Prospective verification of sonographic fetal weight estimators among term parturients in Uganda

Abstract Background Accuracy of fetal weight estimation by ultrasound is essential in making decisions on the time and mode of delivery. There are many proposed formulas for fetal weight estimation such as Hadlock 1, Hadlock 2, Hadlock 3, Hadlock 4 and Shepard. What best applies to the Ugandan population is not known since no verification of any of the formulas has been done before. The primary aim of this study was to determine the accuracy of sonographic estimation of fetal weight using five most commonly used formulas, and analyze formula variations for different weight ranges. Methods This was a hospital based prospective cohort study at Mulago National Referral Hospital, Kampala, Uganda. A total of 356 pregnant women who consented and were within 3 days of birth were enrolled. Prenatal ultrasound fetal weight determined by measuring the biparietal diameter, head circumference, abdominal circumference, femoral length, and then was compared with actual birth weight. Results The overall accuracy of Hadlock 1, Hadlock 2, Hadlock 3, Hadlock 4 and Shepard formula were 66.9, 73.3, 77.3, 78.4 and 69.7% respectively. All Hadlocks showed significant mean difference between weight estimates and actual birth weight (p < 0.01) whereas Shepard formula did not [p - 0.2], when no stratification of fetal weights was done. However, all Hadlocks showed a none significant (p-values > 0.05) mean difference between weight estimates and actual birth weight when the actual birth weight was ≥4000.0 g. Shepard weight estimates showed a none significant mean difference when actual birth weight was < 4000 g. Bland-Altman graphs also showed a better agreement of weight estimated by Shepard formula and actual birth weights. Conclusion All the five formulas were accurate at estimating actual birth weights within 10% accuracy. However, this accuracy varied with the fetal birth weight. Shepard was more accurate in estimating actual birth weights < 4000 g whereas all Hadlocks were more accurate when the actual birthweight was ≥4000 g.

Download Full-text

Validation of Sonographic Fetal Weight Estimators Among Term Parturients in Uganda

10.21203/rs.3.rs-103139/v1 ◽

2020 ◽

Author(s):

Senai Goitom Sereke ◽

Richard Okello Omara ◽

Felix Bongomin ◽

Sarah Nakubulwa ◽

Harriet Nalubega Kisembo

Keyword(s):

Birth Weight ◽

Mode Of Delivery ◽

Mean Difference ◽

Fetal Weight ◽

Abdominal Circumference ◽

Weight Estimation ◽

Fetal Weight Estimation ◽

Biparietal Diameter ◽

Mulago National Referral Hospital ◽

Fetal Birth Weight

Abstract BackgroundAccuracy of fetal weight estimation by ultrasound is essential in making decisions on the time and mode of delivery. There are many proposed formulas for fetal weight estimation such as Hadlock 1, Hadlock 2, Hadlock 3, Hadlock 4 and Shepard. What best applies to the Ugandan population isn’t known since no validation of any of the formulas has been done before. The primary aim of this study was to determine the accuracy of sonographic estimation of fetal weight using five most commonly used formulas, and analyze formula variations for different weight ranges. MethodsThis was a hospital based prospective cohort study at Mulago National Referral Hospital, Kampala, Uganda. A total of 356 pregnant women who consented and were within three days of birth, prenatal ultrasound fetal weight determined by measuring the biparietal diameter, head circumference, abdominal circumference, femoral length, and then was compared with actual birth weight. ResultsThe overall accuracy of Hadlock 1, Hadlock 2, Hadlock 3, Hadlock 4 and Shepard formula were 66.9%, 73.3%, 77.3%, 78.4% and 69.7% respectively. All Hadlocks showed significant mean difference between weight estimates and actual birth weight (p<0.01) whereas Shepard formula did not [p - 0.2], when no stratification of fetal weights was done. However, all Hadlocks showed a none significant (p-values > 0.05) mean difference between weight estimates and actual birth weight when the actual birth weight was ≥4000.0gms. Shepard weight estimates showed a none significant mean difference when actual birth weight was <4000gms. Bland-Altman graphs also showed a better agreement of weight estimated by Shepard formula and actual birth weights. ConclusionAll the five formulas were accurate at estimating actual birth weights within 10% accuracy. However, this accuracy varied with the fetal birth weight. Shepard was more accurate in estimating actual birth weights <4000grams whereas all Hadlocks were more accurate when the actual birthweight was ≥ 4000grams.

Download Full-text

Accuracy of ultrasonic fetal weight estimation using head and abdominal circumference and femur length

Medicinski pregled ◽

10.2298/mpns0512548m ◽

2005 ◽

Vol 58 (11-12) ◽

pp. 548-552 ◽

Cited By ~ 1

Author(s):

Ljiljana Mladenovic-Segedi ◽

Dimitrije Segedi

Keyword(s):

Birth Weight ◽

Head Circumference ◽

Fetal Weight ◽

Abdominal Circumference ◽

Weight Estimation ◽

Fetal Head ◽

Total Body Mass ◽

Femur Length ◽

Fetal Weight Estimation ◽

Gynecology And Obstetrics

Introduction Former investigations have shown that the accuracy of fetal weight estimation is significantly higher if several ultrasonic fe?tal parameters are measured, because the total body mass depends on the size of fetal head, abdominal circumference and femur length. The aim of this investigation was to establish the best regression model, that is a number of combinations of fetal parameters providing the most accurate fetal weight estimation in utero in our population. Material and methods This prospective study was carried out at the Gynecology and Obstetrics Clinic of the Clinical Center Novi Sad. It included 270 pregnant women with singleton pregnancies within 72 hours of delivery who underwent ultrasound measurements of the biparietal diameter (BPD), head circumference (HC), ab?dominal circumference (AC) and femur length (FL). Results In regard to fetal weight estimation formulas, the deviation was lowest using regression models that simultaneously analyzed four fetal parameters (0.55%) with SD ?7.61%. In these models the estimates of fetal weights were within ?5% of actual birth weight in 48.89%, and within ?10% of actual birth weight in 81.48%. Good results were also obtained using AC, FL measurements (0.92% ? 8.20) as well as using AC, HC, FL measurements (-1.45% ? 7.81). In our sample the combination of AC and FL model gave better results in fetal weight estimation (0.92 ? 8.20%) than the one using BPD and AC (2.97 ? 8.83%). Furthermore, the model using parameters AC, HC and FL showed a lower error in accuracy (-1.45 ? 7.81%) than the model using BPD, AC and FL (2.51 ? 7.82%). Conclusion This investigation has confirmed that the accuracy of fetal weight estimation increases with the number of measured ultra?sonic fetal parameters. In our population the greatest accuracy was obtained using BPD, HC, AC and FL model. In cases when fast estimation of fetal weight is needed, AC, HC, FL model may be appropriate, but if fetal head circumference cannot be measured (amnion rupture and/or fetal head already in the pelvis) the AC, FL model should be used.

Download Full-text

INTEGRATION OF FETAL MID THIGH SOFT TISSUE THICKNESS IN ULTRASOUND BIRTH WEIGHT ESTIMATION FORMULA INCREASES THE ACCURACY OF FETAL WEIGHT ESTIMATION NEAR TERM

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2018.v11i4.23776 ◽

2018 ◽

Vol 11 (4) ◽

pp. 446

Author(s):

Shripad Hebbar ◽

Sukriti Malaviya ◽

Sunanda Bharatnur

Keyword(s):

Birth Weight ◽

Prediction Models ◽

Fetal Weight ◽

Abdominal Circumference ◽

Estimation Methods ◽

Weight Estimation ◽

Singleton Pregnancy ◽

Fetal Biometry ◽

Fetal Weight Estimation ◽

Soft Tissue Thickness

Objective: The objective of the study was to find whether incorporation of MTSTT in fetal weight estimation formulae which are traditionally based on biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) improves birth weight (BW) estimation. Methods: In a prospective observational study, MTSTT was measured within 1 week of delivery in 100 women with term singleton pregnancy along with other standard biometric parameters, i.e. BPD, HC, AC and FL, and MTSTT. Multiple regression analysis was carried out using PHOEBE regression software using different combinations of biometric variables to find out the best fit model of fetal weight estimation. The predicted BW was compared with actual neonatal BW soon after delivery and regression coefficients (R2) were determined for each of prediction models for comparing the accuracies. Results: Mean gestational age at delivery was 38.4±1.08 weeks and the BW of neonates varied between 2.18 kg and 4.38 kg (mean ± standard deviation: 3.07±0.43 kg). By adding MTSTT to BPD, HC, AC, and FL, we obtained the formula Log 10 (BW) = −0.14783+0.00725 *BPD +0.00043 *HC +0.00436 *AC +0.01942 *FL +0.16299 *MTSTT, which had a very good Pearson regression coefficient ((r2: 0.89 p<0.001) compared to conventional models based on standard fetal biometry. All prediction models had better strength of correlation when combined with MTSTT (p<0.001). The routine four parameter formula could identify 45% and 80% of fetuses within 5% and 10% weight range; pick up rate was further increased to 61% and 95% by addition of MTSTT. Conclusion: It is evident that addition of MTSTT to other biometric variables in models of fetal weight estimation improves neonatal BW prediction (r2=0.89).

Download Full-text

The Accuracy of the Weight of the Fetal Agency Using Ultrasound Based on the Formula Hadlock Compared to the Birth of New Body Weight

KnE Life Sciences ◽

10.18502/kls.v4i15.5741 ◽

2019 ◽

Author(s):

Nurbaiti . ◽

Sri Haryati Gofar ◽

Samsun . ◽

Guntur Winarno ◽

Akhmadi .

Keyword(s):

Body Weight ◽

Birth Weight ◽

T Test ◽

Fetal Weight ◽

Weight Estimation ◽

Fetal Weight Estimation ◽

Significant Difference ◽

Fetal Birth Weight ◽

Estimated Fetal Weight

The purpose of this study is to analyze the result of the calculation of fetal weight estimation based on Hadlock’s formula with baby birth weight. The design of this research is quantitative analytic. The data is analyzed by the t-test. The results of this study showed that the analysis of the average comparison between TBJ (Fetal Weight Estimation) and BBL (Fetal Birth Weight) is 2623,60 with 2946,67. There is a significant difference with the value of sig.(2-tailed) 0,000 <0,05, which means there is a significant difference between the estimated fetal weight based on Hadlock’s formula with baby birth weight. Based on the result of the study of fetal weight interpretation using Hadlock’s formula, an accuracy of 89,34% was seen.

Download Full-text

Estimation of Fetal Birth Weight Using Ultra Sonographic Parameters

Journal of Nepal Medical Association ◽

10.31729/jnma.735 ◽

1970 ◽

Vol 39 (135) ◽

pp. 284-286

Author(s):

Kaveeta Dawaka ◽

G C Das

Keyword(s):

Birth Weight ◽

Fetal Weight ◽

Weight Estimation ◽

Term Pregnancy ◽

Femur Length ◽

Actual Weight ◽

Medical College ◽

Biparietal Diameter ◽

Fetal Birth Weight ◽

The Mean

One hundred antenatal patients were studied at term pregnancy at Gauhati Medical College, Guwahati, andfetal birth weight estimation was done in utero Ultrasono-graphically. The parameters measured wereAbdominal Circumference (AC), Biparietal diameter (BPD) and Femur Length (FL), Fetal weightprediction was done with Shepards formula using AC and BPD as well as Hadlocks formula using FL andAC. The scan delivery interval was maintained at 72 hours or less. Results of both formulae were comparedwith the actual fetal birthweight taken within 15 minutes of delivery. With Shepards formula, the predictedfetal weight was within 100 gm of the actual fetal weight in 71% cases, within 150gm in 86% cases, within200 gms in 93% cases and within 250 gms in 98%. With Hadlocks formula, the predicted birthweight waswithin 100 gms of the actual fetal weight in 72% cases, within 150 gms in 83%, within 200 gms in 92%cases and within 300 gms in 98%. The mean percent error calculated as Error % = Predicted weight - actualweight divided by actual weight x 100 was 2.9% with Shepards formula and 3% with Hadlocks. These datathus support a significant correlation between ultrasonographic estimation and actual fetal birth weight.Key Words: Fetal birth weight, AC, BPD, FL

Download Full-text

Accuracy of Fetal Weight Estimation Using Hadlock II Formula

Indonesian Journal of Obstetrics and Gynecology ◽

10.32771/inajog.v7i3.556 ◽

2019 ◽

pp. 166-169

Author(s):

Dwi Pratika Anjarwati ◽

Yudhistya Ngudi Insan Ksyatria ◽

Widardo Widardo

Keyword(s):

Birth Weight ◽

Skills Training ◽

Cross Sectional Study ◽

Fetal Weight ◽

Weight Estimation ◽

Cross Sectional ◽

Fetal Weight Estimation ◽

Fetal Birth Weight ◽

The Relationship ◽

Estimated Fetal Weight

abstract Objective: to investigate the accuracy of estimated fetal weight using Hadlock II formula in RSUD Dr Moewardi. Methods: This cross-sectional study was conducted at RSUD Dr Moewardi in June 2017. Subjects were women who gave birth at RSUD Dr Moewardi from August 2014 to March 2017. The method of collecting data by quoting the medical record as required. Data analysis was done by using linear regression statistic test. Result: By distribution, the number of samples that, according to the standard, is 81.67 %. With the value of R = 0.706 which means that the relationship between two research variables are strong and the value of R Square = 0.499 which means that estimated fetal weight using Hadlock II formula has contribution 49.9 % on fetal birth weight and 50.1 % others by other factors. Conclusion: Fetal weight estimation using Hadlock II formula in RSUD Dr Moewardi has low accuracy. Operator skills training is required to improve the accuracy of estimated fetal weight. Keywords: fetal birth weight, fetal weight estimation, Hadlock II abstrak Tujuan : Mengetahui keakuratan taksiran berat janin menggunakan rumus Hadlock II di RSUD Dr Moewardi. Metode : Penelitian ini adalah penelitian observasional analitik. Penelitian ini dilaksanakan di RSUD Dr Moewardi pada Juni 2017. Subjek penelitian ini adalah data rekam medis dari ibu hamil yang mengalami partus di RSUD Dr Moewardi pada Agustus 2014 – Maret 2017. Metode pengumpulan data dengan mengutip data rekam medis pasien sesuai ketentuan. Analisis data dilakukan dengan uji statistik regresi linier. Hasil : Secara distribusi, jumlah sampel yang memenuhi standar yaitu 81,67 %. Dengan nilai R = 0,706 yang artinya bahwa hubungan kedua variabel penelitian ada dalam kategori kuat dan nilai R Square = 0,499 yang berarti taksiran berat janin menggunakan rumus Hadlock II memiliki pengaruh kontribusi sebesar 49,9% terhadap berat bayi lahir sedangkan 50.1 % lainnya dipengaruhi oleh faktor lain. Kesimpulan : Taksiran berat janin menggunakan rumus Hadlock II di RSUD Dr Moewardi kurang akurat. Perlu dilakukan pelatihan ketrampilan operator sehingga diharapkan dapat meningkatkan keakuratan taksiran berat janin. Kata kunci: berat bayi lahir , Hadlock II, , taksiran berat janin

Download Full-text

Deviasi Taksiran Berat Janin pada Metode Johnson-Toshack, Formula Sederhana dan Formula Dare

Jurnal Kesehatan ◽

10.26630/jk.v8i2.496 ◽

2017 ◽

Vol 8 (2) ◽

pp. 235

Author(s):

Emy Rianti ◽

Siti Aminah

Keyword(s):

Birth Weight ◽

Simple Formula ◽

Fetal Weight ◽

Abdominal Circumference ◽

Weight Estimation ◽

Cross Sectional ◽

Birth Canal ◽

Fetal Weight Estimation ◽

Method Of Measurement ◽

Infant Birth

The ability of the birth attendant to estimate the birth weight of the fetus is very important that it does not cause childbirth dystocia that may cause rip in the birth canal. The aim of this study was to compare the deviation of fetal weight estimation according to Johnson-Toshack method, simple formula and Dare formula. Thedesign used was cross sectional, the data taken primarily, involving 100 respondents at Fatmawati General Hospital Jakarta, from August to September 2015. The findings showed that the smallest deviation mean of fetal weight estimation is Johnson-Toshack method. The results of this method of measurement tend to be close to infant birth weight, especially in the client childbirth with abdominal circumference 90 - 100 cm. The conclusion of this study is that Johnson-Toshack's fetal weighing estimates are more appropriate for childbirth with 90 to 100 cm abdominal circumference size, except in childbirth with ruptured membranes, applying a fetal weight estimate based on the Dare formula would be more appropriate.

Download Full-text

Ultrasound measurement of fetal abdominal subcutaneous tissue thickness as a predictor of large versus small fetuses for gestational age

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-019-0088-6 ◽

2019 ◽

Vol 50 (1) ◽

Cited By ~ 1

Author(s):

Esraa A. Khalifa ◽

Shaimaa A. Hassanein ◽

Hazem H. Eid

Keyword(s):

Birth Weight ◽

Gestational Age ◽

Subcutaneous Tissue ◽

Mode Of Delivery ◽

Statistical Correlation ◽

Weight Estimation ◽

Tissue Thickness ◽

Fetal Weight Estimation ◽

Fetal Gender ◽

Fetal Birth Weight

Abstract Background Commonly used ultrasound fetal weight estimation formulas show variable degrees of error which is more evident in fetuses with nutritional and metabolic issues; better accuracy of fetal weight estimation can be obtained by incorporation of fetal soft tissue parameters like the fetal subcutaneous tissue in the weight estimation process. The aim of this study was to assess the accuracy of fetal abdominal subcutaneous tissue thickness (FASTT) as an indicator of fetal birth weight. Results FASTT showed a high significant statistical correlation with fetal birth weight (r = 0.94, P value = 0.00); it showed higher sensitivity for large for gestational age (LGA) than small for gestational age (SGA) (90.9% and 86.9%, respectively). The best cutoff value for the detection of LGA was ≥ 9.2 mm and ≤ 4.5 for SGA. FASTT showed lower accuracy than abdominal circumference (AC) as an indicator of LGA (92% versus 96%, respectively). Used alone, FASTT is less sensitive than Hadlock formula in both LGA and SGA (90.9% versus 94.5% in LGA and 86.9% versus 88.9% for SGA, respectively). There was no statistical correlation between FASTT and mode of delivery (r = 0.09, P value = 0.23) nor fetal gender (r = 0.15, P value = 0.11) Conclusion FASTT is a good indicator of fetal birth weight especially LGA, yet it is less sensitive than AC in the prediction of LGA. It cannot be used as a predictor of mode of delivery and not affected by fetal gender.

Download Full-text

Discrepancy Analysis between Clinical Versus Ultrasound Estimated Fetal Weight and Actual Birth Weight at 3rd Trimester

Journal of Shaheed Suhrawardy Medical College ◽

10.3329/jssmc.v11i1.43176 ◽

2019 ◽

Vol 11 (1) ◽

pp. 32-38

Author(s):

Naznin Rashid Shewly ◽

Menoka Ferdous ◽

Hasina Begum ◽

Shahadat Hossain Khan ◽

Sheema Rani Debee ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Fetal Weight ◽

P Value ◽

Weight Estimation ◽

Third Trimester ◽

Mortality And Morbidity ◽

Fetal Weight Estimation ◽

Obstetric Management ◽

Estimated 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