268: Do maternal body mass index and amniotic fluid index affect the accuracy of sonographic estimation of fetal weight near delivery?

Blitz, Matthew J.; Stork, Leah B.; Augustine, Stephanie; Greenberg, Meir; Sison, Cristina; Rochelson, Burton

doi:10.1016/j.ajog.2016.11.174

Cited by 5 publications

(9 citation statements)

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“…In disagreement with our study, Blitz et al found that EFW was more likely to be overestimated in cases of oligohydramnios while Polyhydramnios was associated with a higher risk of underestimating EFW [9] . Further studies with larger sample size and multicenter studies are needed to confirm the current results.…”

Section: Discussioncontrasting

confidence: 99%

“…~ 81 ~ However, in the study of Blitz et al, oligohydramnios & polyhydramnios were identified in 9.7% &1.6% of pregnancies [9] . Whereas in the study of Karahanoglu et al, the AFI values of the polyhydramnios, oligohydramnios & control groups differed significantly (P = 0.00), at 274 (34) mm, 35.4 (12) mm & 141.2 (21.7) mm, respectively [10] .…”

Section: Discussionmentioning

confidence: 98%

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The relationship between amniotic fluid index and accuracy of sonographic estimated fetal weight

El-Sharkawy¹,

Omar²,

El-Sayed³

et al. 2023

Int. J. Clin. Obstet. Gynaecol.

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Background: Ultrasound is the gold standard in evaluation of amniotic fluid volume and diagnosis of volume disorders as oligohydramnios and polyhydramnios. While the amniotic fluid may be thought of as an expansion of the foetus extracellular fluid compartment during the first two trimesters of pregnancy, most amniotic fluid is actually produced during the third trimester due to foetal micturition. We hypothesised a link between the amniotic fluid indexes (AFI) and estimated foetal weight (EFW), which might suggest that EFW be considered in amniotic fluid evaluation. Methods: This cross-sectional study was conducted on 75 pregnant cases (Age was >18 years) and carrying singleton pregnancy with GA from 18 weeks to 40 weeks (GA evaluation was based on menstrual history & early US assessment) for 1 year. All participants underwent full history taking, abdominal ultrasonography examination and assessment of amniotic fluid index. Results: The majority of included pregnancies showed cephalic presentation of the fetus. The overall AFI ranged from 2 to 30 cm, with a mean value of 17.2 (SD, 7.4) cm and a median value of 18 (IQR, 11) cm. The majority of included pregnancies showed a normal BPP. There was no significant association between AFI and EFW for all categories of gestational age, except in the 27-29 week's group. Conclusions:The AFI and EFW numbers found in this research fell within a certain range. Nevertheless, these variables showed no statistically meaningful correlation with one another. Inferring from that, it seems unlikely that either measure is worth focusing on when the other is subject to fluctuation.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 98%

The relationship between amniotic fluid index and accuracy of sonographic estimated fetal weight

El-Sharkawy¹,

Omar²,

El-Sayed³

et al. 2023

Int. J. Clin. Obstet. Gynaecol.

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“…This trend was true for both ultrasound and Leopold assessments of full-term fetuses. Whereas some studies show a similar trend, 22 other studies have shown that there is no difference in accuracy of ultrasound EFWs at full term when analyzed in terms of maternal BMI 23–25 . In the present study, the decreased accuracy of EFW assessments with increasing maternal BMI may be due to the general lack of ultrasound and Leopold experience in the performing resident physicians, whereas assessments in other studies are performed by practicing physicians, sonographers, or midwives.…”

Section: Discussioncontrasting

confidence: 49%

“…Whereas some studies show a similar trend, 22 other studies have shown that there is no difference in accuracy of ultrasound EFWs at full term when analyzed in terms of maternal BMI. [23][24][25] In the present study, the decreased accuracy of EFW assessments with increasing maternal BMI may be due to the general lack of ultrasound and Leopold experience in the performing resident physicians, whereas assessments in other studies are performed by practicing physicians, sonographers, or midwives. As such, obstetrics and gynecology residency programs may consider extra training sessions on optimizing sonographic skills to improve accuracy of EFW assessments in patients with elevated BMI.…”

Section: Discussionmentioning

confidence: 69%

Accuracy of Estimated Fetal Weight by Ultrasound Versus Leopold Maneuver

Lunardhi,

Huynh,

Lee

et al. 2023

Ultrasound Quarterly

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Estimated fetal weight (EFW) is frequently used for clinical decision-making in obstetrics. The goals of this study were to determine the accuracy of EFW assessments by Leopold and ultrasound and to investigate any associations with maternal characteristics. Postgraduate years 1 and 2 obstetrics and gynecology resident physicians from Harbor-UCLA Medical Center from 2014 to 2020 performed EFW assessments on 10 preterm (<37 weeks' gestational age) fetuses by ultrasound biometry and 10 full-term (≥37 weeks' gestational age) fetuses by ultrasound biometry and Leopold maneuver. Assessments were included if the patients delivered within 2 weeks of the assessments. One thousand six hundred ninety-seven EFW assessments on 1183 patients performed by 33 residents were analyzed; 72.6% of sonographic full-term EFWs, 69% of Leopold full-term EFWs, and 61.5% of sonographic preterm EFWs were within 10% of the neonatal birth weight (BW). The lowest estimation error in our study occurred when actual BW was 3600 to 3700 g. After adjusting for BW, residents were found to have lower accuracy when the mother had a higher body mass index (BMI) for full-term estimation methods (Leopold and ultrasound, β = 0.13 and 0.12, P = 0.001 and 0.002, respectively). Maternal BMI was not related to estimation error for preterm fetuses (β = 0.01, P = 0.75). Clinical and sonographic EFW assessments performed by obstetrics and gynecology junior residents are within 10% of neonatal BW much of the time. In our cohort, they tended to overestimate EFWs of lower-BW infants and underestimate EFWs of higher-BW infants. Accuracy of full-term EFW assessments seems to decrease with increasing maternal BMI.

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“…Ashwal et al and Blitz et al performed the estimated fetal weight measurement within a week before birth in their study, while Karahanoğlu et al shortened this period to 72 hours. 1,5,6 In our study, we included pregnant women whose ultrasound examination was performed with in 24 hours before labor in order to determine fetal weight estimation with the highest accuracy.…”

Section: Discussionmentioning

confidence: 99%

The Impact of the Active Stage of Labor on Estimate Fetal Weight: A Prospective Cohort Study

BARUT

2023

Kocaeli Üniversitesi Sağlık Bilimleri Dergisi

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Objective: In the literature, there have been few data on ultrasound measurements during the active phase of labor. In this study, it was aimed to compare the accuracy of fetal weight estimation by ultrasound in terms of active phase of labor. Methods: This was a prospective cohort study at the obstetrics clinic of Esenler Gynecology and Children's Hospital in Istanbul. A total of 85 patients in active labor were included in the study. All pregnant women were evaluated for estimated fetal weight (EFW) by ultrasound evaluation, and cervical dilation and effacement measurements by pelvic examination, at most 24 hours before labor. Hadlock-4 formula was used for EFW. EFW and actual birth weight (ABW) and absolute errors of pregnant women in active labor were compared. Results: The mean EFW and ABW of the patients were 3161±482 and 3150±476 g, respectively. In terms of EFW and ABW, a finding in favor of the ultrasound was found. The error and error rates between EFW and ABW were found to be 234±191 g and 7.6±6.2, respectively. No significant difference was found in terms of these parameters (p>0.05). A significant and strong (0.80) correlation was found with estimated fetal weights and actual birth weights. Conclusion: Ultrasound can be used as a safe method to measure estimated fetal weight in the active phase of labor.

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268: Do maternal body mass index and amniotic fluid index affect the accuracy of sonographic estimation of fetal weight near delivery?

Cited by 5 publications

References 0 publications

The relationship between amniotic fluid index and accuracy of sonographic estimated fetal weight

The relationship between amniotic fluid index and accuracy of sonographic estimated fetal weight

Accuracy of Estimated Fetal Weight by Ultrasound Versus Leopold Maneuver

The Impact of the Active Stage of Labor on Estimate Fetal Weight: A Prospective Cohort Study

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