scholarly journals Caveats in the monitoring of fetal growth using ultrasound estimated fetal weight

Ultrasound ◽  
2020 ◽  
pp. 1742271X2095450
Author(s):  
Nicholas John Dudley ◽  
Helen Varley
Keyword(s):  
Fetal Growth ◽  
Measurement Data ◽  
Measurement Methods ◽  
Fetal Weight ◽  
Growth Trajectory ◽  
Original Form ◽  
Weight Growth ◽  
Normal Ranges ◽  
The Impact ◽  
Estimated Fetal Weight

Introduction Ultrasound estimated fetal weight is increasingly being used in the monitoring of fetal growth. Differences between estimated fetal weight formulae, curves and measurement methods could lead to significant differences in results. The aim of this study was to investigate the potential impact of these differences on estimated fetal weight and its use in monitoring fetal growth, both by modelling and by analysis of ultrasound scan data. Methods Four estimated fetal weight curves were compared in their original form and also normalised to term weight. Estimated fetal weight was calculated from 50th centiles of widely used charts of abdominal and head circumference and femur length and plotted on a widely used estimated fetal weight curve. Fetal measurement data were used to assess the impact of fetal proportions on estimated fetal weight error and on growth trajectory when different estimated fetal weight formulae are used. Results Estimated fetal weight curves differ significantly, but after normalisation there is closer agreement. Estimated fetal weight modelled using modern measurement methods differs from the widely used estimated fetal weight growth curve. Errors in estimated fetal weight are correlated with differences in fetal proportions and this can lead to significant changes in estimated fetal weight growth trajectory if different estimated fetal weight formulae are used. Conclusions Choice of measurement methods, estimated fetal weight formulae and growth curves have a significant effect on estimated fetal weight growth trajectories relative to normal ranges. It is important to understand these caveats when using estimated fetal weight to monitor fetal growth.

DIAGNOSIS AND MANAGEMENT OF SELECTIVE FETAL GROWTH RESTRICTION IN MONOCHORIONIC TWINS

2009 ◽  
Vol 20 (4) ◽  
pp. 269-281 ◽  
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.

scholarly journals The impact of laser therapy on fetal growth discordance in twin-to-twin transfusion syndrome

2005 ◽  
Vol 5 (3) ◽  
pp. 313-317
Author(s):  
Renato A. Moreira de Sa ◽  
Salomon J. Laurent ◽  
Yuichiro Takahashi ◽  
Masami Yamamoto ◽  
Yves Ville
Keyword(s):  
Laser Therapy ◽  
Fetal Growth ◽  
Fetal Weight ◽  
Abdominal Circumference ◽  
Mean Values ◽  
Biparietal Diameter ◽  
Ultrasound Assessment ◽  
The Mean ◽  
The Impact ◽  
Estimated Fetal Weight

OBJECTIVES: to evaluate the impact of laser therapy on inter-twin discordance in twin-to-twin transfusion syndrome (TTTS). METHODS: biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL) and estimated fetal weight were prospectively collected during a five-year period (1999 to 2004). The inter-twin discordance was expressed as a percentage of the largest twin's measurements. The measurements were made the day before laser, twice following laser and after delivery. The mean values of discordance in measurements and in fetal weight were calculated. ANOVA was used to compare mean values. RESULTS: the mean (SD) discordance for BPD, HC, AC, FL and estimated fetal weight the day before laser were 8.53% (5.28), 8.75% (2.76), 16.19% (4.85), 12.92% (5.13) and 28.50% (6.46) respectively. At the at 2nd ultrasound assessment after surgery were 4.37% (3.55), 3.73% (2.71), 8.90% (4.42), 6.61% (4.99) and 19.11% (8.01) respectively; and at birth the weight discordance was 18.55% (8.74). There was a significant decrease in discordance for HC and AC for each ultrasound assessment. CONCLUSIONS: there was a decrease in fetal growth discordance following laser therapy in TTTS. These changes might be related to re-adaptation of blood flow following laser therapy.

scholarly journals Swedish intrauterine growth reference ranges for estimated fetal weight

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.

Influence of Estimated Fetal Weight on Labor Management

2019 ◽  
Vol 37 (03) ◽  
pp. 252-257
Author(s):  
Elisa T. Bushman ◽  
Norris Thompson ◽  
Meredith Gray ◽  
Robin Steele ◽  
Sheri M. Jenkins ◽  
...  
Keyword(s):  
Cesarean Delivery ◽  
Secondary Analysis ◽  
Physical Exam ◽  
Fetal Weight ◽  
Secondary Outcome ◽  
Labor Management ◽  
Increased Risk ◽  
Tertiary Center ◽  
The Impact ◽  
Estimated Fetal Weight

Abstract Objective Prior studies suggest knowledge of estimated fetal weight (EFW), particularly by ultrasound (US), increases the risk for cesarean delivery. These same studies suggest that concern for macrosomia potentially alters labor management leading to increased rates of cesarean delivery. We aimed to assess if shortened labor management, as a result of suspected macrosomia (≥4,000 g), leads to an increased rate of cesarean delivery. Study Design This is a secondary analysis of a retrospective cohort study at a single tertiary center in 2015 of women with singleton pregnancies ≥36 weeks with documented EFW by US within 3 weeks or physical exam on admission. Women were excluded if an initial cervical exam was ≥6 cm or no attempt was made to labor. In addition, patients were excluded for the diagnosis of hypertension, diabetes, or prior cesarean delivery, as these comorbidities influence the use of US, labor management, and cesarean delivery independent of fetal weight. Patients were classified as EFW of ≥4,000 and <4,000 g. Secondary analysis examined the impact of US within 3 weeks of admission when compared with physical exam at the time of admission. The primary maternal outcomes were duration of labor and cesarean delivery. Duration of labor was evaluated as total time from 4 cm to delivery (with 4-cm dilation being a surrogate marker for active labor), length of time allowed from 4 cm until the first documented cervical change (or delivery), and time in second stage of labor (complete dilation to delivery). Cesarean delivery for arrest of labor was a secondary outcome. Student's t-test, Mann–Whitney U-test, chi-squared test, and Fisher's exact test were used for univariate data analysis as appropriate. Results Of 1,506 patients included, 54 (3.5%) had EFW of ≥4,000 g. Women with EFW of ≥4,000 g had a larger body mass index, higher fetal birth weight, were more likely to be undergoing induction of labor, had a more advanced gestational age, and were more likely to have had an US within 3 weeks of delivery. They were more likely to undergo cesarean delivery (29.6 vs. 9.3%, adjusted odds ratio [AOR]: 2.7, 95% confidence interval [CI]: 1.3–5.5) despite not having shortened labor times. When analyzing this population by method of obtaining EFW, those with EFW based on US rather than external palpation were more likely to undergo cesarean delivery (13.1 vs. 7.9%, AOR: 1.5, 95% CI: 1.01–2.12), again without having shortened labor times. Conclusion EFW of ≥4,000 g and use of US to estimate fetal weight do not appear to shorten labor management despite being associated with an increased risk of cesarean delivery.

scholarly journals HUBUNGAN KENAIKAN BERAT BADAN IBU DENGAN TAKSIRAN BERAT JANIN

2021 ◽  
Vol 6 (1) ◽  
pp. 17
Author(s):  
Yati Isnaini Safitri ◽  
Nur Masruroh
Keyword(s):  
Weight Gain ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Sampling Technique ◽  
Fetal Weight ◽  
Maternal Weight ◽  
Chi Square ◽  
Purposive Sampling ◽  
Starting Point ◽  
Estimated Fetal Weight

Kecukupan gizi ibu hamil ditentukan oleh kenaikan berat badan ibu yang juga akan mendukung kenaikan berat badan janin serta kecepatan janin mensintesis jaringan. Pencatatan hasil berat badan pada setiap kunjungan ibu hamil bermanfaat untuk mengetahui kesejahteraan janin yang ada di dalam kandungan ibu. Pengukuran Tinggi Fundus Uteri (TFU) menjadi titik awal evaluasi pertumbuhan janin. Taksiran berat janin berguna untuk memantau pertumbuhan janin dalam rahim, sehingga diharapkan dapat mendeteksi dini kemungkinan terjadinya pertumbuhan janin yang abnormal. Tujuan penelitian Menganalisis hubungan antara kenaikan berat badan ibu hamil dengan taksiran berat janin di RBG Zakat Surabaya. Sampel berjumlah 25 ibu adalah ibu hamil trimester 3 yang datang berkunjung ke klinik RBG Zakat Surabaya selama bulan Mei-Agustus 2019. Tehnik pengambilan sample menggunakan teknik purposive sampling. Analisis data menggunakan chi-square. Hasil penelitian Berdasarkan hasil uji statistic dengan chi-square di dapatkan hasil perhitungan menunjukkan signifikansi (α) = 0,396. Dengan asumsi jika ρ <0,05 Ho Ditolak maka ada hubungan antara kenaikan berat badan ibu dengan taksiran berat badan janin.The nutritional adequacy of pregnant women is determined by the increase in maternal weight, which will also support the increase in fetal weight, and the rate at which the fetus synthesizes tissue. Recording weight results at every visit of pregnant women is useful to know the welfare of the fetus in the mother's womb. Uterine Fundus Height Measurement (TFU) is the starting point for evaluating fetal growth. Estimated fetal weight is useful for monitoring fetal growth in the uterus, so it is expected to detect early the possibility of abnormal fetal growth. Research Objectives To analyze the relationship between weight gain of pregnant women and fetal weight estimates in RBG Zakat Surabaya. The sample of 25 mothers was 3rd trimester pregnant women who came to visit the Zakat Surabaya RBG clinic during May-August 2019. The sampling technique used purposive sampling technique. Data analysis using chi-square. Results of the study Based on the results of the statistical test with chi-square obtained the calculation results showed significance (α) = 0.396. Assuming if ρ <0.05 Ho is rejected then there is a relationship between maternal weight gain and estimated fetal weight. 

scholarly journals Relationship between Sonographic Umbilical cord Diameter and Gestational Age in Third Trimester of Pregnancy

2021 ◽  
pp. 20-27
Author(s):  
Sara Essam ALdabouly ◽  
Mohamed Mohsen El Namori ◽  
Mona Khaled Omar ◽  
Essmat Hamdy AboZeid
Keyword(s):  
Pregnant Women ◽  
Umbilical Cord ◽  
Fetal Growth ◽  
Gestational Age ◽  
Umbilical Vein ◽  
Well Being ◽  
Fetal Weight ◽  
University Hospital ◽  
Third Trimester ◽  
Estimated Fetal Weight

Background: Throughout the fourth week of embryonic development the umbilical cord (UC) is formed, which corresponds to the fifth to the twelfth weeks of gestation. Fetuses with intrauterine growth restriction (IUGR) have leaner UCs than fetuses of appropriate gestational age do, and the caliber of the umbilical vein decreases significantly, resulting in a worsening of the Doppler parameters of the umbilical artery in the mother. The goal of this study was to evaluate the significance of sonographic UC diameter in determining gestational age in third trimester in pregnant women. Methods: We conducted a comparative cross-sectional research on 300 pregnant women aged range between (20-35) years, singleton gestation, gestational age (3rd) trimester estimated from antenatal mothers last menstrual period (LMP), viable fetus, presenting to obstetrics and gynecology department at Tanta university hospital. Results: Highly statistically significant positive correlation between UC diameter and gestational age, BPD, FL, AC, AFI, and estimated fetal weight was found. The increase in UC diameter was positively and significantly correlated with the increase in gestational age and estimated fetal weight, indicating that those who have prolonged gestational age and estimated fetal weight are more likely to have wider UC diameter. Conclusions: The UC diameter (UCD) has the potential to be a valuable indicator of fetal growth, well-being, and perinatal outcome. Sonographic measurement of UC diameter could be an efficient method of measuring fetal growth and predicting gestational age (GA), particularly between 28-40 weeks GA. It is possible that abnormal UC diameter can be a strong indicator to identify antenatal mothers at risk for IUFD and poor fetal outcomes.

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