scholarly journals Modification ultrasonic methods estimating expected fetal weight

2016 ◽  
Vol 65 (2) ◽  
pp. 31-37
Author(s):  
Viktor A Mudrov
Keyword(s):  
Gestational Age ◽  
Fetal Tissue ◽  
Average Density ◽  
Fetal Weight ◽  
Abdominal Circumference ◽  
Average Error ◽  
Mortality And Morbidity ◽  
Pregnancy And Childbirth ◽  
Ultrasonic Methods ◽  
Maternity Hospitals

Selection of the optimal tactics of pregnancy and childbirth greatly depends on the expected weight of the fetus. Frequency of perinatal mortality and morbidity increased in grоup with growth retardation and fetal macrosomia. The aim of the study was a modification of ultrasonic methods for determining the expected fetal weight. Materials and methods. On the basis of maternity hospitals Trans-Baikal Region in the years 2013-2015 was held retrospective and prospective analysis of 210 labor histories, which were divided into 3 equal groups: 1 group - pregnant women with a body mass index (BMI) for Quetelet less than 24, group 2 - with a BMI from 24 to 30, group 3 - with a BMI more than 30. In order to determine the expected fetal weight by ultrasonic methods used formula of Hadlock, Shephard and Demidov. The error in determining fetal weight standard methods more than 250 g, which identified the need to establish new precise formula. The increase in the error in determining fetal weight at border gestation due to the lack of assessment of fetal tissue density. On the basis of mathematical and 3d-modeling of the body’s volume, depending on its mass determined pattern change of the average density of fetal tissue, depending on the gestational age, which is expressed by the formula: ρ = 0,833 + 0,004475GA, where ρ - the average density of tissue, GA - gestational age. Through a comprehensive analysis of ultrasound data’s fetometry and medium-density tissue defined fetal weight formula: M = (0,2777 + 0,001492 × GA) × OFD × AC × (Fe + Ti + Hu + Ra), where GA - gestational age (weeks), AC - abdominal circumference (cm), OFD - occipitofrontal diameter (cm), Fe - femur’s length (cm), Ti - tibia’s length (cm), Hu - humerus’s length (cm), Ra - radius’s length (cm), 0.2777 and 0.001492 - digital prognostic factors. In calculating the weight of the fetus according to the proposed formula ultrasonic average error does not exceed 150 g. Thus, the method has a smaller error compared to the standard, and can be used to reliably determine fetal weight in II and III trimester of pregnancy.

scholarly journals The possibility of modifications methods of determine volume of amniotic fluid

2016 ◽  
Vol 65 (3) ◽  
pp. 12-17
Author(s):  
Viktor A Mudrov
Keyword(s):  
Body Mass Index ◽  
Amniotic Fluid ◽  
Pregnant Women ◽  
Body Mass ◽  
Gestational Age ◽  
First Trimester ◽  
Fetal Weight ◽  
Abdominal Circumference ◽  
Pregnancy And Childbirth ◽  
Maternity Hospitals

Selection of the optimal tactics of pregnancy and childbirth significantly depends on the expected volume of amniotic fluid. The amount of amniotic fluid reflects a condition of a fetus and changes at pathological conditions of both a fetus, and an uteroplacental complex. The aim of the study was a modification of methods for determining the expected volume of amniotic fluid. On the basis of maternity hospitals Trans-Baikal Region in the years 2013-2015 was held retrospective and prospective analysis of 300 labor histories, which were divided into 3 equal groups: 1 group - pregnant women with a body mass index (BMI) for Quetelet less than 24, Group 2 - with a BMI from 24 to 30, group 3 - with a BMI more than 30. In order to determine the expected volume of amniotic fluid were used the subjective method, the Chamberlain’s and Phelan’s methods. The error in determining volume of amniotic fluid by the existing methods exceeds 10 %, that defined need of creation of a quantitative method. On the basis of mathematical and 3d-modeling of the volume of amniotic fluid and fetal weight determined pattern change, which is expressed by the formula: VAF = IAF × М × π / GA2, where IAF - index of amniotic fluid (mm), M - fetal weight (g), GA - gestational age (weeks). Through a comprehensive analysis of anthropometric research of the pregnant women defined formula’s volume of amniotic fluid: V = 0,017 × HUF × (AC - 25 × BMI / GA)2 - М, where GA - gestational age (weeks), AC - abdominal circumference of the pregnant women (cm), BMI - body mass index for Quetelet in the first trimester of pregnancy (kg/m2), HUF - height of an uterine fundus (cm), M - the estimated fetal weight (g). In calculating volume of amniotic fluid according to the proposed ultrasonic formula error does not exceed 5,3 %, anthropometric formula error does not exceed 10,2 %. Thus, the method has a smaller error compared to the standard, and can be used to reliably determine volume of amniotic fluid in II and III trimester of pregnancy.

Abdominal Circumference Alone versus Estimated Fetal Weight after 24 Weeks to Predict Small or Large for Gestational Age at Birth: A Meta-Analysis

2017 ◽  
Vol 34 (11) ◽  
pp. 1115-1124 ◽  
Author(s):  
José Yordan ◽  
Bradley Holbrook ◽  
Pranita Nirgudkar ◽  
Ellen Mozurkewich ◽  
Nathan Blue
Keyword(s):  
Gestational Age ◽  
Meta Analysis ◽  
Screening Method ◽  
Case Series ◽  
Fetal Weight ◽  
Abdominal Circumference ◽  
Large For Gestational Age ◽  
Predictive Values ◽  
Sensitivity Specificity ◽  
Estimated Fetal Weight

Objective We compared the sensitivity and specificity of abdominal circumference (AC) alone versus estimated fetal weight (EFW) to predict small for gestational age (SGA) or large for gestational age (LGA) at birth. Study Design We searched the literature for studies assessing an ultrasonographic AC or EFW after 24 weeks to predict SGA or LGA at birth. Case series or studies including anomalous fetuses or multiple gestations were excluded. We computed the sensitivity, specificity, and positive and negative predictive values of any AC or EFW cutoff analyzed by at least two studies. Results We identified 2,460 studies, of which 40 met inclusion criteria (n = 36,519). Four studies assessed AC alone to predict SGA (n = 5,119), and six assessed AC to predict LGA (n = 6,110). Sixteen assessed EFW to predict SGA (n = 13,825), and 22 evaluated EFW to predict LGA (n = 18,896). To predict SGA, AC and EFW < 10th percentile have similar ability to predict SGA. To predict LGA, AC cutoffs were comparable to all EFW cutoffs, except that AC > 35 cm had better sensitivity. Conclusion After 24 weeks, AC is comparable to EFW to predict both SGA and LGA. In settings where serial EFWs are inaccessible, a simpler screening method with AC alone may suffice.

scholarly journals Prenatal care in Southern Brazil

2019 ◽  
Vol 53 ◽  
pp. 40
Author(s):  
Janaina S Saavedra ◽  
Juraci A Cesar ◽  
Angélica O Linhares
Keyword(s):  
Prenatal Care ◽  
Gestational Age ◽  
Laboratory Tests ◽  
Linear Trend ◽  
Rio Grande ◽  
Chi Square ◽  
Pregnancy And Childbirth ◽  
Maternity Hospitals ◽  
The Family ◽  
Adequacy Of Prenatal Care

OBJECTIVE: To estimate coverage, examine trend and assess the disparity reduction regarding household income during prenatal care between mothers living in Rio Grande, state of Rio Grande do Sul, in 2007, 2010, 2013 and 2016. METHODS: This study included all recent mothers living in this municipality, between 1/1 and 12/31 of those years, who had a child weighing more than 500 grams or 20 weeks of gestational age in one of the only two local maternity hospitals. Trained interviewers applied, still in the hospital and up to 48 hours after delivery, a unique and standardized questionnaire, seeking to investigate maternal demographic and reproductive characteristics, the socioeconomic conditions of the family and the assistance received during pregnancy and childbirth. To assess the adequacy of prenatal care, the criteria proposed by Takeda were used, which considers only the number of prenatal appointments and gestational age at initiation, and by Silveira et al., who in addition to these two variables, considers the achievement of some laboratory tests. Chi-square tests were used to compare proportions and assess the linear trend. RESULTS: The total of 10,669 recent mothers were included in this survey (96.8% of the total). Prenatal coverage substantially increased between 2007 and 2016. According to Takeda, it rose from 69% to 80%, while for Silveira et al., it increased from 21% to 55%. This improvement occurred for all income groups (p < 0.01). The disparity between the extreme categories of income reduced, according to Takeda, and increased according to Silveira et al. CONCLUSIONS: The provision of prenatal care, considering only the number of appointments and the early start, occurred in greater proportion among the poorest. However, only the richest recent mothers were contemplated with more elaborate care, such as laboratory tests, which increased the disparities in the provision of prenatal care.

Gastroschisis: incidence and prediction of growth restriction

2015 ◽  
Vol 43 (5) ◽  
Author(s):  
Fadi G. Mirza ◽  
Samuel T. Bauer ◽  
Anne Van der Veer ◽  
Lynn L. Simpson
Keyword(s):  
Gestational Age ◽  
Intrauterine Growth Restriction ◽  
Growth Restriction ◽  
Fetal Weight ◽  
Abdominal Circumference ◽  
Month Of Birth ◽  
Intrauterine Growth ◽  
Increased Risk ◽  
Tertiary Center ◽  
Estimated Fetal Weight

AbstractFetuses with gastroschisis are at increased risk of intrauterine growth restriction (IUGR). However, there is a tendency for underestimation of fetal abdominal circumference and hence fetal weight, leading to overdiagnosis of IUGR. Our objective was to evaluate the accuracy of ultrasound for the prediction of being small for gestational age (SGA) at birth in these cases.A retrospective study of prenatally diagnosed cases of gastroschisis was conducted at a tertiary center. Fetal weight was estimated using the formula of Hadlock. IUGR was defined as an estimated fetal weight ≤10th percentile for gestational age. SGA at the time of birth was defined as a birth weight ≤10th percentile for gestational age. The incidence of IUGR on last ultrasound and that of SGA at birth were calculated, and the precision of ultrasound in predicting SGA was determined.IUGR was reported on the last ultrasound prior to delivery in 9/25 cases (36%). Postnatally, 13/25 newborns (52%) were SGA. All sonographically suspected cases of IUGR based on the last ultrasound were SGA at birth. The positive predictive value of the last ultrasound in identifying SGA was 100%.At least half of the infants affected by gastroschisis were SGA at birth. Sonographic estimation of fetal weight within 1 month of birth reliably predicted SGA in infants with gastroschisis.

scholarly journals Correlation between Estimated Fetal Weight at Term by Ultrasonogram and Actual Birth Weight

2014 ◽  
Vol 32 (1) ◽  
pp. 21-25
Author(s):  
NR Shapla ◽  
MA Aleem ◽  
E Jesmin ◽  
H Ahmed ◽  
YS Lepe
Keyword(s):  
Birth Weight ◽  
High Risk ◽  
Gestational Age ◽  
Mode Of Delivery ◽  
Simple Random Sampling ◽  
Fetal Weight ◽  
Abdominal Circumference ◽  
Biometric Data ◽  
Age Range ◽  
Estimated Fetal Weight

The estimation of foetal birth weight is an important factor in the management of high risk pregnancies. Estimated foetal weight is calculated in the standard routine antepartum evaluation of high risk pregnancies and deliveries. This prospective observational study was done at the Department of Obstetrics and Gynecology in Border Guard Hospital, Peelkhana, Dhaka over a period of 6 months from January 2012 to June 2012. The present study was carried out to compare the accuracy of actual and ultrasonographic estimation of foetal weight at term. Hundred pregnant women at different gestational age from 37 weeks to 40 weeks were selected by simple random sampling. Ultrasonography was done for determination of estimated foetal weight (EFW) at term by using Hadlock method and birth weight was measured just after delivery. Data analysis was done by percentage and paired ‘t’ test. The age range of patients were 18-37 years with mean ±SD is 25.13±4.46. Among 100 study patients 33% were nuliparous and 67% were multiparous. The mean ±SD of gestational age and actual birth weight is 38.76±1.09 and 3.11±0.391 respectively. Ultrasound biometric data that includes mean ±SD biparietal diameter (BPD) in mm, abdominal circumference (AC) in mm and femur length (FL) in cm were 90.21±3.52, 327.67±20.75 and 7.45±1.43 respectively. Mean ±SD of estimated foetal weight (EFW) Kg was 2.97±0.53. Actual birth weight is correlated with the estimated foetal weight and the result was not statistically significant (P >.05). Calculation of estimated fetal weight by ultrasonography is recommended to make decision about mode of delivery, so that an obstetrician can plan early in high risk cases. DOI: http://dx.doi.org/10.3329/jbcps.v32i1.21032 J Bangladesh Coll Phys Surg 2014; 32: 21-25

Isolated Abdominal Circumference < 5% or Estimated Fetal Weight 10 to 19% as Predictors of Small for Gestational Age Infants

2013 ◽  
Vol 31 (06) ◽  
pp. 469-476 ◽  
Author(s):  
Hayley Quant ◽  
Nadav Schwartz ◽  
Michal Elovitz ◽  
Jamie Bastek ◽  
Amy Turitz
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Fetal Weight ◽  
Abdominal Circumference ◽  
Estimated Fetal Weight

Timing of Delivery in Pregnancies Complicated by Suspected Fetal Growth Restriction without Doppler Abnormalities

2019 ◽  
Vol 37 (06) ◽  
pp. 647-651
Author(s):  
Beth L. Pineles ◽  
Sarah Crimmins ◽  
Ozhan Turan
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Fetal Growth Restriction ◽  
Primary Outcome ◽  
Perinatal Outcomes ◽  
Growth Restriction ◽  
Abdominal Circumference ◽  
Fetal Ultrasound ◽  
Mortality And Morbidity ◽  
Increased Risk

Abstract Objective This study aimed to identify the optimal gestational age for delivery of pregnancies complicated by fetal growth restriction (FGR) without Doppler abnormalities. Study Design Cases of FGR (ultrasound-estimated fetal weight less than the 10th or abdominal circumference less than the 5th percentile for gestational age) without fetal Doppler abnormalities were identified from a fetal ultrasound database. The primary outcome was a composite of perinatal mortality and morbidity. The risk of the primary outcome for each gestational age was compared with pregnancies delivered at 390/7 to 406/7 weeks. Odds ratios were adjusted for potential confounders. Results The analysis included 1,024 pregnancies. FGR was identified at a median of 235/7 weeks (range: 20–42 weeks). Four cases of fetal death (234/7—376/7 weeks) and no neonatal deaths were included. The primary outcome occurred in 209 patients (20.4%). This was greater for patients delivered at less than 37 weeks' gestation than for those delivered at or after 39 weeks' gestation, with no increased risk after 40 weeks. Conclusion Among pregnancies complicated by suspected FGR without Doppler abnormalities, delivery at 39 weeks is safe with no difference in perinatal outcomes from 37 to 42 weeks.

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