Intra‐ and interobserver variability in fetal ultrasound measurements

Sarris, Ippokratis; Ioannou, Christos; Chamberlain, P.; Ohuma, Eric O; Roseman, Fenella; Hoch, Laura; Altman, Douglas G.; Papageorghiou, A.T.

doi:10.1002/uog.10082

Cited by 159 publications

(163 citation statements)

References 28 publications

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“…Inaccurate measurements can lead to erroneous detection of fetal growth restriction or macrosomia leading to unnecessary intervention, maternal anxiety and iatrogenic perinatal morbidity; or may lead to inaccurate identification of growth-restricted fetuses as normal [18].…”

Section: Discussionmentioning

confidence: 99%

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Comparison of ultrasound fetal biometry of singleton fetuses with a reference chart in pregnant women with normal nutritional and health status

Dias

Chandrasiri

Abeykoon³

et al. 2017

Ceylon Med. J.

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Objectives The aim of this study was to compare fetal biometry of singleton fetuses in pregnant women with normal nutritional and health status in the Ampara district, with a commonly used reference chart.Methods A cross sectional study was carried out in the Ampara District. Women with normal nutritional and health status and minimal environmental constraints on fetal growth (n=714) were enrolled during the first trimester and gestational age was confirmed by fetal crown-rump length measurement between 11 weeks + 0 days and 13 weeks + 6 days. For this study, each mother was considered only once for measurement of fetal biometry, at gestations between 11 and 41 weeks. Fetal bi-parietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL) were measured using standard techniques, and separate regression models were fitted to estimate the means and standard deviations and derive gestation specific centiles for each parameter, assuming that the measurements have a normal distribution at each gestational age. The fetal biometry results obtained from the current study were compared with a commonly used reference chart. ResultsThe fitted 10th, 50th and 90th centiles at 40 weeks of gestation were, 87.9 mm, 93.2 mm and 98.5 mm for BPD, 313.8 mm, 328.9 mm and 344.0 mm for HC; 298.2 mm, 322.5 mm and 346.9 mm for AC and 69.7 mm, 75.0 mm and 80.2 mm for FL. When compared with the reference chart, significant differences of fetal biometry were seen in the third trimester but not in the second trimester.Conclusions Ultrasound fetal biometry of singleton fetuses in pregnant women with normal nutritional and health status in the Ampara District were significantly different in the third trimester, from a routinely used reference chart.Comparison of ultrasound fetal biometry of singleton fetuses with a reference chart in pregnant women with normal nutritional and health status

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Section: Discussionmentioning

confidence: 99%

“…This trend is known to be more pronounced for HC and AC than for FL [18]. However, studies have also shown good intraand inter observer reproducibility of ultrasound measurements of fetal biometry [25][26][27].…”

Section: Papermentioning

confidence: 94%

Comparison of ultrasound fetal biometry of singleton fetuses with a reference chart in pregnant women with normal nutritional and health status

Dias

Chandrasiri

Abeykoon³

et al. 2017

Ceylon Med. J.

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“…Reliability was confirmed within 7.5% for the measurements taken by the sonographer compared with ENH. Recent work has compared the inter‐observer reliability when performing fetal biometry with 95% limits of agreement for AC ± 8.8% 28 . Although it was possible that the results would be affected by the relative inexperience of ENH and the fact that that AC measurement is difficult to measure reliably, particularly in the third trimester, 29 , 30 the data showing accuracy for the AC measurement are reassuring.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound (in)accuracy: it's in the formulae not in the technique – assessment of accuracy of abdominal circumference measurement in term pregnancies

Nesbitt‐Hawes

Tetstall

Gee

et al. 2014

Australas J Ultrason Med

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Introduction: Fetal abdominal circumference (AC) is utilised in calculations for the estimation of fetal weight (EFW) and has been proposed as a method of monitoring diabetic pregnancies. We evaluated true ultrasound accuracy by comparing fetal AC biometry with neonatal anthropometry and compared this with standard ultrasound estimations of fetal weight. Methods: A prospective observational study was performed at a tertiary referral centre. Women who were having their confinement of a term, singleton gestation either by induction of labour or elective caesarean section from 2009–2011 were approached to participate. An ultrasound was performed within 24 hours of delivery measuring the biometric parameters of AC, head circumference (HC), biparietal diameter and femur length. Following delivery the AC, HC and birthweight were measured on the neonate. Results: Fifty‐two patients were enrolled in the study with data collected from 50. Mean AC measurement was 35.1 ± 2.1 cm and birth weight was 3596 ± 517 g. A Bland‐Altman plot was used to compare the two AC measurements with the 95% limits of agreement ranging from −2.33–4.69 cm around a mean difference of 1.2 cm. Mean percentage error was 5.0% and 6.2% for the AC and HC measurements respectively, in comparison with percentage errors of 7.0–13.8% for estimation of fetal weight (EFW) from 27 formulae. Conclusions: Sonographic AC measurement is accurate in term pregnancies, with a percentage error less than HC or EFW. Perceptions of ultrasound inaccuracy may relate to the application of formulae rather than the ultrasound technique itself. Fetal surveillance using serial AC measurement has been proposed, in particular monitoring of diabetic pregnancies and in such a group AC may be easier and faster to obtain and more meaningful than EFW.

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“…Prvi razlog je da je većina studija koje su analizirale ponovljivost različitih ultrazvučnih merenja u akušerstvu koristila ovaj metod, što daje mogućnost adekvatnije diskusije postignutih rezultata (Bland et Altman, 1990;Brennan et Silman, 1992;Sarris et al, 2012). Drugi razlog je njegova prednost u objektivnijem tumačenju rezultata ove studije, obavljene kod trudnica u drugom i trećem trimestru trudnoće, jer njegova evaluacija uzima u obzir i različitu gestacionu starost (Sarris et al, 2012). Iako bi različita fetalna prezentacija, intenzivirana fetalna aktivnost i povećani BMI (koji se često viđaju u trudnoćama komplikovanim GDM-om) mogli otežati pregled i povećati varijabilnost merenja, rezultati disertacije nisu ispunili ova očekivanja.…”

Section: Procena Pouzdanosti Ultrazvučnog Skora U Otkrivanju šEćerne unclassified

“…Iako bi različita fetalna prezentacija, intenzivirana fetalna aktivnost i povećani BMI (koji se često viđaju u trudnoćama komplikovanim GDM-om) mogli otežati pregled i povećati varijabilnost merenja, rezultati disertacije nisu ispunili ova očekivanja. Uvidom u literaturne podatke, ustanovljeno je da su i drugi autori došli do zaključka da pomenute varijable i faktori nisu značajno uticali na varijabilitet (Harstad et al, 1994;Sarris et al, 2012). Značaj ove studije ogleda se i u tome što je u nju uključen i veliki broj trudnica sa povišenim vrednostima BMI (maksimalna BMI vrednost u momentu ultrazvučnog pregleda u studijskoj populaciji iznosila je 47.47), a s obzirom da je to i jedan od mogućih inkluzionih kriterijuma, a za razliku od nekih prethodnih studija koje su kao gornji limit BMI imali vrednost od 29.9 (Sarris et al, 2012).…”

Section: Procena Pouzdanosti Ultrazvučnog Skora U Otkrivanju šEćerne unclassified

Diagnostic significance of ultrasonographic score in detection of gestational diabetes mellitus

Perović¹

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Intra‐ and interobserver variability in fetal ultrasound measurements

Abstract: Although intra- and interobserver variability increases with advancing gestation when expressed in millimeters, both are constant as a percentage of the fetal dimensions or when reported as a Z-score. Thus, measurement variability should be considered when interpreting fetal growth rates.

Cited by 159 publications

References 28 publications

Comparison of ultrasound fetal biometry of singleton fetuses with a reference chart in pregnant women with normal nutritional and health status

Comparison of ultrasound fetal biometry of singleton fetuses with a reference chart in pregnant women with normal nutritional and health status

Ultrasound (in)accuracy: it's in the formulae not in the technique – assessment of accuracy of abdominal circumference measurement in term pregnancies

Diagnostic significance of ultrasonographic score in detection of gestational diabetes mellitus

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