OC104: Soft tissue parameters improve the precision of fetal weight estimation

Abstract

Objectives: Current weight estimation models do not consider the contribution of fetal soft tissue to fetal weight. We have investigated new weight estimation models that use a combination of conventional biometry and soft tissue parameters. Methods: A cross-sectional study of 248 fetuses was performed using 3DUS to acquire standard biometry (BPD, AC, FDL), fractional arm volume (Avol), and fractional thigh volume (TVol) within 4 days of delivery. Multiple linear regression was used to develop a 'modified Hadlock' model (BPD, AC, FDL) and similar models that also included soft tissue parameters for predicting birth weight (BW). New models were prospectively applied in 55 pregnancies. Predicted and observed weights were compared and signed percent differences calculated. Mean and SD of % differences were taken as measures of systematic and random prediction errors, respectively. Proportion of subjects with predicted BW within 5 or 10% (inclusive) were compared using McNemar's test. Results: For the validation group, the mean maternal age was 27 ± 7.0 (SD) years. Introduction: For successful reproductive outcome embryo quality and endometrial receptivity are essential requirements. The definition of the latter, however, has stirred some controversy and the reason for the low implantation rate remains as yet unclear. Although several studies on intrauterine and ovarian blood flow have been reported results have been at best conflicting. Methods: The prospective study was designed to investigate the role of VEGF-concentration in serum and follicular fluid and the role of 2D/3D (Doppler) sonography of the ovaries in predicting conception in an in-vitro fertilization-embryo transfer (IVF-ET) programme. Transvaginal 2D/3D (Doppler) sonography was performed in 102 patients on the day of oocyte retrieval. Primary outcome variable was the correlation between conception rate and sonographic as well as biochemical parameters. Results: As expected, significant correlation was found between ovarian volume, number of aspirated oocytes and serum estradiol concentration. In contrast, none of the sonographic parameters were correlated with reproductive outcome. Of note, VEGF concentration in serum but not in follicular fluid was significantly higher in conception than in non-conception cycles (p = 0.024). A serum VEGF cut-off level of 233 pg/ml is able to predict conception with a sensitivity of 65% and a specificity of 71%. Conclusion: In contrast to 2D/3D (Doppler) sonography serum VEGF levels may allow prediction of IVF success. Objectives: To evaluate three-dimensional (3D) ultrasound for verification of the position of micro-inserts after sterilization. Methods: Prospective study of 20 consecutive patients who had ESSURE devices inserted. All patients had an X-ray scan three months after insertion; if there was any doubt about position, hysterosalpingography was performed. 3D ultrasound by a different investigator preceded the radiography. OC107

Sonographic fetal weight estimation in prolonged pregnancy: comparative study of two‐ and three‐dimensional methods

“…The models yielding the best results were those including BPD, AC and thigh volume. Somewhat surprisingly, we found the 2D method of FW estimation to perform better than the Lee 1 formula10 and similarly to the Lee 2 formula11. It could be argued that this may have been due to the examiner lacking sufficient experience in the use of 3D ultrasound imaging.…”

“…By using 3D ultrasound imaging it is possible to generate volume data sets of the fetus. There is published evidence that fetal limb volume measurements and abdominal volume measurements may be valuable in estimating FW2, 9–14. Lee et al have developed several BW prediction models using 3D volumetric measurements of thigh, arm and abdomen, including one or more parameters1, 9–11.…”

“…One hundred and seventy‐six women fulfilled the above criteria and constituted the Study Group (Group 1). Their data were used for a comparison of three previously published formulae8, 10, 11. While the study was ongoing, we decided to perform measurement of fetal abdominal volume as well.…”

“…For calculation of FW based on 2D measurements, the Persson and Weldner formula was used8, and for FW estimation based on 3D measurements, including fetal thigh volumetry, the two formulae by Lee et al (Lee 110; Lee 211) were applied (Table 2).…”

Comparison of Estimated Fetal Weights Using Volume and 2-Dimensional Sonography and Their Relationship to Neonatal Markers of Fat

“…This finding corroborates those of a previous study of incorporation of the fractional fetal thigh volume into the estimation of fetal weight. 18,19 We found fetal weight estimates that included the fractional thigh volume to be more frequently within 15% of actual birth weights and to be consistently accurate across a wide range of birth weights compared with traditional 2D biometric measurements. A larger study may be necessary to corroborate this finding given the small subset of patients who had birth weights of less than 2500 g. We also observed that the fetal fractional thigh and upper arm volumes correlated significantly with neonatal skin fold measurements and markers of neonatal obesity.…”