Introduction At term, fetal weight estimation is an important factor for decisions about the delivery mode and the timing of labor induction. This study aimed to compare the accuracy of abdominal palpation with that of ultrasound performed by different examiners to estimate fetal weight. The study investigated whether differences in the examinersʼ training affected fetal weight estimates. The accuracy of the weight estimates made for fetuses with extreme birth weights was also evaluated. Finally, the accuracy of Johnsonʼs method and of Insler and Bernsteinʼs formula for estimating fetal weight were compared with the other two methods.Methods This prospective study included singleton pregnancies between 37 weeks of gestation and 12 days post-term planned for vaginal delivery or cesarean section. Ultrasound and abdominal palpation using Leopoldʼs maneuvers were performed by examiners with different levels of professional experience. Fetal weight was additionally estimated using Insler and Bernsteinʼs formula and Johnsonʼs method. Conclusion Fetal weight should be estimated using ultrasound. A good ultrasound training is essential.

The focus of this prospective study was to evaluate whether experience and level of training improves and influences the accuracy of fetal weight prediction by ultrasound. At term fetal weight is an important component for decisions concerning delivery mode and timing of labor induction. In 204 singleton pregnancies at term fetal weight estimation by ultrasound was performed by three examiners of different levels of professional experience and education. Examiner 1 was a specialist experienced consultant. Examiner 2 was a resident in the 2 nd year, who had a structured supervised ultrasound training for six month and examiner 3 was a resident in the 2 nd year, who received no structured supervised ultrasound training. The results of this study clearly showed that experienced ultrasound examiners estimate fetal weights more accurately than unexperienced examiners. Additionally, there is an impact of the level of resident's training on the results. The professional, most experienced examiner 1 estimated fetal weight the most precise, followed by the trained examiner 2, who achieved more accurate weight estimation than examiner 3. We could show that an intensive supervised training of at least six months is adequate to improve the accuracy of weight estimation significantly. Obstetric ultrasound is getting increasingly important in daily maternal-fetal medicine. Thus, it is essential not only to develop effective training curricula for obstetric and gynecological residents, but also to implement a comprehensive supervised ultrasound training. The results could demonstrate that it seems justified to spent time and resources on residents training, in order to meet the increasing demands of modern obstetric medicine.

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