Fetal head circumference: relation to menstrual age

Hadlock, Frank P.; Deter, R L; Harrist, R B; Sk, Park

doi:10.2214/ajr.138.4.649

Cited by 192 publications

(158 citation statements)

References 18 publications

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“…These data confirmed the observation of Crane and Kopta [14] that socalled "asymmetric" fetal growth retardation (defined by an abnormally high head circumference/abdominal circumfer ence ratio [6]) results from relative rather than absolute head sparing, as indicated by the fact that the mean head circumference is at the third percentile. These data also indicate compromise of the crown-heel length [15,16] in this population, with the mean value at the third percentile [15].…”

Section: Growth-retarded Fetusessupporting

confidence: 53%

A date-independent predictor of intrauterine growth retardation: femur length/abdominal circumference ratio

Hadlock¹,

Deter²,

Harrist³

et al. 1983

American Journal of Roentgenology

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106

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The relation between sonographically measured fetal femur length and abdominal circumference (expressed as femur length/abdominal circumference x 100) was studied in 361 normal pregnancies between 15 and 42 weeks. This ratio was found to be independent of menstrual age, with a normal range after 21 weeks (mean ± 2 SD) of 22 ± 2. This ratio also was evaluated as a predictor of intrauterine growth retardation in 30 cases using the 90th percentile (23.5) as the upper limit of normal, which resulted in identification of 63% of the growth-retarded fetuses. Because it is independent of menstrual age, this ratio should prove most useful in evaluating high-risk patients who present in the third trimester of pregnancy with no dates. It is also of value in detecting growth retardation in patients with good menstrual history, since it was shown to become abnormal in asymmetrically growth-retarded fetuses before the estimated weight fell below the 10th percentile. Fetal intrauterine growth retardation, which is typically defined as a weight below the 10th percentile for age, is associated with increased perinatal morbidity and mortality. Proper obstetric management depends on recognition of this problem in utero, but its recognition is difficult prenatally on clinical findings alone. Efforts have been made to detect fetal growth retardation using a number of sonographic measurements such as biparietal diameter, serial biparietal di ameters, head to body circumference ratios, head to body area ratios, crownrump length times trunk area, total intrauterine volume, and fetal femur length [1, 2]. Proper use of all these measurements, however, requires precise knowledge of the true menstrual age, which often is not known in the high-risk indigent patient. It would be very helpful to have a screening tool for fetal growth retardation, which is age-independent.In our sonographic studies of fetal age using multiple fetal growth factors (biparietal diameter, head circumference, abdominal circumference, femur length) [3], we have noticed that after 21 weeks in a normal pregnancy the femur length and abdominal circumference seem to have a relatively constant relation to one another regardless of menstrual age. We also have observed growthretarded fetuses in which the fetal abdominal circumference was disproportionally reduced compared with the fetal femur length, a finding that is analogous to the postnatal observation in growth-retarded babies of disproportionate de creases in fetal weight compared with fetal crown-heel length (i.e., an abnormal ponderal index) [4]. In view of these observations, our study was undertaken with the following objectives: (1) to quantitate normal data for the femur length/ abdominal circumference ratio throughout gestation and to determine if this relation changes with time, and (2) to determine the usefulness of the femur length/abdominal circumference ratio in detecting intrauterine growth retarda tion.

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Section: Growth-retarded Fetusessupporting

confidence: 53%

A date-independent predictor of intrauterine growth retardation: femur length/abdominal circumference ratio

Hadlock¹,

Deter²,

Harrist³

et al. 1983

American Journal of Roentgenology

Self Cite

106

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show abstract

“…Early detection o f IUGR is essential for effective obstetric manage ment, whether in attempts to enha nce 16 have been developed in a largely Caucasian middle class population of women on whom ultrasound was performed within two weeks of delivery. Formulas for EFW have similarly been validated in studies of ultrasound examinations performed within 2 weeks, 11 3 days, n or as little as 2 days of delivery .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of early third-trimester ultrasound screening for intrauterine growth retardation.

Skovron

Gs²,

Lapinski³

et al. 1991

Journal of Ultrasound in Medicine

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Ultrasound fetal biometry is widely used for detection of intrauterine growth retardation (IUGR). Since fetal growth is a dynamic process, studies estimating validity of ultrasound near term may not be applicable earlier in pregnancy. This study applied receiver operating characteristic (ROC) curve analysis to ultrasound biometric data obtained at 26‐34 weeks gestation to predict fetuses destined to be IUGR at birth. In this method, the area under the curve (theta) is the index of performance. Sixty‐nine (9%) of the 768 singleton infants studied were IUGR at birth. Ultrasound estimated fetal weight (theta = .793) and abdominal circumference (theta = .785) had equivalent performance, significantly better than head circumference (theta = .724) or femur length/abdominal circumference ratio (theta = .619). Performance was not as good as suggested by studies conducted within 2 weeks of delivery.

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“…Manual measurements of the biparietal diameter, head circumference, abdominal circumference, humerus length, and femur length were performed according to guidelines previously described. [2][3][4][5][6] Automated measurements were performed using the syngo Auto OB software application with a Siemens S2000 ultrasound system as previously described. 1 A digital video recorder captured all on-screen activity associated with the sonographic examination, and a researcher not involved in the sonographic evaluations (S.G.) transcribed the recordings.…”

Section: Methodsmentioning

confidence: 99%

Does the Use of Automated Fetal Biometry Improve Clinical Work Flow Efficiency?

Espinoza

Good

Russell

et al. 2013

Journal of Ultrasound in Medicine

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This study was designed to compare the work flow efficiency of manual measurements of 5 fetal parameters with a novel technique that automatically measures these parameters from 2‐dimensional sonograms. This prospective study included 200 singleton pregnancies between 15 and 40 weeks' gestation. Patients were randomly allocated to either manual (n = 100) or automatic (n = 100) fetal biometry. The automatic measurement was performed using a commercially available software application. A digital video recorder captured all on‐screen activity associated with the sonographic examination. The examination time and number of steps required to obtain fetal measurements were compared between manual and automatic methods. The mean time required to obtain the biometric measurements was significantly shorter using the automated technique than the manual approach (P < .001 for all comparisons). Similarly, the mean number of steps required to perform these measurements was significantly fewer with automatic measurements compared to the manual technique (P < .001). In summary, automated biometry reduced the examination time required for standard fetal measurements. This approach may improve work flow efficiency in busy obstetric sonography practices.

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Fetal head circumference: relation to menstrual age

Cited by 192 publications

References 18 publications

A date-independent predictor of intrauterine growth retardation: femur length/abdominal circumference ratio

A date-independent predictor of intrauterine growth retardation: femur length/abdominal circumference ratio

Evaluation of early third-trimester ultrasound screening for intrauterine growth retardation.

Does the Use of Automated Fetal Biometry Improve Clinical Work Flow Efficiency?

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