Local References for Ultrasound-Estimated Fetal Weight Based on 2,211 Singleton Pregnancies in the City of Curitiba, South of Brazil

Abstract Objective To develop reference curves of estimated fetal weight for a local population in Curitiba, South of Brazil, and compare them with the curves established for other populations. Methods An observational, cross-sectional, retrospective study was conducted. A reference model for estimated fetal weight was developed using a local sample of 2,211 singleton pregnancies with low risk of growth disorders and well-defined gestational age. This model was compared graphically with the Hadlock and Intergrowth 21st curves. Results Reference curves for estimated fetal weight were developed for a local population. The coefficient of determination was R2 = 99.11%, indicating that 99.11% of the fetal weight variations were explained by the model. Compared with Hadlock curves, the 50th, 90th, and 97th percentiles in this model were lower, whereas the 10th percentile nearly overlapped, and the 3rd percentile was slightly higher in the proposed model. The percentiles were higher in the proposed model compared with the Intergrowth 21st curves, particularly for the 3rd, 10th, and 50th percentiles. Conclusion We provide a local reference curve for estimated fetal weight. The proposed model was different from other models, and these differences might be due to the use of different populations for model construction.

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Reference Curve for the Mean Uterine Artery Pulsatility Index in Singleton Pregnancies

Geburtshilfe und Frauenheilkunde ◽

10.1055/s-0043-108764 ◽

2017 ◽

Vol 77 (05) ◽

pp. 516-523

Author(s):

Alexander Weichert ◽

Andreas Hagen ◽

Michael Tchirikov ◽

Ilka Fuchs ◽

Wolfgang Henrich ◽

...

Keyword(s):

Pulsatility Index ◽

Uterine Artery ◽

Flow Patterns ◽

Trophoblast Invasion ◽

Reference Curve ◽

Pulsed Doppler ◽

Increased Risk ◽

Reference Curves ◽

The Mean ◽

Singleton Pregnancies

Abstract Introduction Doppler sonography of the uterine artery (UA) is done to monitor pregnancies, because the detected flow patterns are useful to draw inferences about possible disorders of trophoblast invasion. Increased resistance in the UA is associated with an increased risk of preeclampsia and/or intrauterine growth restriction (IUGR) and perinatal mortality. In the absence of standardized figures, the normal ranges of the various available reference curves sometimes differ quite substantially from one another. The causes for this are differences in the flow patterns of the UA depending on the position of the pulsed Doppler gates as well as branching of the UA. Because of the discrepancies between the different reference curves and the practical problems this poses for guideline recommendations, we thought it would be useful to create our own reference curves for Doppler measurements of the UA obtained from a singleton cohort under standardized conditions. Material and Methods This retrospective cohort study was carried out in the Department of Obstetrics of the Charité – Universitätsmedizin Berlin, the Department for Obstetrics and Prenatal Medicine of the University Hospital Halle (Saale) and the Center for Prenatal Diagnostics and Human Genetics Kurfürstendamm 199. Available datasets from the three study locations were identified and reference curves were generated using the LMS method. Measured values were correlated with age of gestation, and a cubic model and Box-Cox power transformation (L), the median (M) and the coefficient of variation (S) were used to smooth the curves. Results 103 720 Doppler examinations of the UA carried out in singleton pregnancies from the 11th week of gestation (10 + 1 GW) were analyzed. The mean pulsatility index (Mean PI) showed a continuous decline over the course of pregnancy, dropping to a plateau of around 0.84 between the 23rd and 27th GW, after which it decreased again. Conclusion Age of gestation, placental position, position of pulsed Doppler gates and branching of the UA can all change the flow pattern. The mean pulsatility index (Mean PI) showed a continuous decrease over time. There were significant differences between our data and alternative reference curves. A system of classifying Doppler studies and a reference curve adapted to the current technology are urgently required to differentiate better between physiological and pathological findings.

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Sonographic Estimated Fetal Weight among Diabetics at ≥ 34 Weeks and Composite Neonatal Morbidity

American Journal of Perinatology Reports ◽

10.1055/s-0038-1660433 ◽

2018 ◽

Vol 08 (02) ◽

pp. e121-e127

Author(s):

Leen Al-Hafez ◽

Michael Pirics ◽

Suneet Chauhan

Keyword(s):

Retrospective Study ◽

Confidence Intervals ◽

Gestational Age ◽

Neonatal Morbidity ◽

Fetal Weight ◽

Inclusion Criteria ◽

Increased Risk ◽

Estimated Fetal Weight ◽

Singleton Pregnancies

Objectives The objective was to assess the composite neonatal morbidity (CNM) among diabetic women with sonographic estimated fetal weight (SEFW) at 10 to 90th versus >90th percentile for gestational age (GA). Study Design The inclusion criteria for this retrospective study were singleton pregnancies at 34 to 41 weeks, complicated by diabetes, and that had SEFW within 4 weeks of delivery. Odds ratios (ORs) with 95% confidence intervals (CI) were calculated. Results Among the 140 cohorts that met the inclusion criteria, 72% had SEFW at 10th to 90th percentile for GA, and 28% at >90th percentile. Compared with women with diabetes with last SEFW at 10th to 90th percentile, those with estimate > 90th percentile for GA had a significantly higher rate of CNM (13 vs. 28%; OR, 2.65; 95% CI, 1.07–6.59). Among 109 diabetic women who labored, the rate of shoulder dystocia was significantly higher with SEFW at >90th percentile for GA than those at 10th to 90th percentile (25 vs. 2%; p = 0.002); the corresponding rate of CNM was 29 versus 10% (p = 0.02). Conclusion Among diabetic women with SEFW > 90th percentile for GA, CNM was significantly higher than in women with estimate at 10 to 90th percentile. Despite the increased risk of CNM, these newborns did not have long-term morbid sequela.

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Symphysis-fundal height curve in the diagnosis of fetal growth deviations

Revista de Saúde Pública ◽

10.1590/s0034-89102010005000044 ◽

2010 ◽

Vol 44 (6) ◽

pp. 1031-1038 ◽

Cited By ~ 2

Author(s):

Djacyr Magna Cabral Freire ◽

Jose Guilherme Cecatti ◽

Cláudio Sergio Medeiros Paiva

Keyword(s):

Fetal Growth ◽

Gestational Age ◽

Small For Gestational Age ◽

Gold Standard ◽

Fetal Weight ◽

Northeastern Brazil ◽

Reference Curve ◽

Ministry Of Health ◽

Predictive Values ◽

Estimated Fetal Weight

OBJECTIVE: To validate a new symphysis-fundal curve for screening fetal growth deviations and to compare its performance with the standard curve adopted by the Brazilian Ministry of Health. METHODS: Observational study including a total of 753 low-risk pregnant women with gestational age above 27 weeks between March to October 2006 in the city of João Pessoa, Northeastern Brazil. Symphisys-fundal was measured using a standard technique recommended by the Brazilian Ministry of Health. Estimated fetal weight assessed through ultrasound using the Brazilian fetal weight chart for gestational age was the gold standard. A subsample of 122 women with neonatal weight measurements was taken up to seven days after estimated fetal weight measurements and symphisys-fundal classification was compared with Lubchenco growth reference curve as gold standard. Sensitivity, specificity, positive and negative predictive values were calculated. The McNemar χ2 test was used for comparing sensitivity of both symphisys-fundal curves studied. RESULTS: The sensitivity of the new curve for detecting small for gestational age fetuses was 51.6% while that of the Brazilian Ministry of Health reference curve was significantly lower (12.5%). In the subsample using neonatal weight as gold standard, the sensitivity of the new reference curve was 85.7% while that of the Brazilian Ministry of Health was 42.9% for detecting small for gestational age. CONCLUSIONS: The diagnostic performance of the new curve for detecting small for gestational age fetuses was significantly higher than that of the Brazilian Ministry of Health reference curve.

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Validation study of the capacity of the reference curves of ultrasonographic measurements of the umbilical cord to identify deviations in estimated fetal weight

Acta Obstetricia Et Gynecologica Scandinavica ◽

10.1080/00016340701876106 ◽

2008 ◽

Vol 87 (3) ◽

pp. 286-291 ◽

Cited By ~ 4

Author(s):

Cristiane Barbieri ◽

Jose Guilherme Cecatti ◽

Fabiana Krupa ◽

Emilio Francisco Marussi ◽

Jose Vilton Costa

Keyword(s):

Umbilical Cord ◽

Validation Study ◽

Fetal Weight ◽

Reference Curves ◽

Estimated Fetal Weight

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STUDY THE CORRELATION BETWEEN PLACENTAL THICKNESS AND ESTIMATED FETAL WEIGHT BY 2D ULTRASONOGRAPHY ON NORMAL FOETUS MORE THAN 16 WEEKS OF AGES

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2011.6.7 ◽

2011 ◽

pp. 58-66

Author(s):

Thanh Nam Nguyen ◽

Minh Loi Hoang ◽

Vu Quoc Huy Nguyen

Keyword(s):

Fetal Weight ◽

The Third ◽

Normal Foetus ◽

Placental Thickness ◽

Estimated Fetal Weight ◽

Singleton Pregnancies

Objectives: To evaluate the development of foetus (BPD, AC, AAD, FL) and placenta (placental thickness - PT) and the correlation between placental thickness and fetal estimated weight. Materials and Method: Ultrasonographic study 1224 singleton pregnancies with normal developing foetus by cross-sessional describtive method from 01/05/2009 to 20/08/2010. Results: The first pregnancies consist of 59.07%, the second – 29.66 %, the third -11.28%. The fetal and placental ultrasonographic parameters continuously increase from 16 weeks to 38 weeks of age and get satistic meaning with p<0.01. There is closed agreeable correlation between BPD, AAD, AC, FL, PT and fetal ages (w) with r = 0.9829, 0.9895, 0.9882, 0.9827, 0.9689 p<0.0001 correlatively. Conclusion: Ultrasonographic fetal parameters strongly correlate with fetal ages. Placental thickness agreable correlation with fetal ages and FEW.

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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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Prospective assessment of INTERGROWTH-21st and World Health Organization estimated fetal weight reference curves

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.17514 ◽

2018 ◽

Vol 51 (6) ◽

pp. 792-798 ◽

Cited By ~ 18

Author(s):

Y. K. Y. Cheng ◽

J. Lu ◽

T. Y. Leung ◽

Y. M. Chan ◽

D. S. Sahota

Keyword(s):

World Health Organization ◽

Fetal Weight ◽

World Health ◽

Prospective Assessment ◽

Reference Curves ◽

Health Organization ◽

Estimated Fetal Weight

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Deviation of Sonographic Estimated Fetal Weight from Actual Birth Weight in Two Consecutive Pregnancies of the Same Parturients

Fetal Diagnosis and Therapy ◽

10.1159/000363601 ◽

2014 ◽

Vol 37 (1) ◽

pp. 37-43

Author(s):

Amir Aviram ◽

Rami Aviram ◽

Kinneret Tenenbaum-Gavish ◽

Liran Hiersch ◽

Eran Ashwal ◽

...

Keyword(s):

Birth Weight ◽

Systematic Error ◽

Fetal Weight ◽

Weak Correlation ◽

Significant Difference ◽

A Minor ◽

Biometric Features ◽

Estimated Fetal Weight ◽

Singleton Pregnancies

Objective: To determine whether maternal features affect the accuracy of sonographic estimated fetal weight (SEFW) by evaluating the consistency of the systematic error of SEFW with regards to the birth weight (BW) in two consecutive pregnancies of the same gravida. Methods: The cohort included women with SEFW within 1 week of delivery (32-42 weeks' gestation) in two consecutive singleton pregnancies from 2007 to 2012. The systematic error was calculated as (SEFW - BW)/BW × 100 and expressed as a percentage of the BW. Results: A total of 636 pregnancies (318 gravidas) were eligible for analysis. The BW and SEFW were correlated in both first examined (r = 0.873, p < 0.001) and consecutive (r = 0.843, p < 0.001) pregnancies. There was a significant difference in mean systematic error between first examined and consecutive pregnancies (3.13 ± 8.95 vs. 0.34 ± 8.75%, p < 0.001), with a very weak correlation between the two (r = 0.135, p = 0.16). Nulliparity or multiparity at the first examined pregnancy was not found to be a significant factor, and in both groups the error was higher in the first examined pregnancy. There were no significant differences between parturients with a minor (10% and below) or major (>10%) difference in the systematic error between the two pregnancies. Conclusion: The systematic error between the SEFW and BW in two consecutive pregnancies is inconsistent, suggesting that it is unaffected by maternal biometric features.

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