A Nomogram of Lateral Abdominal Wall Fat Thickness in Normal Third Trimester Fetuses

Dubinsky, Theodore J.; OʼRegan, Jeremiah; Sonneborn, Rachelle; Hippe, Daniel S.; Dighe, Manjiri; Moshiri, Mariam

doi:10.1097/ruq.0000000000000425

Cited by 5 publications

(3 citation statements)

References 22 publications

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“…Care should also be taken to ensure accurate dating so that EFW measurements and fetal weight percentiles are a true reflection of gestational age. Clinicians should be aware of other measurements of fetal growth and well-being including fetal abdominal wall fat thickness, 20 deepest vertical pocket or amniotic fluid index, umbilical cord artery Doppler examinations, biophysical profiles, and overall trend in growth curves 21 when making clinical decisions such as delivery timing.…”

Section: Discussionmentioning

confidence: 99%

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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Section: Discussionmentioning

confidence: 99%

Accuracy of Estimated Fetal Weight by Ultrasound Versus Leopold Maneuver

Lunardhi,

Huynh,

Lee

et al. 2023

Ultrasound Quarterly

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“…We did not perform an inter observer test since measuring FAST is a routine measurement in our specialized outpatient clinic and a good inter observer correlation of FAST measurements has been proven by many other researchers [ 20 , 21 ].…”

Section: Methodsmentioning

confidence: 99%

The Relevance of Fetal Abdominal Subcutaneous Tissue Recording in Predicting Perinatal Outcome of GDM Pregnancies: A Retrospective Study

Weschenfelder

Baum

Schleußner

et al. 2020

JCM

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Guidelines on the management of gestational diabetes (GDM) instruct physicians to involve ultrasound-based monitoring of fetal growth in addition to blood glucose. So far, glucose control besides clinical parameters like maternal body mass index (BMI) and gestational weight gain have been shown to predict neonatal outcome. We aimed to evaluate the discriminative ability of fetal abdominal subcutaneous tissue (FAST) in addition to standard ultrasound parameters like abdominal circumference (AC) and estimated fetal weight (EFW) for perinatal complications like large for gestational age (LGA), hypoglycemia, hyperbilirubinemia, mode of delivery and admission to neonatal intensive care unit (NICU). Ultrasound data and neonatal outcome was collected of 805 GDM cases from 2012 to 2016: 3205 FAST, 3195 AC-measurements and 3190 EFW calculations were included. AC, EFW and FAST increased linear with gestational age. Combining ultrasound and clinical parameters improved predictive power for LGA. In the subgroup where fetuses grow with an AC > 75th additional adding of FAST to standard ultrasound parameters increased predictive power for hypoglycemia. Our results confirm inclusion of ultrasound parameters to be beneficial in monitoring GDM pregnancies. Additional FAST determination revealed to be of potential clinical relevance in the subgroup AC > 75th percentile.

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“…positive predictive value for determining a GA of greater than 37 weeks (40). Finally, fetal subcutaneous tissue measurements may prove useful for validating the GA, assessing fetal metabolic reserve, and predicting the neonatal outcome of fetuses with growth abnormalities (Fig 13) (41)(42)(43). Published nomograms show that lateral abdominal wall thickness increases linearly, approximately 0.19 mm per week, with gestation (41).…”

Section: Adjuncts To Standard Biometrymentioning

confidence: 99%