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Yılmaz Ergani S, Çakır BT, Akay A, Ulusoy CO, Akdaş Reis Y, Sarsmaz K, Örgül G, Esin S, Çağlar AT. Predicting the fetal weight by ultrasonography for isolated polyhydramnios: Comparison of 14 formulas. J Obstet Gynaecol Res 2024. [PMID: 39054749 DOI: 10.1111/jog.16025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 07/07/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE To recalculate the estimated fetal weight (EFW) based on ultrasound measurements in patients complicated with isolated polyhydramnios, using 14 current formulas to observe which formula better predicts the EFW. METHODS This study examined pregnant women who gave birth in the hospital between January 2015 and January 2020. Maximum vertical pocket (MVP) was classified as, mild, moderate, and severe polyhydramnios, and the patients' measurements were reanalyzed using 14 formulas. The estimation of birth weight (EBW) alongside observed birth weight (OBW) facilitated the computation of statistical indices, namely the mean absolute percentage error (MAPE) expressed as [(EBW - OBW)/OBW × 100], the mean percentage error (MPE) denoted as (EBW - OBW)/(OBW × 100), and their corresponding 95% confidence intervals. RESULTS A total of 564 polyhydramnios patients were included in the study. When looking at the MAPE, the lowest rate (7.65) was found in the Hadlock 2 formula. Hadlock 1, Hadlock 3, and Shinozuka formulas demonstrated MAPE values most closely aligned with Hadlock 2. Weiner I and Thurnau were the formulas with the highest MAPE values. When the cut-off values for MAPE were taken as 10%, 4/14 of the formulas (Weiner I-II, Vintzleos and Thurnau) gave results above 10%. Among 14 formulas, 3 (21.4%) had positive (sonographic overestimation) (Hadlock 3, Shinozuka, and Vintzleos) and the other 11 (78.6%) had negative MPE (sonographic underestimation). CONCLUSION The Hadlock 2 formula had the lowest MAPE in predicting birth weight in patients with polyhydramnios, closely followed by the Hadlock 1, Hadlock 3, and Shinozuka formulas.
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Affiliation(s)
- Seval Yılmaz Ergani
- Department of Perinatology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Betül Tokgöz Çakır
- Department of Perinatology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Arife Akay
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Can Ozan Ulusoy
- Department of Perinatology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Yıldız Akdaş Reis
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Kemal Sarsmaz
- Department of Perinatology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Gökçen Örgül
- Department of Perinatology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Sertaç Esin
- Department of Perinatology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Ali Turhan Çağlar
- Department of Perinatology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
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Lee D, Yoon S, Kim J, Mo JW, Jo Y, Kwon J, Lee SI, Kwon J, Park C. Application of ultrasonographic human estimated foetal weight formulas to cynomolgus monkeys (Macaca fascicularis) at 129-132 days of gestation: A comparative study of estimated and actual birthweight. Vet Med Sci 2024; 10:e1521. [PMID: 38952271 PMCID: PMC11217594 DOI: 10.1002/vms3.1521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 05/29/2024] [Accepted: 06/10/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND Cynomolgus monkeys (Macaca fascicularis) are essential in biomedical research, including reproductive studies. However, the application of human estimated foetal weight (EFW) formulas using ultrasonography (USG) in these non-human primates is not well established. OBJECTIVES This study aims to evaluate the applicability of human EFW formulas for estimating foetal weight in cynomolgus monkeys at approximately 130 days of gestation. METHODS Our study involved nine pregnant cynomolgus monkeys. We measured foetal parameters, including biparietal diameter, head circumference, abdominal circumference and femur length using USG. The EFW was calculated using 11 human EFW formulas. The actual birthweight (ABW) was recorded following Cesarean section, the day after the EFW calculation. For comparing EFW and ABW, we employed statistical methods such as mean absolute percentage error (APE) and Bland-Altman analysis. RESULTS The ABW ranged between 200.36 and 291.33 g. Among the 11 formulas, the Combs formula showed the lowest APE (4.3%) and highest correlation with ABW (p < 0.001). Notably, EFW and ABW differences for the Combs formula were ≤5% in 66.7% and ≤10% in 100% of cases. The Bland-Altman analysis supported these results, showing that all cases fell within the limits of agreement. CONCLUSIONS The Combs formula is applicable for estimating the weight of cynomolgus monkey fetuses with USG at approximately 130 days of gestation. Our observations suggest that the Combs formula can be applied in the prenatal care and biomedical research of this species.
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Affiliation(s)
- Dong‐Ho Lee
- Primate Resources CenterKorea Research Institute of Bioscience and Biotechnology (KRIBB)JeongeupRepublic of Korea
- Department of Laboratory Animal MedicineJeonbuk National University College of Veterinary MedicineIksanRepublic of Korea
| | - Seung‐Bin Yoon
- Primate Resources CenterKorea Research Institute of Bioscience and Biotechnology (KRIBB)JeongeupRepublic of Korea
| | - Ji‐Su Kim
- Primate Resources CenterKorea Research Institute of Bioscience and Biotechnology (KRIBB)JeongeupRepublic of Korea
| | - Jun Won Mo
- Primate Resources CenterKorea Research Institute of Bioscience and Biotechnology (KRIBB)JeongeupRepublic of Korea
| | - Yu‐Jin Jo
- Primate Resources CenterKorea Research Institute of Bioscience and Biotechnology (KRIBB)JeongeupRepublic of Korea
| | - Jeongwoo Kwon
- Primate Resources CenterKorea Research Institute of Bioscience and Biotechnology (KRIBB)JeongeupRepublic of Korea
| | - Sang Il Lee
- Primate Resources CenterKorea Research Institute of Bioscience and Biotechnology (KRIBB)JeongeupRepublic of Korea
| | - Jungkee Kwon
- Department of Laboratory Animal MedicineJeonbuk National University College of Veterinary MedicineIksanRepublic of Korea
| | - Chan‐Wook Park
- Department of Obstetrics and GynecologySeoul National University College of MedicineSeoulRepublic of Korea
- Seoul National University Medical Research CenterInstitute of Reproductive Medicine and PopulationSeoulRepublic of Korea
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Sgayer I, Barbara T, Darwish A, Aiob A, Lowenstein L, Wolf MF, Odeh M. The accuracy of sonographic fetal weight in very preterm infants (≤32 weeks). J Gynecol Obstet Hum Reprod 2024; 53:102785. [PMID: 38583861 DOI: 10.1016/j.jogoh.2024.102785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE To examine the accuracy of sonographic fetal weight to predict birthweight in very preterm infants (<32 weeks), and to compare the accuracy of estimated fetal weight (EFW) between those small for gestational age (SGA) and those appropriate for gestational age (AGA). STUDY DESIGN A retrospective study was conducted of data recorded between January 2010 and March 2023. Included were women with singleton livebirths at 23+0-31+6 weeks who had an EFW within one week from delivery. Mean percentage error, mean absolute percentage error, and underestimation and overestimation rates were calculated. We compared the accuracy of EFW between SGA and AGA infants. RESULTS In total, 360 women were included. The mean absolute percentage error was 7.8 % (range 0 %-68.9 %); for 207 (57.5 %) infants the percentage error was within ±10 %. Overestimation error >10 % was observed in 102 (28.3 %) infants and errors >20 % in 34 (9.4 %). Among infants born in the periviable period (23+0 - 25+6 weeks; N = 56), the mean absolute percentage error was 9.8 % (range: 0 %-40.3 %); the value was within ±10 % for only 28 periviable infants (50 %) and exceeded 20 % for 16.1 %. Among SGA compared to AGA infants, the mean absolute percentage error was higher (11.1% vs. 6.6 %, p = 0.035). Overestimation error >10 % was more frequent among SGA than AGA infants (55 (49.1 %) vs. 47 (19.0 %), p < 0.001). In a multivariate logistic regression analysis, SGA status was independently associated with a higher mean percentage error (beta = 0.260, p < 0.001) and an increased risk of an error >10 % (odds ratio = 2.1, 95 % confidence interval 1.2-3.5, p = 0.008). CONCLUSIONS Sonographic EFW is limited in assessing very preterm infants, particularly those who are SGA or born during the periviable period. These limitations should be considered regarding impending very preterm births and concerns about abnormal fetal growth.
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Affiliation(s)
- Inshirah Sgayer
- Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya, Israel; Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel.
| | - Tala Barbara
- Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
| | - Asal Darwish
- Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya, Israel
| | - Ala Aiob
- Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya, Israel; Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
| | - Lior Lowenstein
- Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya, Israel; Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
| | - Maya Frank Wolf
- Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya, Israel; Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
| | - Marwan Odeh
- Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya, Israel; Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
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Eze C, Cosmas K, Nwamba J, Upeh E. Validity of sonographic prediction of birth weight: A study of three algorithms in a cohort of healthy pregnant women of Yoruba descent in a suburb of Lagos state, Southwest Nigeria. WEST AFRICAN JOURNAL OF RADIOLOGY 2022. [DOI: 10.4103/wajr.wajr_6_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Predicting fetal weight by three-dimensional limb volume ultrasound (AVol/TVol) and abdominal circumference. Chin Med J (Engl) 2021; 134:1070-1078. [PMID: 33883411 PMCID: PMC8116021 DOI: 10.1097/cm9.0000000000001413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Fetal weight is an important parameter to ensure maternal and child safety. The purpose of this study was to use three-dimensional (3D) limb volume ultrasound combined with fetal abdominal circumference (AC) measurement to establish a model to predict fetal weight and evaluate its efficiency. METHODS A total of 211 participants with single pregnancy (28-42 weeks) were selected between September 2017 and December 2018 in the Beijing Obstetrics and Gynecology Hospital of Capital Medical University. The upper arm (AVol)/thigh volume (TVol) of fetuses was measured by the 3D limb volume technique. Fetal AC was measured by two-dimensional ultrasound. Nine cases were excluded due to incomplete information or the interval between examination and delivery >7 days. The enrolled 202 participants were divided into a model group (134 cases, 70%) and a verification group (68 cases, 30%) by mechanical sampling method. The linear relationship between limb volume and fetal weight was evaluated using Pearson Chi-squared test. The prediction model formula was established by multivariate regression with data from the model group. Accuracy of the model formula was evaluated with verification group data and compared with traditional formulas (Hadlock, Lee2009, and INTERGROWTH-21st) by paired t-test and residual analysis. Receiver operating characteristic curves were generated to predict macrosomia. RESULTS AC, AVol, and TVol were linearly related to fetal weight. Pearson correlation coefficient was 0.866, 0.862, and 0.910, respectively. The prediction model based on AVol/TVol and AC was established as follows: Y = -481.965 + 12.194TVol + 15.358AVol + 67.998AC, R2adj = 0.868. The scatter plot showed that when birth weight fluctuated by 5% (i.e., 95% to 105%), the difference between the predicted fetal weight by the model and the actual weight was small. A paired t-test showed that there was no significant difference between the predicted fetal weight and the actual birth weight (t = -1.015, P = 0.314). Moreover, the residual analysis showed that the model formula's prediction efficiency was better than the traditional formulas with a mean residual of 35,360.170. The combined model of AVol/TVol and AC was superior to the Lee2009 and INTERGROWTH-21st formulas in the diagnosis of macrosomia. Its predictive sensitivity and specificity were 87.5% and 91.7%, respectively. CONCLUSION Fetal weight prediction model established by semi-automatic 3D limb volume combined with AC is of high accuracy, sensitivity, and specificity. The prediction model formula shows higher predictive efficiency, especially for the diagnosis of macrosomia. TRIAL REGISTRATION ClinicalTrials.gov, NCT03002246; https://clinicaltrials.gov/ct2/show/NCT03002246?recrs=e&cond=fetal&draw=8&rank=67.
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Ladhani NNN, Chari RS, Dunn MS, Jones G, Shah P, Barrett JFR. No. 347-Obstetric Management at Borderline Viability. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2019; 39:781-791. [PMID: 28859764 DOI: 10.1016/j.jogc.2017.03.108] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The primary objective of this guideline was to develop consensus statements to guide clinical practice and recommendations for obstetric management of a pregnancy at borderline viability, currently defined as prior to 25+6 weeks. INTENDED USERS Clinicians involved in the obstetric management of women whose fetus is at the borderline of viability. TARGET POPULATION Women presenting for possible birth at borderline viability. EVIDENCE This document presents a summary of the literature and a general consensus on the management of pregnancies at borderline viability, including maternal transfer and consultation, administration of antenatal corticosteroids and magnesium sulfate, fetal heart rate monitoring, and considerations in mode of delivery. Medline, EMBASE, and Cochrane databases were searched using the following keywords: extreme prematurity, borderline viability, preterm, pregnancy, antenatal corticosteroids, mode of delivery. The results were then studied, and relevant articles were reviewed. The references of the reviewed studies were also searched, as were documents citing pertinent studies. The evidence was then presented at a consensus meeting, and statements were developed. VALIDATION METHODS The content and recommendations were developed by the consensus group from the fields of Maternal-Fetal Medicine, Neonatology, Perinatal Nursing, Patient Advocacy, and Ethics. The quality of evidence was rated using criteria described in the Grading of Recommendations Assessment, Development and Evaluation methodology framework (reference 1). The Board of the Society of Obstetricians and Gynaecologists of Canada approved the final draft for publication. METHODS The quality of evidence was rated using the criteria described in the Grading of Recommendations, Assessment, Development, and Evaluation methodology framework. The interpretation of strong and weak recommendations is described later. The Summary of Findings is available upon request. BENEFITS, HARMS, AND COSTS A multidisciplinary approach should be used in counselling women and families at borderline viability. The impact of obstetric interventions in the improvement of neonatal outcomes is suggested in the literature, and if active resuscitation is intended, then active obstetric interventions should be considered. GUIDELINE UPDATE Evidence will be reviewed 5 years after publication to decide whether all or part of the guideline should be updated. However, if important new evidence is published prior to the 5-year cycle, the review process may be accelerated for a more rapid update of some recommendations. SPONSORS This guideline was developed with resources funded by the Society of Obstetricians and Gynaecologists of Canada and the Women and Babies Program at Sunnybrook Health Sciences Centre. RECOMMENDATIONS
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Anggraini D, Abdollahian M, Marion K. Foetal weight prediction models at a given gestational age in the absence of ultrasound facilities: application in Indonesia. BMC Pregnancy Childbirth 2018; 18:436. [PMID: 30400880 PMCID: PMC6219176 DOI: 10.1186/s12884-018-2047-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 10/08/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Birth weight is one of the most important indicators of neonatal survival. A reliable estimate of foetal weight at different stages of pregnancy would facilitate intervention plans for medical practitioners to prevent the risk of low birth weight delivery. This study has developed reliable models to more accurately predict estimated foetal weight at a given gestation age in the absence of ultrasound facilities. METHODS A primary health care centre was involved in collecting retrospective non-identified Indonesian data. The best subset model selection criteria, coefficient of determination, standard deviation, variance inflation factor, Mallows Cp, and diagnostic tests of residuals were deployed to select the most significant independent variables. Simple and multivariate linear regressions were used to develop the proposed models. The efficacy of models for predicting foetal weight at a given gestational age was assessed using multi-prediction accuracy measures. RESULTS Four weight prediction models based on fundal height and its combinations with gestational age (between 32 and 41 weeks) and ultrasonic estimates of foetal head circumference and foetal abdominal circumference have been developed. Multiple comparison criteria show that the proposed models were more accurate than the existing models (mean prediction errors between - 0.2 and 2.4 g and median absolute percentage errors between 4.1 and 4.2%) in predicting foetal weight at a given gestational age (between 35 and 41 weeks). CONCLUSIONS This research has developed models to more accurately predict estimated foetal weight at a given gestational age in the absence of ultrasound machines and trained ultra-sonographers. The efficacy of the models was assessed using retrospective data. The results show that the proposed models produced less error than the existing clinical and ultrasonic models. This research has resulted in the development of models where ultrasound facilities do not exist, to predict the estimated foetal weight at varying gestational age. This would promote the development of foetal inter growth charts, which are currently unavailable in Indonesian primary health care systems. Consistent monitoring of foetal growth would alleviate the risk of having inter growth abnormalities, such as low birth weight that is the most leading factor of neonatal mortality.
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Affiliation(s)
- Dewi Anggraini
- School of Science (Mathematical and Geospatial Sciences), College of Science, Engineering, and Health, RMIT University, GPO BOX 2476, Melbourne, VIC 3001 Australia
- Study Program of Statistics, Faculty of Mathematics and Natural Sciences, University of Lambung Mangkurat (ULM), Ahmad Yani Street, Km. 36, Banjarbaru, South Kalimantan 70714 Indonesia
| | - Mali Abdollahian
- School of Science (Mathematical and Geospatial Sciences), College of Science, Engineering, and Health, RMIT University, GPO BOX 2476, Melbourne, VIC 3001 Australia
| | - Kaye Marion
- School of Science (Mathematical and Geospatial Sciences), College of Science, Engineering, and Health, RMIT University, GPO BOX 2476, Melbourne, VIC 3001 Australia
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de Lima AMH, de Carvalho PRN, Junior SCG, Carioca ACC, Lopes JMDA. Analysis of the Performance of 11 Formulae for Fetal Weight Estimation in Preterm Fetuses with Abnormal Doppler Velocimetry - A Retrospective Multicenter Study. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2018; 40:580-586. [PMID: 30235474 PMCID: PMC10467365 DOI: 10.1055/s-0038-1670643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 06/12/2018] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To assess 11 formulae commonly used to estimate fetal weight in a population of premature fetuses who had abnormal Doppler velocimetry due to early-onset placental insufficiency. The performance of each formula was evaluated in subgroups of fetuses with expected growth and intrauterine growth restriction. METHODS Data were collected from fetuses and mothers who delivered at three Brazilian hospitals between November 2002 and December 2013. We used the following formulae: Campbell; Hadlock I, II, III, IV and V; Shepard; Warsof; Weiner I and II; and Woo III. RESULTS We analyzed 194 fetuses. Of these, 116 (59.8%) were considered appropriate for gestational age (AGA), and 103 (53.1%) were male. The amniotic fluid volume was reduced in 87 (44.8%) fetuses, and the umbilical artery Doppler revealed absence or inversion of diastolic flow in 122 (62.9%) cases, and the analysis of the ductus venosus revealed abnormal flow in 60 (34.8%) fetuses. The Hadlock formulae using three or four fetal biometric parameters had low absolute percentage error in the estimated fetal weight among preterm fetuses with abnormal Doppler studies who were born within 5 days of the ultrasound evaluation. The results were not influenced by the clinical and ultrasound parameters often found in early-onset placental insufficiency. CONCLUSION In this study, the formulae with the best performance for fetal weight estimation in the analyzed population were Hadlock I and IV, which use four and three fetal biometric parameters respectively to estimate the weight of preterm fetuses with abnormal Doppler studies.
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Affiliation(s)
| | - Paulo Roberto Nassar de Carvalho
- Diagnostic Center, Clínica Perinatal Laranjeiras, Rio de Janeiro, RJ, Brazil
- Fetal Medicine Center, Instituto Nacional Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Saint Clair Gomes Junior
- Fetal Medicine Center, Instituto Nacional Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Ana Carolina Costa Carioca
- Fetal Medicine Center, Instituto Nacional Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - José Maria de Andrade Lopes
- Diagnostic Center, Clínica Perinatal Laranjeiras, Rio de Janeiro, RJ, Brazil
- Fetal Medicine Center, Instituto Nacional Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
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Ladhani NNN, Chari RS, Dunn MS, Jones G, Shah P, Barrett JF. No 347-Prise en charge obstétricale près de la limite de viabilité du fœtus. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2017; 39:792-804. [DOI: 10.1016/j.jogc.2017.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Esin S, Hayran M, Tohma YA, Guden M, Alay I, Esinler D, Yalvac S, Kandemir O. Estimation of fetal weight by ultrasonography after preterm premature rupture of membranes: comparison of different formulas. J Perinat Med 2017; 45:253-266. [PMID: 27935855 DOI: 10.1515/jpm-2016-0258] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 10/27/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To compare different ultrasonographic fetal weight estimation formulas in predicting the fetal birth weight of preterm premature rupture of membrane (PPROM) fetuses. METHODS Based on the ultrasonographic measurements, the estimated fetal weight (EFW) was calculated according to the published formulas. The comparisons used estimated birth weight (EBW) and observed birth weight (OBW) to calculate the mean absolute percentage error [(EBW-OBW)/OBW×100], mean percentage error [(EBW-OBW)/OBW×100)] and their 95% confidence intervals. RESULTS There were 234 PPROM patients in the study period. The mean gestational age at which PPROM occured was 31.2±3.7 weeks and the mean gestational age of delivery was 32.4±3.2 weeks. The mean birth weight was 1892±610 g. The median absolute percentage error for 33 formulas was 11.7%. 87.9% and 21.2% of the formulas yielded inaccurate results when the cut-off values for median absolute percentage error were 10% and 15%, respectively. The Vintzileos' formula was the only method which had less than or equal to 10% absolute percentage error in all age and weight groups. CONCLUSIONS For PPROM patients, most of the formulas designed for sonographic fetal weight estimation had acceptable performance. The Vintzileos' method was the only formula having less than 10% absolute percentage error in all gestational age and weight groups; therefore, it may be the preferred method in this cohort. Amniotic fluid index (AFI) before delivery had no impact on the performance of the formulas in terms of mean percentage errors.
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Hoopmann M, Kagan KO, Sauter A, Abele H, Wagner P. Comparison of Errors of 35 Weight Estimation Formulae in a Standard Collective. Geburtshilfe Frauenheilkd 2016; 76:1172-1179. [PMID: 27904167 DOI: 10.1055/s-0042-118598] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Issue: The estimation of foetal weight is an integral part of prenatal care and obstetric routine. In spite of its known susceptibility to errors in cases of underweight or overweight babies, important obstetric decisions depend on it. In the present contribution we have examined the accuracy and error distribution of 35 weight estimation formulae within the normal weight range of 2500-4000 g. The aim of the study was to identify the weight estimation formulae with the best possible correspondence to the requirements of clinical routine. Materials and Methods: 35 clinically established weight estimation formulae were analysed in 3416 foetuses with weights between 2500 and 4000 g. For this we determined and compared the mean percentage error (MPE), the mean absolute percentage error (MAPE), and the proportions of estimates within the error ranges of 5, 10, 20 and 30 %. In addition, separate regression lines were calculated for the relationship between estimated and actual birth weights for the weight range 2500-4000 g. The formulae were thus examined for possible inhomogeneities. Results: The lowest MPE were achieved with the Hadlock III and V formulae (0.8 %, STW 9.2 % or, respectively, -0.8 %, STW 10.0 %). The lowest absolute error (6.6 %) as well as the most favourable frequency distribution in cases below 5 % and 10 % error (43.9 and 77.5) were seen for the Halaska formula. In graphic representations of the regression lines, 16 formulae revealed a weight overestimation in the lower weight range and an underestimation in the upper range. 14 formulae gave underestimations and merely 5 gave overestimations over the entire tested weight range. Conclusion: The majority of the tested formulae gave underestimations of the actual birth weight over the entire weight range or at least in the upper weight range. This result supports the current strategy of a two-stage weight estimation in which a formula is first chosen after a pre-estimation of the weight range.
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Affiliation(s)
- M Hoopmann
- Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
| | - K O Kagan
- Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
| | - A Sauter
- Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
| | - H Abele
- Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
| | - P Wagner
- Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
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Faschingbauer F, Dammer U, Raabe E, Kehl S, Schmid M, Schild RL, Beckmann MW, Mayr A. A New Sonographic Weight Estimation Formula for Small-for-Gestational-Age Fetuses. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:1713-1724. [PMID: 27353069 DOI: 10.7863/ultra.15.09084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 12/02/2015] [Indexed: 06/06/2023]
Abstract
OBJECTIVES The purpose of this study was to develop a new specific weight estimation formula for small-for-gestational-age (SGA) fetuses that differentiated between symmetric and asymmetric growth patterns. METHODS A statistical estimation technique known as component-wise gradient boosting was applied to a group of 898 SGA fetuses (symmetric, n = 750; asymmetric, n = 148). A new formula was derived from the data obtained and was then compared to other commonly used equations. RESULTS The new formula derived is as follows: estimated fetal weight = e^[1.3734627 + 0.0057133 × biparietal diameter + 0.0011282 × head circumference + 0.0201147 × abdominal circumference + 0.0183081 × femur length - 0.0000177 × biparietal diameter(2) - 0.0000018 × head circumference(2) - 0.0000297 × abdominal circumference(2) -0.0001007 × femur length(2) + 0.0397563 × I(sex = male) + 0.0064505 × gestational age (days) + 0.0096528 × I(SGA = asymmetric)], where the function I denotes an indicator function, which is 1 if the expression is fulfilled (sex = male; SGA type = asymmetric) and otherwise 0. In the whole study group and the 2 subgroups, the new formula showed the lowest median absolute percentage error, mean percentage error, and random error and the best distribution of absolute percentage errors within prespecified error bounds. CONCLUSIONS The new formula substantially improves weight estimation in SGA fetuses.
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Affiliation(s)
- Florian Faschingbauer
- Department of Obstetrics and Gynecology, University Hospital of Erlangen, Erlangen, Germany
| | - Ulf Dammer
- Department of Obstetrics and Gynecology, University Hospital of Erlangen, Erlangen, Germany
| | - Eva Raabe
- Department of Obstetrics and Gynecology, University Hospital of Erlangen, Erlangen, Germany
| | - Sven Kehl
- Department of Obstetrics and Gynecology, University Hospital of Erlangen, Erlangen, Germany
| | - Matthias Schmid
- Department of Medical Informatics, Biometry, and Epidemiology, Rheinische Friedrich-Wilhelms-University of Bonn, Bonn, Germany
| | - Ralf L Schild
- Department of Obstetrics and Perinatal Medicine, Diakonischen Dienste Hanover Frauenkliniken, Hanover, Germany
| | - Matthias W Beckmann
- Department of Obstetrics and Gynecology, University Hospital of Erlangen, Erlangen, Germany
| | - Andreas Mayr
- Department of Medical Informatics, Biometry, and Epidemiology, University of Erlangen-Nuremberg, Erlangen, Germany
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Gabbay-Benziv R, Aviram A, Bardin R, Ashwal E, Melamed N, Hiersch L, Wiznitzer A, Yogev Y, Hadar E. Prediction of Small for Gestational Age: Accuracy of Different Sonographic Fetal Weight Estimation Formulas. Fetal Diagn Ther 2016; 40:205-213. [DOI: 10.1159/000443881] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 12/28/2015] [Indexed: 11/19/2022]
Abstract
Objective: To compare the accuracy of various sonographic estimated fetal weight (sEFW) formulas for the prediction of small for gestational age (SGA) neonates. Methods: A retrospective analysis of 6,126 fetal biometrical measurements performed within 3 days of delivery. SGA prediction was evaluated for various sEFW formulas by calculating the sensitivity, specificity, positive/negative predictive value (PPV/NPV), likelihood ratio (+LR/-LR), overall accuracy and area under the receiver operating characteristic curve (AUC). Systematic error, random error, proportion of estimates >10% of birth weights, actual and absolute weight differences were compared between SGA and non-SGA neonates. Results: Overall, 638 (10.4%) neonates were SGA. There was considerable variation among formulas in sensitivity (mean ± SD, 62 ± 14.4%; range, 32.4-91.2), PPV (72.5 ± 10.7%; 45.8-95.6) and +LR (24.2 ± 10.9; 7.2-57.3), mild variation in specificity (96.6 ± 2.7%; 87.4-99.4), NPV (94.6 ± 5.3%; 72.2-98.9) and -LR (0.4 ± 0.1; 0.1-0.7) and minimal variation in AUC (mean, 0.93; range, 0.91-0.93). The majority of formulas had a lower accuracy for the SGA neonates, with systematic error and random error ranging from -4.2 to 14.3% and from 8.4 to 12.9% for SGA, and from -8.7 to 16.1% and from 7.2 to 10.5% for non-SGA, respectively. Conclusion: sEFW formulas differ in their accuracy for SGA prediction. In our population, the most accurate formula for SGA prediction was Hadlock's formula utilizing femur length, abdominal and head circumference.
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Melamed N, Ryan G, Windrim R, Toi A, Kingdom J. Choice of Formula and Accuracy of Fetal Weight Estimation in Small-for-Gestational-Age Fetuses. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:71-82. [PMID: 26635253 DOI: 10.7863/ultra.15.02058] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 04/27/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES The purpose of this study was to identify the most accurate sonographic models for fetal weight estimation in specific subgroups of small-for-gestational-age (SGA) fetuses. METHODS We conducted a retrospective study of women who delivered an SGA neonate and underwent a sonographic estimation of fetal weight within 7 days of delivery in a single tertiary center (n = 370). The accuracy of fetal weight estimation was compared for 33 sonographic models (27 nontargeted and 6 targeted SGA- or low-birth-weight-specific models) in specific subgroups of SGA fetuses: early versus late SGA, asymmetric versus symmetric, and presence of Doppler abnormalities. RESULTS A wide variation in the accuracy of the different models was found (systematic error, -12.5% to 15.1%; random error, 7.8% to 15.5%). Most nontargeted models tended to systematically overestimate the weight of SGA fetuses. The best performing model in the overall SGA group was the targeted model of Scott et al (J Ultrasound Med 1996; 15:669-672; systematic error ± random error, -2.8% ± 8.3%). However, the optimal models varied for different subgroups of SGA fetuses, and in most cases the targeted models were the most accurate. An approach that used the optimal model for each subgroup of SGA fetuses compared with the uniform use of the model of Scott et al for all SGA fetuses was associated with a lower systematic error (-0.38% versus -2.8%; P < .001) and a higher proportion of weight estimations within 5%, 10%, and 15% of birth weight (48.4% versus 40.8%; P= .038; 78.6% versus 71.4%; P= .022; 95.1% versus 89.2%; P = .003, respectively). CONCLUSIONS Sonographic models in current use for fetal weight estimation in SGA fetuses have significant errors, and their performance varies for specific subgroups of SGA fetuses. An approach that uses subgroup-specific models may improve the accuracy of weight estimation among SGA fetuses.
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Affiliation(s)
- Nir Melamed
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada (N.M.); Fetal Medicine Division (Placenta Clinic), Department of Obstetrics and Gynecology (G.R., R.W., J.K.), and Department of Medical Imaging (A.T.), Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
| | - Greg Ryan
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada (N.M.); Fetal Medicine Division (Placenta Clinic), Department of Obstetrics and Gynecology (G.R., R.W., J.K.), and Department of Medical Imaging (A.T.), Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Rory Windrim
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada (N.M.); Fetal Medicine Division (Placenta Clinic), Department of Obstetrics and Gynecology (G.R., R.W., J.K.), and Department of Medical Imaging (A.T.), Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Ants Toi
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada (N.M.); Fetal Medicine Division (Placenta Clinic), Department of Obstetrics and Gynecology (G.R., R.W., J.K.), and Department of Medical Imaging (A.T.), Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - John Kingdom
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada (N.M.); Fetal Medicine Division (Placenta Clinic), Department of Obstetrics and Gynecology (G.R., R.W., J.K.), and Department of Medical Imaging (A.T.), Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
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15
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Neonatal mortality amongst Scottish preterm singleton births (2001–2010): record linkage of maternity data and neonatal mortality data. Public Health 2015; 129:1597-601. [DOI: 10.1016/j.puhe.2015.07.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 05/13/2015] [Accepted: 07/13/2015] [Indexed: 11/20/2022]
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16
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Huber C, Zdanowicz JA, Mueller M, Surbek D. Factors influencing the accuracy of fetal weight estimation with a focus on preterm birth at the limit of viability: a systematic literature review. Fetal Diagn Ther 2014; 36:1-8. [PMID: 24863502 DOI: 10.1159/000358518] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Accepted: 01/03/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Fetal weight estimation (FWE) is an important factor for clinical management decisions, especially in imminent preterm birth at the limit of viability between 23(0/7) and 26(0/7) weeks of gestation. It is crucial to detect and eliminate factors that have a negative impact on the accuracy of FWE. DATA SOURCES In this systematic literature review, we investigated 14 factors that may influence the accuracy of FWE, in particular in preterm neonates born at the limit of viability. RESULTS We found that gestational age, maternal body mass index, amniotic fluid index and ruptured membranes, presentation of the fetus, location of the placenta and the presence of multiple fetuses do not seem to have an impact on FWE accuracy. The influence of the examiner's grade of experience and that of fetal gender were discussed controversially. Fetal weight, time interval between estimation and delivery and the use of different formulas seem to have an evident effect on FWE accuracy. No results were obtained on the impact of active labor. DISCUSSION This review reveals that only few studies investigated factors possibly influencing the accuracy of FWE in preterm neonates at the limit of viability. Further research in this specific age group on potential confounding factors is needed.
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Affiliation(s)
- Chantal Huber
- Department of Obstetrics and Gynaecology, Bern University Hospital, Bern, Switzerland
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17
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Yazdi B, Zanker P, Wanger P, Sonek J, Pintoffl K, Hoopmann M, Kagan KO. Optimal caliper placement: manual vs automated methods. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2014; 43:170-175. [PMID: 23671025 DOI: 10.1002/uog.12509] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To examine the inter- and intra-operator repeatability of manual placement of callipers in the assessment of basic biometric measurements and to compare the results to an automated calliper placement system. METHODS Stored ultrasound images of 95 normal fetuses between 19 and 25 weeks' gestation were used. Five operators (two experts, one resident and two students) were asked to measure the BPD, OFD and FL two times manually and automatically. For each operator, intra-operator repeatability of the manual and automated measurements was assessed by within operator standard deviation. For the assessment of the interoperator repeatability, the mean of the four manual measurements by the two experts was used as the gold standard.The relative bias of the manual measurement of the three non-expert operators and the operator-independent automated measurement were compared with the gold standard measurement by means and 95% confidence interval. RESULTS In 88.4% of the 95 cases, the automated measurement algorithm was able to obtain appropriate measurements of the BPD, OFD, AC and FL. Within operator standard deviations of the manual measurements ranged between 0.15 and 1.56, irrespective of the experience of the operator.Using the automated biometric measurement system, there was no difference between the measurements of each operator. As far as the inter-operator repeatability is concerned, the difference between the manual measurements of the two students, the resident, and the gold standard was between -0.10 and 2.53 mm. The automated measurements tended to be closer to the gold standard but did not reach statistical significance. CONCLUSION In about 90% of the cases, it was possible to obtain basic biometric measurements with an automated system. The use of automated measurements resulted in a significant improvement of the intra-operator but not of the inter-operator repeatability, but measurements were not significantly closer to the gold standard of expert examiners.
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Affiliation(s)
- B Yazdi
- Department of Obstetrics and Gynaecology, University of Tuebingen, Tuebingen, Germany
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Ferdynus C, Quantin C, Abrahamowicz M, Burguet A, Sagot P, Gouyon JB. Comparison of the ability of alternative birthweight and fetal weight standards to identify preterm newborns at increased risk of perinatal death. BJOG 2013; 120:1456-64. [DOI: 10.1111/1471-0528.12282] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2013] [Indexed: 11/28/2022]
Affiliation(s)
- C Ferdynus
- Centre d'Epidémiologie des Populations; Université de Bourgogne; Dijon France
- Unité de Soutien Méthodologique; University Hospital; Saint Denis de la Réunion France
| | - C Quantin
- CHRU; Service de Biostatistique et d'Informatique Médicale; CHU de Dijon France
- Inserm; U866; Dijon; Université de Bourgogne; Dijon France
| | - M Abrahamowicz
- Department of Epidemiology and Biostatistics; McGill University; Montreal QC Canada
- Department of Biostatistics; Réunion University (France) and CHU de La Reunion; Centre d'Etudes Périnatales de l'Océan Indien; Saint-Pierre Cedex France
| | - A Burguet
- Inserm; CIE1; Dijon France
- CHRU Dijon; Centre d'Investigation Clinique-Epidémiologie Clinique/Essais Cliniques; Dijon France
- Université de Bourgogne; Dijon France
| | - P Sagot
- Centre d'Epidémiologie des Populations; Université de Bourgogne; Dijon France
- Department of Obstetrics and Gynaecology; University Hospital; Dijon France
| | - J-B Gouyon
- Centre d'Epidémiologie des Populations; Université de Bourgogne; Dijon France
- Department of Paediatrics; University Hospital; Dijon France
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