Intrapartum fetal subcutaneous tissue/femur length ratio: An ultrasonographic clue to fetal macrosomia

Macrosomia: a new formula for optimized fetal weight estimation

“…Matsumoto et al 33 , Santolaya-Forgas et al 34 and Petrikovsky et al 35 used three-dimensional qualitative sonographic evaluation of fetal soft tissue, the sonographically measured fetal subcutaneous tissue/FL ratio, and the sonographically measured abdominal subcutaneous tissue thickness, respectively, and achieved improved weight assessment in macrosomic fetuses. Matsumoto and colleagues examined 52 fetuses between the 29 th and 41 st week of gestation, and determined a fetal nutrition score by measuring subcutaneous fatty tissue at three sites in the body (face, ribs and buttocks).…”

“…Santolaya-Forgas et al compared measurement accuracy of the fetal AC, EFW and fetal subcutaneous tissue/FL ratio in predicting large-for-gestational age fetuses. They found that the fetal subcutaneous tissue/FL ratio was a parameter independent of gestational age and able to provide greater sensitivity in identifying large-for-gestational age fetuses than AC measurements 34 . Petrikovsky et al measured subcutaneous tissue diameter in the abdominal area and found it significantly different between normal and macrosomic fetuses (7.0 mm vs. 12.4 mm; P < 0.0001) 35 .…”

What is the value of ultrasound soft tissue measurements in the prediction of abnormal fetal growth?

“…In a two-stage study to compare the accuracy of ultrasonographic intrapartum measurement of the AC, EFW and the midthigh subcutaneous tissue thickness/ femur length (FL) ratio to screen for macrosomia (490th centile for gestational age), 274 women were scanned (Santolaya-Forgas et al 1994). The midthigh subcutaneous tissue thickness was measured at the level of the femur diaphysis; the callipers were placed at the outer and inner edges of the subcutaneous layer.…”

“…All the women had either a normal glucose challenge or a glucose tolerance test and delivered within 48 h of the ultrasound scan. The midthigh subcutaneous tissue thickness was measured as previously described (Santolaya-Forgas et al 1994). There were 27 macrosomic (above 90th centile for gestational age) infants.…”

Goals of Metabolic Management of Gestational Diabetes

“…However, this approach has not been confirmed by others and has not gained wide popularity. Others suggested that measuring subcutaneous fetal fat tissue (e.g., width/femur length ratio) achieves increased sensitivity and specificity (37)(38)(39)(40)(41). Moreover, assessment of sonographic markers for deviant fetal growth as the width of fetal fat layers, assessment of intraventricular septum width, and abdominal circumference were tested (42).…”