Comparison of Fetal Weight Estimation with Clinical, Ultrasonographic Methods, and Combined Formula of Ultrasonography and Maternal Weight

Document Type : Original Article

Authors

1 Associate Professor, Department of Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, School of Medicine, Babol University of Medical Sciences, Babol, Iran.

2 Medical Student, School of Medicine, Babol University of Medical Sciences, Babol, Iran.

3 General Practitioner, Non-Communicable Pediatric Diseases Research Center, School of Medicine, Babol University of Medical Sciences, Babol, Iran.

Abstract

Introduction: Accurate fetal weight estimation is clinically important because of known complications of the wrong estimation. Since there are different ideas about fetal weight estimation methods, this study was designed to compare fetal weight estimation with clinical and ultrasonographic methods, and combined formula of ultrasonography and maternal weight.
Methods: This descriptive-analytic study was conducted on 160 singleton pregnant women with gestational age of 37-41 weeks in Ayatollah Rohani hospital of Babol, Iran during 2010-2011. Fetal weight was estimated clinically by Leopold's maneuvers, ultrasonographic and a combination of ultrasonography and maternal weight (Hart formula). Birth weight of neonates was measured accurately during less than three days after estimating fetal weight and child birth. Estimation error and percentage of estimates within 10% of actual birth weight were measured and analyzed by SPSS software version 18, t-test and Pearson correlation coefficient tests. P value less than 0.05 was considered significant.
Results: Mean of actual birth weight was 3422.56±442.24 grams. Mean of fetal weight estimation with clinical, ultrasonographic, and Hart formula methods were respectively 3395±336.28, 3367.57±388.11, and 3178.89±428.71 grams. Clinical estimation had fewer errors in weight estimation. The percentage of estimates within 10% of actual birth weight was 74.4% in clinical, 73.1% in ultrasonographic estimation by Hadlock Ш formula, and 3.46% in Hart formula methods. The difference between clinical estimation by Leopold's maneuvers and ultrasonographic method was not statistically significant (p=0.79). The estimate within 10% of actual birth weight with Hart formula was significantly different with two other methods (p=0.001).
Conclusion: Both clinical estimation by Leopold's maneuvers and ultrasound assessment (Hadlock III) of fetal weight are associated with actual birth weight but hart formula assessment has less accuracy in compared of two methods.

Keywords


  1. 1 Chauhan SP, West DJ, Scardo JA, Boyd JM, Joiner J, Hendrix NW. Antepartum detection of macrosomic fetus: clinical versus sonographic, including soft-tissue measurements. Obstet Gynecol 2000 May;95(5):639-42.
  2. Kramer MS, Morin I, Yang H, Platt RW, Usher R, McNamara H, et al. Why are babies getting bigger? Temporal trends in fetal growth and its determinants. J Pediatr 2002 Oct;141(4):538-42.
  3. Surkan PJ, Hsieh CC, Johansson AL, Dickman PW, Cnattingius S. Reasons for increasing trends in large for gestational age births. Obstet Gynecol 2004 Oct;104(4):720-6.
  4. Nahum GG, Stanislaw H. Prediction of birth weight by ultrasound in the third trimester. Obstet Gynecol 2000 Aug;96(2):319-20.
  5. Brieger GM, Rogers MS, Rushton AW, Mongelli M. Are Hong Kong babies getting bigger? Int J Gynaecol Obstet 1997 Jun;57(3):267-71.
  6. Orskou J, Kesmodel U, Henriksen TB, Secher NJ. An increasing proportion of infants weigh more than 4000 grams at birth. Acta Obstet Gynecol Scand 2001 Oct;80(10):931-6.
  7. Abramowicz JS, Robischon K, Cox C. Incorporating sonographic cheek-to-cheek diameter, biparietal diameter and abdominal circumference improves weight estimation in the macrosomic fetus. Ultrasound Obstet Gynecol 1997 Jun;9(6):409-13.
  8. Dudley NJ. A systematic review of the ultrasound estimation of fetal weight. Ultrasound Obstet Gynecol 2005 Jan;25(1):80-9.
  9. Horton A , Diaz J , Mastrogiannis D . Accuracy of estimated fetal weight by ultrasonography compared with the Leopold maneuver and effect of maternal obesity. Obstet Gynecol 2014 May;123 Suppl 1:193S .
  10. Pressman EK, Bienstock JL, Blakemore KJ, Martin SA, Callan NA. Prediction of birth weight by ultrasound in the third trimester. Obstet Gynecol 2000 Apr;95(4):502-6.
  11. Sokol RJ ,Chik L, Dombrowski MP, Zador IE. Correctly identifying the macrosomic fetus: improving ultrasonography-based prediction. Am J Obstet Gynecol 2000 Jun;182(6):1489-95.
  12. Weiner Z, Ben-Shlomo I, Beck-Fruchter R, Goldberg Y, Shalev E. Clinical and ultrasonographic weight estimation in large for gestational age fetus. Eur J Obstet Gynecol Reprod Biol 2002 Oct;105(1):20-4.
  13. Murlewska J, Pietryga M, Wender-Ozegowska E. [Ultrasound macrosomic fetal weight estimation formula using maternal weight measurements] [Article in Polish]. Ginekol Pol 2011 Feb;82(2):114-8.
  14. Hart NC, Hilbert A, Meurer B, Schrauder M, Schmid M, Siemer J, et al. Macrosomia: a new formula for optimized fetal weight estimation. Ultrasound Obstet Gynecol 2010 Jan;35(1):42-7.
  15. Ugwu EO, Udealor PC, Dim CC, Obi SN, Ozumba BC, Okeke DO, et al. Accuracy of clinical and ultrasound estimation of fetal weight in predicting actual birth weight in Enugu, Southeastern Nigeria. Niger J Clin Pract 2014 May-Jun;17(3):270-5.
  16. Nahar N, Akhter N, Hoque ME, Ferdous S, Mustafa MR. Comparative study between clinical and sonographic estimation of fetal weight in third trimester of pregnancy and itsrelationship with actual birth weight. Mymensingh Med J 2008 Jul;17(2):157-63.
  17. Behnamfar F , Sadat Z , Mousavi SG, Moosavi F. [Results of clinical and sonographic estimation of fetal weight] [Article in Persian]. Feyz Kashan Univ Med Sci 2006;9(36):23-6.
  18. Mehdizadeh A, Chaichian S, Hoursan H. [Comparison of ultrasonographic & clinical methods in fetal weight estimation] [Article in Persian]. Med Sci J Islam Azad Univ Tehran Med Unite 2004;14(1):51-5.
  19. Shittu AS, Kuti O, Orji EO, Makinde NO, Ogunniy SO, Ayoola OO, et al. Clinical versus sonographic estimation of foetal weight in southwest Nigeria. J Health Popul Nutr 2007 Mar;25(1):14-23.
  20. Prechapanich J, Thitadilok W. Comparison of the accuracy of fetal weight estimation using clinical and sonographic methods. J Med Assoc Thai 2004 Oct;87 Suppl 3:S1-7.
  21. Humphries J, Reynolds D, Bell-Scarbrough L, Lynn N, Scardo JA, Chauhan SP. Sonographic estimate of birth weight: relative accuracy of sonographers versus maternal-fetal medicine specialists. J Matern Fetal Neonatal Med 2002 Feb;11(2):108-12.
  22. Hoopmann M, Abele H, Wagner N, Wallwiener D, Kagan KO. Performance of 36 different weight estimation formulae in fetuses with macrosomia. Fetal Diagn Ther 2010;27(4):204-13.
  23. Noumi G, Collado-Khoury F, Bombard A, Julliard K, Weiner Z. Clinical and sonographic estimation of fetal weight performed during labor by residents. Am J Obstet Gynecol 2005 May;192(5):1407-9.