scholarly journals Factors Affecting Ultrasonographic Fetal Weight Estimation Accuracy in Low Birth Weight Newborns

Author(s):  
Nevin Tuten ◽  
Onur Guralp ◽  
Koray Gok ◽  
Abdullah Tuten ◽  
Altay Gezer

Objective: To investigate the accuracy of fetal weight estimation made by the last prenatal ultrasound measurement in low birth weight newborns (<2500 g). Study Design: A total of 1082 women were evaluated in this retrospective cohort study. Demographic and clinical information of the mother and newborn and obstetric ultrasonography measurements and findings performed in the last week before birth were recorded. Accuracy of fetal weight estimation and parameters affecting it was investigated. Results: Accurate estimation rates were lower in the term compared to the preterm delivery group; and in the SGA group compared to the AGA group (respectively, p=0.016, p=0.032). Accurate estimation rates (p=0.182) were comparable between the 500-1500 g and 1501-2500 g subgroups. The multiple linear regression analysis showed that gestational age at birth, birth weight, examination during labor, and duration between examination to delivery were statistically significant for the accurate estimation(p=0.001) Conclusions: Accurate estimation rates were lower in the term compared to the preterm delivery group, and in the SGA group compared to the AGA group. The factors affecting accurate estimation were found to be gestational age at birth, birth weight, examination during labor, and duration between examination to delivery.Keywords: Accurate estimation rate, Duration between examination to delivery, Examination during

2019 ◽  
Vol 11 (1) ◽  
pp. 32-38
Author(s):  
Naznin Rashid Shewly ◽  
Menoka Ferdous ◽  
Hasina Begum ◽  
Shahadat Hossain Khan ◽  
Sheema Rani Debee ◽  
...  

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


PEDIATRICS ◽  
1970 ◽  
Vol 45 (5) ◽  
pp. 886-887
Author(s):  
Linda C. Eaves ◽  
Harry Klonoff ◽  
Henry G. Dunn

In the printing of our article on the subject in the January issue of Pediatrics (45:9, 1970) the wording of a sentence on page 10 was unfortunately changed in such a manner as to distort the personal communication we had received from Dr. Ruth Griffiths in London, England. As printed, the sentence is: "It does not seem admirable to try and meaningful to correct such D.Q. figures according to gestational age at birth." The statement we wished to make was: "It does not seem advisable to try and correct such D.Q. figures according to gestational age at birth."


2003 ◽  
Vol 58 (6) ◽  
pp. 299-304
Author(s):  
Marinice Duarte da Ponte ◽  
Sérgio Tadeu Martins Marba

PURPOSE: This study aims to characterize the peri-intraventricular hemorrhages in the neonatal period in very low birth weight newborns in 2 institutions that provide neonatal tertiary assistance. METHOD: This was a comparative and observational study in 2 neonatal intensive care units, the Maternity Hospital of Campinas and the "Centro de Atenção Integrada à Saúde da Mulher" of the State University of Campinas, from December 01, 1998 to November 30, 1999. We examined 187 newborns for peri-intraventricular hemorrhages, using transfontanel ultrasound (76 and 11 respectively at the first and second unit), and classified them into 4 grades. We observed their gender, intrauterine growth, weight, and gestational age at birth. RESULTS: We diagnosed 34 cases of peri-intraventricular hemorrhages (13 and 21, respectively), and both groups differed as to the birth weight and the adequacy of weight to the gestational age at birth. There was no difference in the prevalence or extent of peri-intraventricular hemorrhages among cases. There was a statistically significant occurrence of lower birth weight at gestational ages of less than 30 weeks. CONCLUSIONS: The prevalence of peri-intraventricular hemorrhages in our study was compared to that reported in the world literature. Although the cases of the second institution had a smaller mean birth weight, the prevalence of peri-intraventricular hemorrhages was similar to that at the first institution, probably because in the first one, 69% of the gestational ages of the neonates with hemorrhage were less than 30 weeks as compared to 48% in the second one. We stress the importance of the ultrasonographic method for diagnosing peri-intraventricular hemorrhages in very low birth weight newborns.


2019 ◽  
Vol 4 (2) ◽  
pp. 738-743
Author(s):  
Roshana Khadka

Introduction: Ultrasonography plays a pivotal role in present day obstetrics. It has been well recognized that the fetuses of extremes of the normal birth weight range are associated with increased perinatal morbidity, mortality and adverse development outcomes. Categorization of fetal weight into either the small or large for gestational age may lead to timed obstetric interventions that collectively represent significant departure from routine antenatal care. Objective: To compare the accuracy of Hadlock's 1, 2, 3, 4 and Shepard model in estimating expected fetal weight and its comparison with actual birth weight in our population at eastern region of Nepal. Methodology A prospective observational study was performed in the Department of Radiodiagnosis, Nobel Medical college and teaching hospital, Biratnagar, over a period of 6 months dated Jan 2018 to June 2018 using systematic random sampling with sample size estimated as 160, with 5% level of significance, 80% power of test and a maximum of 200 grams differences by our predicting model from actual mean weight. Singleton, term pregnancy (37- 42 weeks gestational age) verified with antenatal USG performed prior to 20 weeks' gestation. Pregnancies complicated by congenital anomalies and deliveries after 2 days of USG examination were excluded. Results: 159 pregnant ladies were enrolled in our study with mean age of 27.60 ± 5.633 years (range 18-43 years). The average (actual) birth weight recorded was 3450.79±438.73gms. The different formulae for estimating birth weight gave us similar results. Estimation of fetal weight by Shepard gave us a mean of 3340.80 ± 463.72. Hadlock1, Hadlock2, Hadlock3 and Hadlock4were 3546.55±429.92grams, 3491.18±439.49 grams, 3445.23 ±422.79grams, and 3446.12±418.43grams respectively. Conclusion: All four Hadlock formulae gave comparable results for fetal weight estimation including the Shepard formula; however, Shepard formula tends to underestimate fetal weight as compared to rest of the formulae. Among the Hadlock's, Hadlock 2 seems to show betier accuracy in fetal weight prediction in our population of study. The mean birth weight recorded using Hadlock 1 formula gave the beer correlation with the actual birth weight though the difference between four Hadlock formulae was all insignificant.


Author(s):  
Alvencia Vaz ◽  
Aheibam Bidya Devi ◽  
Naorem Nabakishore Singh ◽  
Wahengbam Jatishwor Singh ◽  
Laiphrakpam Ranjit Singh ◽  
...  

Background: Accurate estimation of fetal weight is of paramount importance in the management of labour and childbirth. In developing countries including India, estimation of fetal weight by clinical method is important as ultrasound is not available in all health care settings. In view of this, the present study was conducted to estimate the fetal weight assessed by clinical and ultrasound method and correlating with the birth weight.Methods: A cross-sectional study was conducted to estimate fetal weight clinically by using Johnson’s formula and sonographically based on Hadlock’s formula in the Department of Obstetrics and Gynecology in collaboration with Department of Radiodiagnosis, Regional Institute of Medical Sciences, Imphal from October 2016 to March 2018. The study consisted of 525 pregnant women between 37 to 40 weeks of gestation in whom delivery was anticipated within one week of fetal weight estimation by clinical and ultrasound method and correlating it with the baby’s birth weight measured immediately after delivery. Analysis was done using Chi-square and Student’s t-test and p-value of <0.05 was taken as significant.Results: Both methods showed positive correlation with birth weight but clinical method (r=0.925) had stronger correlation compared with ultrasound method (r=0.508).Conclusions: Fetal weight estimation using Johnson’s formula had stronger correlation with the birth weight than ultrasound method and hence, useful for developing countries and all health care workers may be sensitized about the method. 


2018 ◽  
Vol 46 (9) ◽  
pp. 1048-1056 ◽  
Author(s):  
Joanna Yu ◽  
Christopher Flatley ◽  
Ristan M. Greer ◽  
Sailesh Kumar

Abstract Background: Birth-weight is an important determinant of perinatal outcome with low birth-weight being a particular risk factor for adverse consequences. Aim: To investigate the impact of neonatal sex, mode of birth and gestational age at birth according to birth-weight centile on serious adverse neonatal outcomes in singleton term pregnancies. Materials and methods: This was a retrospective cohort study of singleton term births at the Mater Mother’s Hospital, Brisbane, Australia. Serious adverse neonatal outcome was defined as a composite of severe acidosis at birth (pH ≤7.0 and/or lactate ≥6 mmol/L and/or base excess ≤−12 mmol/L), Apgar <3 at 5 min, neonatal intensive-care unit admission and antepartum or neonatal death. The main exposure variable was birth-weight centile. Results: Of the 69,210 babies in our study, the overall proportion of serious adverse neonatal outcomes was 9.1% (6327/69,210). Overall, neonates in the <3rd birth-weight centile category had the highest adjusted odds ratio (OR) for serious adverse neonatal outcomes [OR 3.53, 95% confidence interval (CI) 3.06–4.07], whilst those in the ≥97th centile group also had elevated odds (OR 1.51, 95% CI 1.30–1.75). Regardless of birth modality, smaller babies in the <3rd centile group had the highest adjusted OR and predicted probability for serious adverse neonatal outcomes. When stratified by sex, male babies consistently demonstrated a higher predicted probability of serious adverse neonatal outcomes across all birth-weight centiles. The adjusted odds, when stratified by gestational age at birth, were the highest from 37+0 to 38+6 weeks in the <3rd centile group (OR 5.97, 95% CI 4.60–7.75). Conclusions: Low and high birth-weights are risk factors for serious adverse neonatal outcomes. The adjusted OR appears to be greatest for babies in the <3rd birth-weight centile group, although an elevated risk was also found in babies within the ≥97th centile category.


2005 ◽  
Vol 58 (11-12) ◽  
pp. 548-552 ◽  
Author(s):  
Ljiljana Mladenovic-Segedi ◽  
Dimitrije Segedi

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.


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