Does percentile decline of estimated fetal weight, within the normal range, affect pregnancy outcome?

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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285 Accuracy of estimated fetal weight in extremely preterm infants and the impact of obesity

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2020.12.307 ◽

2021 ◽

Vol 224 (2) ◽

pp. S186-S187

Author(s):

Katherine Himes ◽

Sarah Rogan ◽

Jacqueline Atlass

Keyword(s):

Preterm Infants ◽

Fetal Weight ◽

Extremely Preterm ◽

Extremely Preterm Infants ◽

The Impact ◽

Estimated Fetal Weight

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Third trimester ultrasound estimated fetal weight for increasing prenatal prediction of small-for-gestational age newborns in low-risk pregnant women

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.1080/14767058.2021.1920915 ◽

2021 ◽

pp. 1-6

Author(s):

Giovanna Martín-Palumbo ◽

Vangeliya Blagoeva Atanasova ◽

María Teresa Rego Tejeda ◽

Eugenia Antolín Alvarado ◽

José Luis Bartha

Keyword(s):

Pregnant Women ◽

Gestational Age ◽

Small For Gestational Age ◽

Low Risk ◽

Fetal Weight ◽

Third Trimester ◽

Estimated Fetal Weight

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Estimated fetal weight and severe neonatal outcomes in preterm prelabor rupture of membranes

Journal of Perinatal Medicine ◽

10.1515/jpm-2019-0474 ◽

2020 ◽

Vol 48 (7) ◽

pp. 687-693 ◽

Cited By ~ 1

Author(s):

Jose R. Duncan ◽

Katherine M. Dorsett ◽

Michael M. Aziz ◽

Zoran Bursac ◽

Mario A. Cleves ◽

...

Keyword(s):

Characteristic Curve ◽

Neonatal Outcomes ◽

Fetal Weight ◽

Clinical Tool ◽

Logistic Regression Models ◽

Clinical Variables ◽

Prognostic Accuracy ◽

Prediction Probability ◽

Prelabor Rupture Of Membranes ◽

Estimated Fetal Weight

AbstractObjectivesOur aim was to study the association of clinical variables obtainable before delivery for severe neonatal outcomes (SNO) and develop a clinical tool to calculate the prediction probability of SNO in preterm prelabor rupture of membranes (PPROM).MethodsThis was a prospective study from October 2015 to May 2018. We included singleton pregnancies with PPROM and an estimated fetal weight (EFW) two weeks before delivery. We excluded those with fetal anomalies or fetal death. We examined the association between SNO and variables obtainable before delivery such as gestational age (GA) at PPROM, EFW, gender, race, body mass index, chorioamnioitis. SNO was defined as having at least one of the following: respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis, neonatal sepsis, or neonatal death. The most parsimonious logistic regression models was constructed using the best subset selection model approach, and receiver operator curves were utilized to evaluate the prognostic accuracy of these clinical variables for SNO.ResultsWe included 106 pregnancies, 42 had SNO (39.6%). The EFW (area under the receiver operating characteristic curve [AUC]=0.88) and GA at PPROM (AUC=0.83) were significant predictors of SNO. The addition of any of the other variables did not improve the predictive probability of EFW for the prediction of SNO.ConclusionsThe EFW had the strongest association with SNO in in our study among variables obtainable before delivery. Other variables had no significant effect on the prediction probability of the EFW. Our findings should be validated in larger studies.

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Accuracy of estimated fetal weight assessment in fetuses with abdominal wall defects

American Journal of Obstetrics & Gynecology MFM ◽

10.1016/j.ajogmf.2021.100385 ◽

2021 ◽

pp. 100385

Author(s):

Laura C. HA ◽

Amanda CRAIG ◽

Matthew R. GRACE ◽

Sarah S. OSMUNDSON ◽

Emily W. TAYLOR ◽

...

Keyword(s):

Abdominal Wall ◽

Fetal Weight ◽

Abdominal Wall Defects ◽

Estimated Fetal Weight

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DIAGNOSIS AND MANAGEMENT OF SELECTIVE FETAL GROWTH RESTRICTION IN MONOCHORIONIC TWINS

Fetal and Maternal Medicine Review ◽

10.1017/s0965539509990106 ◽

2009 ◽

Vol 20 (4) ◽

pp. 269-281 ◽

Cited By ~ 1

Author(s):

EDUARD GRATACÓS ◽

ELISENDA EIXARCH ◽

FATIMA CRISPI

Keyword(s):

Fetal Growth ◽

Common Sense ◽

Fetal Growth Restriction ◽

Growth Restriction ◽

Fetal Weight ◽

Abdominal Circumference ◽

Monochorionic Twins ◽

Normal Ranges ◽

Estimated Fetal Weight ◽

Simple Definition

Selective fetal growth restriction (sFGR) has been reported to occur in about 10–15% of monochorionic (MC) twins. The diagnosis of sFGR has been based on variable criteria including estimated fetal weight (EFW), abdominal circumference and/or the degree of fetal weight discordance. Recent studies tend to use a simple definition which includes the presence of an EFW less than the 10th percentile in the smaller twin. Some would argue that the intertwin fetal weight discordance should be included in the definition. Indeed this factor plays a major role in the complications presented by these cases. While the majority of cases with one fetus below the 10th percentile usually will also present with a large intertwin EFW discordance, the contrary is not always true. Thus, it is possible to find MC twins with remarkable intertwin EFW discordance but the EFW of both fetuses are still within normal ranges. Although it appears to be common sense that a large intertwin discrepancy might represent a higher risk for some of the complications described later in this review, there is no consistent evidence to support this notion. Therefore, due to its simplicity, a definition based on an EFW below 10th percentile in one twin is probably the most useful for clinical and research purposes.

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