Standard biometry in periviable neonates does not predict intubation difficulty.


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