The utility of ultrasound in late pregnancy compared with clinical evaluation in detecting small and large for gestational age fetuses in low-risk pregnancies

Al-Amin, Ahmed; Hingston, Tania J.; Mayall, Peter; Júnior, Edward Araujo; Silva, Costa Fabrício Da; Friedman, Deborah

doi:10.3109/14767058.2014.961007

Cited by 8 publications

(5 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As discussed earlier, the sonography methods can be affected by genetic variations, such as the head shape, positioning of the fetus and pathologic conditions. While the error of the ultrasound-based GA predictors increases with gestational age (Caughey et al, 2008; Falatah et al, 2014; Al-Amin et al, 2015), according to our results, the error of the valve-based method does not change with gestational progression. The accuracy of the FHR-based method even increased with advancing gestation.…”

Section: Discussionsupporting

confidence: 73%

“…The accuracy of the FHR-based method even increased with advancing gestation. Therefore our proposed physiological measures can be used in second and third trimesters, when the ultrasound imaging measures have a low accuracy and fail to detect abnormal growth, particularly in late gestation (Al-Amin et al, 2015). Overall, the proposed technique can be used as a measure of the physiological development and an adjunct in estimating the GA where ultrasound methods are unavailable or inadequate due to pathologies, unsuitable positioning, lack of skilled ultrasound operators, or other technical issues.…”

Section: Discussionmentioning

confidence: 99%

“…The prediction interval may be as large as ±7 weeks for the estimators with higher standard errors, such as AC (Sherwood et al, 2000). The error also increases with the gestational age and generally the ultrasound methods are more precise when performed in the first-trimester (Caughey et al, 2008; Falatah et al, 2014; Al-Amin et al, 2015). Pathological conditions may also introduce a high levels of inaccuracy or significant bias in many estimation methods.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Assessment of Fetal Development Using Cardiac Valve Intervals

et al. 2017

View full text Add to dashboard Cite

An automated method to assess the fetal physiological development is introduced which uses the component intervals between fetal cardiac valve timings and the Q-wave of fetal electrocardiogram (fECG). These intervals were estimated automatically from one-dimensional Doppler Ultrasound and noninvasive fECG. We hypothesize that the fetal growth can be estimated by the cardiac valve intervals. This hypothesis was evaluated by modeling the fetal development using the cardiac intervals and validating against the gold standard gestational age identified by Crown-Rump Length (CRL). Among the intervals, electromechanical delay time, isovolumic contraction time, ventricular filling time and their interactions were selected in a stepwise regression process that used gestational age as the target in a cohort of 57 fetuses. Compared with the gold standard age, the newly proposed regression model resulted in a mean absolute error of 3.8 weeks for all recordings and 2.7 weeks after excluding the low quality recordings. Since Fetal Heart Rate Variability (FHRV) has been proposed in the literature for assessing the fetal development, we compared the performance of gestational age estimation by our new valve-interval based method, vs. FHRV, while assuming the CRL as the gold standard. The valve interval-based method outperformed both the model based on FHRV. Results of evaluation for 30 abnormal cases showed that the new method is less affected by arrhythmias such as tachycardia and bradycardia compared to FHRV, however certain types of heart anomalies cause large errors (more than 10 weeks) with respect to the CRL-based gold standard age. Therefore, discrepancies between the regression based estimation and CRL age estimation could indicate the abnormalities. The cardiac valve intervals have been known to reflect the autonomic function. Therefore the new method potentially provides a novel approach for assessing the development of fetal autonomic nervous system, which may be growth curve independent.

show abstract

Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Assessment of Fetal Development Using Cardiac Valve Intervals

et al. 2017

View full text Add to dashboard Cite

show abstract

“…These findings informed our choice of 36–37 weeks as the optimum gestational‐age window in which to perform growth ultrasound in low‐risk pregnancies. Additional recent studies support the superiority of universal routine third‐trimester ultrasound in detecting SGA fetuses, especially if done near term and combined with physiological parameters such as UA and MCA Doppler studies 23–25 .…”

Section: Discussionmentioning

confidence: 95%

Routine third‐trimester ultrasound for the detection of small‐for‐gestational age in low‐risk pregnancies (ROTTUS study): randomized controlled trial

Wanyonyi

Orwa

Ozelle

et al. 2021

Ultrasound in Obstet & Gyne

View full text Add to dashboard Cite

The use of a routine late third-trimester ultrasound-based protocol in well-selected low-risk pregnancies significantly increases the detection rate of small-forgestational-age (SGA) neonates compared with a selective symphysis-fundus height measurement-based approach. What are the clinical implications of this work?Considering the association between stillbirth and undetected fetal growth abnormalities, especially in underserved areas, we recommend routine third-trimester ultrasound in low-risk pregnancies to detect SGA. This justifies the routine use of ultrasound for fetal growth monitoring between 36 + 0 and 37 + 6 weeks.

show abstract

“…The accuracy of the growth assessment is dependent on several factors, which include operator experience, maternal BMI and gestational age. The Hadlock formula has the highest PPV and negative predictive value (NPV) likelihood ratios [3 ▪▪ ,5,7]. Other studies have suggested the use of volumetric estimation via MRI scan, but to date, this method has not been shown to be superior to ultrasonic estimation [8].…”

Section: Accuracy Of Growth Scans In Third Trimestermentioning

confidence: 99%

Additional single third trimester ultrasound scan in detection of large for gestational age fetuses

Kwok

Angioni²

2022

Current Opinion in Obstetrics &Amp; Gynecology

View full text Add to dashboard Cite

Purpose of reviewTo evaluate the accuracy of growth scans in the third trimester. To evaluate the accuracy of universal third trimester ultrasound scans in the detection of large for gestational age (LGA) fetuses. To investigate how universal ultrasound scans affect the delivery and outcomes.Recent findingsUniversal third trimester screening for LGA recorded a 22% positive predictive value (PPV), and 96% negative predicted value (NPV). The sensitivity in most studies reaches around 70% or more, of all the LGA fetuses delivered, there are different studies for and against universal ultrasonic screening of LGA. Estimated fetal weight (>4 kg/90th centile) and abdominal circumference are the best predictors of LGA with nearly 70% sensitivity. One study reported that an antenatal ultrasonic diagnosis of LGA in a low risk population has a weak association with the incidence of shoulder dystocia or poor neonatal outcomes. Universal screening in the third trimester for LGAs is not cost effective.SummaryLow risk pregnancies constitute the majority of the pregnancy population. All low risk pregnancy women will only receive two routine scans throughout the whole pregnancy. There is no evidence at present that conclusively demonstrates that an additional scan at 36 weeks improves maternal and neonatal outcomes and is cost effective.

show abstract

The utility of ultrasound in late pregnancy compared with clinical evaluation in detecting small and large for gestational age fetuses in low-risk pregnancies

Cited by 8 publications

References 27 publications

Assessment of Fetal Development Using Cardiac Valve Intervals

Assessment of Fetal Development Using Cardiac Valve Intervals

Routine third‐trimester ultrasound for the detection of small‐for‐gestational age in low‐risk pregnancies (ROTTUS study): randomized controlled trial

Additional single third trimester ultrasound scan in detection of large for gestational age fetuses

Contact Info

Product

Resources

About