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      Accuracy of sonographic fetal weight estimation in full-term singleton pregnant women

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          Abstract

          Objectives:

          To investigate the factors which might influence the sonographic fetal weight estimation (SFWE) accuracy.

          Methods:

          This prospective study was conducted among 949 singleton term pregnant women who delivered at a tertiary center, from January 2017 to December 2017. All participants’ maternal (i.e. parity, age, body mass index and gestational weight gain during pregnancy), fetal sonographic (i.e. fetal presentation, amniotic fluid index, localization of placenta and estimated fetal weight) and neonatal (birth weight and gender) characteristics were recorded. A p<0.05 was considered significant.

          Results:

          The mean absolute percent error (APE) values of SFWE was 8.2±6.5 percent, and overall failure ratio (APE >10%) was 33%. In failure group, primiparous woman and cephalic presentation fetus were significantly more common compared to accuracy group (55.9% vs.44.8%; p=0.001 and 98% vs. 95.2%; p=0.03, respectively). In contrast, the mean neonatal birth weight (NBW) value was significantly lower in failure group compared to success group (3250±565 gr vs. 3404±410 gr; p=0.001). The correlation between SFWE and NBW was linear, however negative, and significant ( p=0.001). Logistic regression analysis revealed that primiparous woman, cephalic presentation fetus and <3300 gr NBW were independent risk factors for the SFWE failure (relative risks were 1.6, 2.8 and 2.4 respectively, p<0.05).

          Conclusion:

          SFWE has a high correlation with NBW, however it’s accuracy is still unsatisfactory, and depend on many unpredictable and inconsistent factors.

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          Most cited references23

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          A systematic review of the ultrasound estimation of fetal weight.

          The range and use of ultrasound fetal measurements have gradually been extended. Measurements have been combined to estimate fetal weight by mathematically based non-linear regression analysis or physically based volumetric methods. Fetal weight estimation is inaccurate, with poor sensitivity for prediction of fetal compromise. Several authors have shown the unacceptable level of intra- and interobserver variability in fetal measurement and the impact of errors on growth assessment. The aims of this study were to review the available methods and possible sources of inaccuracy. Four databases were searched for studies comparing ultrasound estimated fetal weight (EFW) with birth weight. Studies meeting the inclusion criteria evaluated 11 different methods. Errors were graphically summarized. No consistently superior method has emerged. Volumetric methods provide some theoretical advantages. Random errors are large and must be reduced if clinical errors are to be avoided. The accuracy of EFW is compromised by large intra- and interobserver variability. Efforts must be made to minimize this variability if EFW is to be clinically useful. This may be achieved through averaging of multiple measurements, improvements in image quality, uniform calibration of equipment, careful design and refinement of measurement methods, acknowledgment that there is a long learning curve, and regular audit of measurement quality. Further work to improve the universal validity and accuracy of fetal weight estimation formulae is also required. Copyright (c) 2004 ISUOG.
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            Clinical and sonographic estimation of fetal weight performed during labor by residents.

            This study was undertaken to assess the accuracy of both clinical and sonographic estimations of the fetal weight (EFW) performed during the active phase of labor by residents.
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              Clinical vs. sonographic estimate of birth weight in term parturients. A randomized clinical trial.

              To determine the relative accuracy of clinical and sonographic birth weight estimation among term parturients (> or = 37 weeks) and to assess the performance of the two techniques in identifying newborns with weights of or = 2,500 g or or = 37 weeks, admitted for delivery and with no known fetal anomalies. Physicians who were unaware of previous sonographic estimates obtained the estimates. Student t and chi 2 tests were used; relative risk (RR) and 95% confidence intervals (CIs) were calculated. Receiver-operating characteristic (ROC) curves were constructed to compare the two techniques' ability to differentiate between abnormal (birth weight 4,000 g) and normal (2,500-3,999 g). P or = 4,000 g. Predictions based on clinical examination were significantly more likely to be within 10% of actual weight (58%) than those derived from ultrasound examination (32%; P .05). Among term parturients, clinical estimates had significantly higher accuracy than ones derived sonographically.
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                Author and article information

                Journal
                Pak J Med Sci
                Pak J Med Sci
                Pakistan Journal of Medical Sciences
                Professional Medical Publications (Pakistan )
                1682-024X
                1681-715X
                Jan-Feb 2019
                : 35
                : 1
                : 34-38
                Affiliations
                [1 ]Emre Erdem Tas, Assistant Professor, Department of Obstetrics and Gynecology, Ankara Yildirim Beyazit University, Faculty of Medicine, Ankara, Turkey
                [2 ]Edip Alptug Kir, M.D. Department of Obstetrics and Gynecology, Ankara Yildirim Beyazit University, Faculty of Medicine, Ankara, Turkey
                [3 ]Gamze Yilmaz, M.D. Department of Obstetrics and Gynecology, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
                [4 ]Prof. Ayse Filiz Yavuz, Department of Obstetrics and Gynecology, Ankara Yildirim Beyazit University, Faculty of Medicine, Ankara, Turkey
                Author notes
                Correspondence: Emre Erdem Tas, Assistant Professor, Department of Obstetrics and Gynecology, Ankara Yildirim Beyazit University, Ankara Ataturk Training and Research Hospital, Mehmet Akif Ersoy Mah, Yesilay Cad. 5A/121, 06200 Yenimahalle/Ankara, Turkey. E-mail: doctortas@ 123456yahoo.com
                Article
                PJMS-35-34
                10.12669/pjms.35.1.373
                6408678
                30881392
                9279d24e-3c4f-44b2-b8de-9c668ea3b870
                Copyright: © Pakistan Journal of Medical Sciences

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 20 August 2018
                : 15 December 2018
                : 08 January 2019
                Categories
                Original Article

                prenatal ultrasonography,fetal weight,birth weight,pregnancy

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