Ultrasonographic weight estimation in large for gestational age fetuses: A comparison of 17 sonographic formulas and four models algorithms

Rosati, Paolo; Arduini, M; Giri, Carla; Guariglia, Lorenzo

doi:10.3109/14767050903410631

Cited by 16 publications

(21 citation statements)

References 31 publications

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“…Notably, however, mathematical models may not be feasible in a clinical practice setting. Taken together, available research supports ultrasound measurement alone not being an accurate predictor of estimated fetal weight, and maternity care providers should consider this when counseling women …”

Section: Methods Of Estimating Fetal Weightmentioning

confidence: 94%

“…A 2010 review of sonographic models and algorithms concluded that the widely accepted Hadlock formula that includes biparietal diameter, abdominal circumference, and femur length, produces an estimated fetal weight that is acceptable; however, the Warsof2 formula that uses the abdominal circumference alone, showed a higher accuracy in the predication of large‐for‐gestational age fetuses. Specifically, the Warsof2 formula demonstrated the highest accuracy (mean percentage error) and precision (standard deviation, SD) for predicting fetal macrosomia with overall prediction within 5%, 10%, and 15% of birth weight in 68%, 94%, and 98% of actual birth weight, respectively …”

Section: Methods Of Estimating Fetal Weightmentioning

confidence: 99%

See 1 more Smart Citation

The Suspected Macrosomic Fetus at Term: A Clinical Dilemma

Ray¹,

Alhusen²

2016

J Midwife Womens Health

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Estimation of fetal weight is an important component of antenatal and intrapartum management of pregnant women. While many clinicians use ultrasound estimates of fetal weight to assess fetal growth, there are inherent challenges in both the diagnosis and management of suspected fetal macrosomia. Given the inaccuracy in estimating fetal weight, and the risks that accompany cesarean birth or induction of labor, the management of suspected fetal macrosomia requires open communication and shared decision making between the woman and her health care providers. This case study and literature review highlight the current management and recommendations for suspected fetal macrosomia.

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Section: Methods Of Estimating Fetal Weightmentioning

confidence: 94%

Section: Methods Of Estimating Fetal Weightmentioning

confidence: 99%

The Suspected Macrosomic Fetus at Term: A Clinical Dilemma

Ray¹,

Alhusen²

2016

J Midwife Womens Health

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“…AC is the most common and reliable single parameter used to assess risk of macrosomia (56) . It is measured on a defined plane incorporating the liver since growth abnormalities are often reflected by changes in liver size (57) .…”

Section: Ultrasound Assessmentmentioning

confidence: 99%

Suspected fetal macrosomia and the risk of shoulder dystocia as an indication for cesarean section

Vlădăreanu¹

2015

Gineco.eu

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Suspected fetal macrosomia and the risk of shoulder dystocia as an indication for cesarean section Macrosomia is associated with increased risk for perinatal complications including prolonged labor, shoulder dystocia, perinatal mortality and maternal morbidity including cesarean delivery, severe postpartum hemorrhage, and vaginal lacerations. Among maternal risk factors for fetal macrosomia are high body-mass index, diabetes mellitus, postterm pregnancy, previous macrosomic infant. Shoulder dystocia occurs in 0.2-3% of all births and represents an obstetric emergency. Although, in general, clinical estimates of birth weight perform favorably, ultrasound immediately prior to labour is more accurate at predicting the high birth-weight fetus. Ultrasound measurement of abdominal circumference and fetal biometry are the only practical methods used to detect fetal weight over 4000 g, but they are characterized by low sensitivity, low positive predictive value and high negative predictive value. Serial sonographic measurements can increase the positive predictive value. By combining three-dimensional volumetric measurements with two-dimensional measurements, should increase the ability to predict macrosomia. Nowadays, clinicians needs to examine all the information available to take a decision on whether the risk of macrosomia and shoulder dystocia is high, and if so then an elective caesarean section is indicated. Predicting fetal macrosomia does not imply that elective caesarean section is the method of choice, but it should be made clear to the couple that elective caesarean section is the low-risk option. Important to note is that each woman should be informed of the particular risks associated with a macrosomic fetus and shoulder dystocia. The mother should be supported in the decision, because it is a situation in which maternal autonomy is paramount.

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“…Muitos estudos salientam que os modelos para estimativa de peso fetal deveriam ser adaptados às diferentes populações, respeitando suas características étnicas [9][10][11][12][13][14][15] . No entanto, a maioria dos centros utiliza fórmulas tradicionais geradas em outros países, que podem levar a erros significativos quando aplicadas localmente 14,15 .…”

Section: Introductionunclassified

“…No entanto, a maioria dos centros utiliza fórmulas tradicionais geradas em outros países, que podem levar a erros significativos quando aplicadas localmente 14,15 . Além disso, a avaliação do tamanho do feto (estimativa do peso em um momento da gestação) é frequentemente considerada como sinônimo de avaliação de crescimento, sendo esta interpretada erroneamente à luz de intervalos de referência provenientes de estudos transversais 16,17 .…”

Section: Introductionunclassified

Elaboração e validação de intervalos de referência longitudinais de peso fetal com uma amostra da população brasileira

Furlan¹,

Bennini²,

Faro³

et al. 2012

Rev. Bras. Ginecol. Obstet.

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ResumoOBJETIVOS: Elaborar modelos de predição de peso fetal e de percentis longitudinais de peso fetal estimado (PFE) com uma amostra da população brasileira. MÉTODOS: Estudo observacional prospectivo. Dois grupos de gestantes foram recrutados: Grupo EPF (estimativa de peso fetal): pacientes para elaboração (EPF-El) e validação (EPF-Val) de um modelo de predição de peso fetal; Grupo IRL (intervalos de referência longitudinais): gestantes para elaboração (IRL-El) e validação (IRL-Val) de intervalos de referência longitudinais de PFE. Regressão polinomial foi utilizada com os dados do subgrupo EPF-El para gerar o modelo de predição de peso fetal. O desempenho deste modelo foi comparado com os de outros disponíveis na literatura. Modelos lineares mistos foram usados para elaboração de intervalos longitudinais de PFE com os dados do subgrupo IRL-El. Os dados do subgrupo IRL-Val foram usados para validação destes intervalos. Os desempenhos de outras fórmulas para estimativa de peso fetal em nossa amostra foram significativamente piores do que os do modelo gerado neste estudo. Equações para predição de percentis condicionais de PFE foram derivadas das avaliações longitudinais do subgrupo IRL-El e validadas com os dados do subgrupo IRL-Val. CONCLUSÕES: descrevemos um método para adaptação de intervalos de referência longitudinais de PFE, sendo este obtido por meio de fórmulas geradas em uma amostra da população brasileira. Abstract PURPOSES:To elaborate models for the estimation of fetal weight and longitudinal reference intervals of estimated fetal weight (EFW) using a sample of the Brazilian population. METHODS: Prospective observational study. Two groups of patients were evaluated: Group EFW (estimation of fetal weight): to elaborate (EFW-El) and validate (EFW-Val) a model for the prediction of fetal weight; Group LRI (longitudinal reference intervals): To elaborate (LRI-El) and validate (LRF-Val) conditional (longitudinal) percentiles of EFW. Polynomial regression analysis was applied to the data from subgroup EFW-El to elaborate a model for the estimation of fetal weight. The performance of this model was compared to those of previously published formulas. Linear mixed models were used for the elaboration of longitudinal reference intervals of EFW using data from subgroup LRI-El. Data obtained from subgroup LRI-Val were used to validate these intervals. RESULTS: Group EFW consisted of 458 patients and Group LRI consisted of 315 patients (LRI-El: 265; LRI-Val: 50). The model obtained for EFW was: EFW=-8.277+2.146xBPDxACxFL-2.449xFLxBPD 2 . The performances of other models were significantly worse than those obtained with our formula. Equations for the prediction of conditional percentiles of EFW were derived from the longitudinal observation of patients of subgroup LRI-El and validated with data from subgroup LRI-Val. CONCLUSIONS: We described a method for customization of longitudinal reference intervals of EFW obtained using formulas generated from a sample of the Brazilian population.

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Ultrasonographic weight estimation in large for gestational age fetuses: A comparison of 17 sonographic formulas and four models algorithms

Abstract: Accuracy of EFW in LGA fetuses is attributable to the biometric parameters used. Our findings show that the best formulas for EFW are those which only consider the abdominal measurements, especially in diabetic mothers. The new variable that we propose (HPT) confirms this result.

Cited by 16 publications

References 31 publications

The Suspected Macrosomic Fetus at Term: A Clinical Dilemma

The Suspected Macrosomic Fetus at Term: A Clinical Dilemma

Suspected fetal macrosomia and the risk of shoulder dystocia as an indication for cesarean section

Elaboração e validação de intervalos de referência longitudinais de peso fetal com uma amostra da população brasileira

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