3D and 2D ultrasound-based fetal weight estimation: a single center experience

Mohsen, Laila; Amin, Mohamed Ahmed

doi:10.1080/14767058.2016.1187125

Cited by 8 publications

(5 citation statements)

References 23 publications

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“…A study of over 9000 singleton pregnancies investigated the effect of maternal age, weight, height, parity, diabetes, fetal sex, presentation, amniotic fluid index and sonographer experience; it was concluded that, although some of these factors had a significant effect on EFW, their contribution was small and of questionable clinical significance. There is some contradictory evidence for whether the precision of EFW can be improved by three‐dimensional (3D) ultrasound volumetry. Recent evidence suggests that EFW using magnetic resonance imaging (MRI) may be more accurate than ultrasound in the prediction of both SGA and LGA neonates.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonographic estimation of fetal weight: development of new model and assessment of performance of previous models

Hammami

Zumaeta

Syngelaki

et al. 2018

Ultrasound in Obstet & Gyne

134

128

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The most accurate models, with the lowest Euclidean distance and highest proportion of AE ≤ 10%, were provided by the formulae incorporating ≥ 3 rather than < 3 biometrical measurements. The systematic review identified 45 studies describing a total of 70 models for EFW by various combinations of measurements of fetal head circumference (HC), biparietal diameter, femur length (FL) and abdominal circumference (AC). The most accurate model with the lowest Euclidean distance and highest proportion of AE ≤ 10% was provided by the formula of Hadlock et al., published in 1985, which incorporated measurements of HC, AC and FL; there was a highly significant linear association between EFW and birth weight (r = 0.959; P < 0.0001), and EFW was within 10% of birth weight in 80% of cases. The performance of the best model developed in this study, utilizing HC, AC and FL, was very similar to that of Hadlock et al. CONCLUSION: Despite many efforts to develop new models for EFW, the one reported in 1985 by Hadlock et al., from measurements of HC, AC and FL, provides the most accurate prediction of birth weight and can be used for assessment of all babies, including those suspected to be either small or large. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.

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Section: Discussionmentioning

confidence: 99%

Ultrasonographic estimation of fetal weight: development of new model and assessment of performance of previous models

Hammami

Zumaeta

Syngelaki

et al. 2018

Ultrasound in Obstet & Gyne

134

128

View full text Add to dashboard Cite

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“…US operator training and audit is unlikely to improve measurement errors within US-EFW calculations significantly; thus, development of alternative methods is required [6]. 3D-US has shown some promise however has not been routinely adopted in the clinical setting because it is yet to be evidenced as being more reliable than 2D-US biometric methods [20][21][22]. The primary aim of this study was to compare the agreement and reliability of US and MRI to measure the EFW in the second trimester and a secondary aim to assess the feasibility of the MRI-EFW in cases of extreme prematurity.…”

Section: Introductionmentioning

confidence: 99%

MRI-Derived Fetal Weight Estimation in the Midpregnancy Fetus: A Method Comparison Study

et al. 2021

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Objectives: The aim of this study was to compare the standard ultrasound (US) estimated fetal weight (EFW) and MRI volume-derived methods for the midtrimester fetus. Methods: Twenty-five paired US and MRI scans had the EFW calculated (gestational age [GA] range = 20–26 weeks). The intra- and interobserver variability of each method was assessed (2 operators/modality). A small sub-analysis was performed on 5 fetuses who were delivered preterm (mean GA 29 +3 weeks) and compared to the actual birthweight. Results: Two MRI volumetry EFW formulae under-measured compared to US by −10.9% and −14.5% in the midpregnancy fetus (p < 0.001) but had excellent intra- and interobserver agreement (intraclass correlation coefficient = 0.998 and 0.993). In the preterm fetus, the mean relative difference (MRD) between the MRI volume-derived EFW (MRI-EFW) and actual expected birthweight (at the scan GA) was −13.7% (−159.0 g, 95% CI: −341.7 to 23.7 g) and −17.1% (−204.6 g, 95% CI: −380.4 to −28.8 g), for the 2 MRI formulae. The MRD was smaller for US at 5.3% (69.8 g, 95% CI: −34.3 to 173.9). Conclusions: MRI-EFW results should be interpreted with caution in midpregnancy. Despite excellent observer agreement with MRI volumetry, refinement of the EFW formula is needed in the second trimester, for the small and for the GA and preterm fetus to compensate for lower fetal densities.

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“…Attempts at improving the prediction of birth weight by the addition of maternal characteristics to fetal biometry have not been found to be successful 24,25 . Similarly, there is some contradictory evidence as to whether the precision of EFW can be improved by three-dimensional ultrasound volumetry [26][27][28] . Second, development of a standardized fetal biometric ultrasound measurement protocol, involving training, assessment and certification of sonographers and both qualitative and quantitative quality-control monitoring, can minimize systematic error and ensure high reproducibility 21 .…”

Section: Discussionmentioning

confidence: 99%

Impact of biometric measurement error on identification of small‐ and large‐for‐gestational‐age fetuses

Wright

Smith³

et al. 2020

Ultrasound in Obstet & Gyne

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CONTRIBUTION What are the novel findings of this work?This study examines the impact of measurement errors in fetal head circumference, abdominal circumference and femur length on sonographic estimated fetal weight (EFW) and their effect on the prediction of small-(SGA) and large-(LGA) for-gestational-age fetuses.What are the clinical implications of this work? Measurement error in fetal biometry causes substantial error in EFW, resulting in misclassification of SGA and LGA fetuses. The extent to which improvement can be achieved through effective quality assurance remains to be seen but, as a first step, it is important for practitioners to understand how biometric measurement error impacts on the prediction of SGA and LGA fetuses. ABSTRACTObjectives First, to obtain measurement-error models for biometric measurements of fetal abdominal circumference (AC), head circumference (HC) and femur length (FL), and, second, to examine the impact of biometric measurement error on sonographic estimated fetal weight (EFW) and its effect on the prediction of small-(SGA) and large-(LGA) for-gestational-age fetuses with EFW < 10 th and > 90 th percentile, respectively.Methods Measurement error standard deviations for fetal AC, HC and FL were obtained from a previous large study on fetal biometry utilizing a standardized measurement protocol and both qualitative and quantitative quality-control monitoring. Typical combinations of AC, HC and FL that gave EFW on the 10 th and 90 th percentiles were determined. A Monte-Carlo simulation study was carried out to examine the effect of measurement error on the classification of fetuses as having EFW above or below the 10 th and 90 th percentiles. ResultsErrors were assumed to follow a Gaussian distribution with a mean of 0 mm and SDs, obtained from a previous well-conducted study, of 6.93 mm for AC, 5.15 mm for HC and 1.38 mm for FL. Assuming errors according to such distributions, when the 10 th and 90 th percentiles are used to screen for SGA and LGA fetuses, respectively, the detection rates would be 78.0% at false-positive rates of 4.7%. If the cut-offs were relaxed to the 30 th and 70 th percentiles, the detection rates would increase to 98.2%, but at false-positive rates of 24.2%. Assuming half of the spread in the error distribution, using the 10 th and 90 th percentiles to screen for SGA and LGA fetuses, respectively, the detection rates would be 86.6% at false-positive rates of 2.3%. If the cut-offs were relaxed to the 15 th and 85 th percentiles, respectively, the detection rates would increase to 97.0% and the false-positive rates would increase to 6.3%.Conclusions Measurement error in fetal biometry causes substantial error in EFW, resulting in misclassification of SGA and LGA fetuses. The extent to which improvement can be achieved through effective quality assurance remains to be seen but, as a first step, it is important for practitioners to understand how biometric measurement error impacts the prediction of SGA and LGA fetuses.

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3D and 2D ultrasound-based fetal weight estimation: a single center experience

Abstract: Fractional limb volume method is a very promising method for fetal weight estimation. Its performance is not significantly different from the modified Hadlock method.

Cited by 8 publications

References 23 publications

Ultrasonographic estimation of fetal weight: development of new model and assessment of performance of previous models

Ultrasonographic estimation of fetal weight: development of new model and assessment of performance of previous models

MRI-Derived Fetal Weight Estimation in the Midpregnancy Fetus: A Method Comparison Study

Impact of biometric measurement error on identification of small‐ and large‐for‐gestational‐age fetuses

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