Impact of maternal BMI on the accuracy of third trimester sonographic estimation of 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

Download Full-text

Comparative assessment of informational content of the equations of F.P. Hadlock and the computer program of V.N. Demidov in determination of term of gestation and fetal weight in the III trimester of gestation

10.21516/2413-1458-2017-16-2-145-150 ◽

2017 ◽

Author(s):

E.A. Derkach , O.I. Guseva

Keyword(s):

Computer Program ◽

High Precision ◽

Gestational Age ◽

Computer Programs ◽

Comparative Assessment ◽

Fetal Weight ◽

Informational Content ◽

Third Trimester ◽

The Third

Objectives: to compare the accuracy of equations F.P. Hadlock and computer programs by V.N. Demidov in determining gestational age and fetal weight in the third trimester of gestation. Materials: 328 patients in terms 36–42 weeks of gestation are examined. Ultrasonography was performed in 0–5 days prior to childbirth. Results: it is established that the average mistake in determination of term of pregnancy when using the equation of F.P. Hadlock made 12,5 days, the computer program of V.N. Demidov – 4,4 days (distinction 2,8 times). The mistake within 4 days, when using the equation of F.P. Hadlock has met on average in 23,1 % of observations, the computer program of V.N. Demidov — 65,9 % (difference in 2,9 times). The mistake more than 10 days, took place respectively in 51,7 and 8,2 % (distinction by 6,3 times). At a comparative assessment of size of a mistake in determination of fetal mass it is established that when using the equation of F.P. Hadlock it has averaged 281,0 g, at application of the computer program of V.N. Demidov — 182,5 g (distinction of 54 %). The small mistake in the mass of a fetus which isn't exceeding 200 g at application of the equation of F.P. Hadlock has met in 48,1 % of cases and the computer program of V.N. Demidov — 64,0 % (distinction of 33,1 %). The mistake exceeding 500 g has been stated in 18 % (F.P. Hadlock) and 4,3 % (V.N. Demidov) respectively (distinction 4,2 times). Conclusions: the computer program of V.N. Demidov has high precision in determination of term of a gestation and mass of a fetus in the III pregnancy.

Download Full-text

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

Download Full-text

Urogynecology in obstetrics: impact of pregnancy and delivery on pelvic floor disorders, a prospective longitudinal observational pilot study

Archives of Gynecology and Obstetrics ◽

10.1007/s00404-021-06022-w ◽

2021 ◽

Author(s):

Russalina Stroeder ◽

Julia Radosa ◽

Lea Clemens ◽

Christoph Gerlinger ◽

Gilda Schmidt ◽

...

Keyword(s):

Risk Factors ◽

Connective Tissue ◽

Pelvic Floor ◽

Pelvic Floor Disorders ◽

Fetal Weight ◽

Vacuum Extraction ◽

Translabial Ultrasound ◽

Third Trimester ◽

Tertiary Center ◽

Prospective Longitudinal

Abstract Purpose To assess changes in the pelvic floor anatomy that cause pelvic floor disorders (PFDs) in primigravidae during and after pregnancy and to evaluate their impact on women’s quality of life (QoL). Methods POP-Q and translabial ultrasound examination was performed in the third trimester and 3 months after delivery in a cohort of primigravidae with singleton pregnancy delivering in a tertiary center. Results were analyzed regarding mode of delivery and other pre- and peripartal factors. Two individualized detailed questionnaires were distributed at 3 months and at 12 months after childbirth to determinate QoL. Results We recruited 45 women, of whom 17 delivered vaginally (VD), 11 received a vacuum extraction delivery (VE) and 17 a Cesarean section in labor (CS). When comparing third-trimester sonography to 3 months after delivery, bladder neck mobility increased significantly in each delivery group and hiatal area increased significantly in the VD group. A LAM avulsion was found in two women after VE. Connective tissue weakness (p = 0.0483) and fetal weight at birth (p = 0.0384) were identified as significant risk factors for the occurrence of PFDs in a multivariant regression analysis. Urinary incontinence was most common with 15% and 11% of cases at 3, respectively, 12 months after delivery. 42% of women reported discomfort during sexual intercourse, 3 months after delivery and 24% 12 months postpartum. Although 93% of women engage a midwife after delivery, only 56% participated in pelvic floor muscle training. Conclusion Connective tissue weakness and high fetal weight at birth are important risk factors for the occurrence of PFDs. Nevertheless, more parturients should participate in postpartal care services to prevent future PFDs.

Download Full-text

OP08.01: Fetal weight estimation at term is not influenced by maternal BMI and weight gain

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.13706 ◽

2014 ◽

Vol 44 (S1) ◽

pp. 79-80

Author(s):

S. Vannuccini ◽

C. Bocchi ◽

M. Torricelli ◽

C. Voltolini ◽

F. Severi ◽

...

Keyword(s):

Weight Gain ◽

Fetal Weight ◽

Weight Estimation ◽

Fetal Weight Estimation ◽

Maternal Bmi

Download Full-text

Third trimester Sonographic estimated fetal weight - What factors affect its’ accuracy

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2021.11.287 ◽

2022 ◽

Vol 226 (1) ◽

pp. S164

Author(s):

Michal Ovadia ◽

Chen Key ◽

Gal Cohen ◽

Sivan Farladansky Gershnabel ◽

Tal Biron-Shental ◽

...

Keyword(s):

Fetal Weight ◽

Third Trimester ◽

Estimated Fetal Weight

Download Full-text

Effect of Maternal Body Mass Index and Amniotic Fluid Index on the Accuracy of Sonographic Estimation of Fetal Weight in Late Gestation

American Journal of Perinatology ◽

10.1055/s-0037-1618588 ◽

2018 ◽

Vol 35 (13) ◽

pp. 1235-1240 ◽

Cited By ~ 3

Author(s):

Burton Rochelson ◽

Leah Stork ◽

Stephanie Augustine ◽

Meir Greenberg ◽

Cristina Sison ◽

...

Keyword(s):

Body Mass Index ◽

Amniotic Fluid ◽

Body Mass ◽

Fetal Weight ◽

Maternal Body Mass Index ◽

Amniotic Fluid Index ◽

Maternal Body ◽

Significant Difference ◽

Substantial Error ◽

Maternal Bmi

Objective The objective of this study was to determine the effect, if any, of maternal body mass index (BMI) and amniotic fluid index (AFI) on the accuracy of sonographic estimated fetal weight (EFW) at 40 to 42 weeks' gestation. Methods This was a retrospective cohort study of singleton gestations with ultrasound performed at 40 to 42 weeks from 2010 to 2013. In this study, patients with documented BMI and sonographic EFW and AFI, concurrently, within 7 days of delivery were included. Chronic medical conditions and fetal anomalies were excluded from this study. The primary variable of interest was the rate of substantial error in EFW, defined as absolute percentage error (APE) >10%. Results A total of 1,000 pregnancies were included. Overall, the APE was 6.0 ± 4.5% and the rate of substantial error was 17.4% (n = 174). There was no significant difference in APE or rate of substantial error between BMI groups. In the final multivariable logistic regression model, the rate of substantial error was increased in women with oligohydramnios (OR 1.79; 95% CI: 1.10–2.92). Furthermore, oligohydramnios was significantly more likely to overestimate EFW while polyhydramnios was more likely to underestimate EFW. Maternal BMI did not affect the accuracy of sonographic EFW. Conclusion Sonographic EFW may be affected by extremes of AFI in the postdates period. Maternal BMI does not affect EFW accuracy at 40 to 42 weeks.

Download Full-text

“A NOVEL ATTEMPT IN ESTIMATION OF FETAL WEIGHT USING NEW SOFT TISSUE MEASUREMENTS”

10.36106/ijsr/0603062 ◽

2021 ◽

pp. 1-3

Author(s):

Sathyan Gnanasigamani ◽

Sudhakar Vadivel ◽

Bala Subramaniam ◽

Sakthivel Raja Ganesan ◽

Pradeebaa Thiyagarajan ◽

...

Keyword(s):

Birth Weight ◽

Soft Tissue ◽

Strong Predictor ◽

Three Dimensional ◽

Fetal Weight ◽

Ultrasound Measurement ◽

Accurate Estimation ◽

Tissue Thickness ◽

Third Trimester ◽

Soft Tissue Thickness

Background: The Accurate estimation of fetal weight is important in modern obstetrics. Currently, Hadlock's formula is used widely for fetal weight estimation, which includes BPD, AC, FL and HC. The correct plane of measurement of various standard parameters is difcult to obtain especially in third trimester. Hence soft tissue thicknesses of the fetus are tested for correlation with birth weight in this study. Materials & Methods: A prospective observational study conducted among 90 pregnant females referred for Ultrasound examination in the third trimester with an interval from the ultrasound scan to delivery of ≤7 days from 2019 to 2020. Results: The measurements of abdominal, fetal mid-thigh and mid-arm soft tissue thicknesses correlated well with birth weight in a high statistically signicant positive linear relationship. A new regression model developed out of the soft tissue thicknesses(FASTT, FMASTT, FTSTT) correlates better than the Hadlock's model and Sujitkumar Hiwale et al model (For Indian population) based on BPD, HC, AC and FL Conclusion: Ultrasound measurement of soft tissue thickness may prove to be a strong predictor of fetal weight essential for sonographic assessment of pregnancy. They are easy and simple hence fetal soft tissue thickness measurements, both two- and three-dimensional, may prove to be a diagnostic parameter that has as small an error rate as possible, is quick to use and reproducible by different examiners

Download Full-text

Fetal weight estimation by automated three-dimensional limb volume model in late third trimester compared to two-dimensional model: a cross-sectional prospective observational study

10.21203/rs.3.rs-271271/v1 ◽

2021 ◽

Author(s):

Xining Wu ◽

Zihan Niu ◽

Zhonghui Xu ◽

Yuxin Jiang ◽

Yixiu Zhang ◽

...

Keyword(s):

Birth Weight ◽

3D Model ◽

Three Dimensional ◽

Fetal Weight ◽

Percentage Error ◽

Limb Volume ◽

Third Trimester ◽

Volume Model ◽

Estimated Error ◽

2D Model

Abstract Background: Accurate estimation of fetal weight is important for prenatal care and for detection of fetal growth abnormalities. Prediction of fetal weight entails the indirect measurement of fetal biometry by ultrasound that is then introduced into formulae to calculate the estimated fetal weight. The aim of our study was to evaluate the accuracy of the automated three-dimensional(3D) fractional limb volume model to predict fetal weight in the third trimester.Methods: Prospective 2D and 3D ultrasonography were performed among women with singleton pregnancies 7 days before delivery to obtain 2D data, including fetal biparietal diameter, abdominal circumference and femur length, as well as 3D data, including the fractional arm volume (AVol) and fractional thigh volume (TVol). The fetal weight was estimated using the 2D model and the 3D fractional limb volume model respectively. Percentage error = (estimated fetal weight - actual birth weight) ÷ actual birth weight × 100. Systematic errors (accuracy) were evaluated as the mean percentage error (MPE). Random errors (precision) were calculated as±1 SD of percentage error.Results: Ultrasound examination was performed on 56 fetuses at 39.6 ± 1.4 weeks gestation. The average birth weight of the newborns was 3393 ± 530 g. The average fetal weight estimated by the 2D model was 3478 ± 467 g, and the MPE was 3.2 ± 8.9. The average fetal weights estimated by AVol and TVol of the 3D model were 3268 ± 467 g and 3250 ± 485 g, respectively, and the MPEs were -3.3 ± 6.6 and -3.9 ± 6.1, respectively. For the 3D TVol model, the proportion of fetuses with estimated error ≤ 5% was significantly higher than that of the 2D model (55.4% vs. 33.9%, p < 0.05). For fetuses with a birth weight < 3500 g, the accuracy of the AVol and TVol models were better than the 2D model (-0.8 vs. 7.0 and -2.8 vs. 7.0, both p < 0.05). Moreover, for these fetus, the proportions of estimated error ≤ 5% of the AVol and TVol models were 58.1% and 64.5%, respectively, significantly higher than that of the 2D model (19.4%) (both p < 0.05). The consistency of different examiners measuring fetal AVol and TVol were satisfactory,with the intraclass correlation coefficients of 0.921 and 0.963, respectively.Conclusion: In this cohort,the automated 3D fractional limb volume model improves the accuracy of weight estimation in most third-trimester fetuses. In particular, the 3D model estimation accuracy for fetuses with weight < 3500 g is significantly higher than that of the traditional 2D model.

Download Full-text