Abstract
Purpose
To evaluate the accuracy of intrapartum sonographic weight estimation (WE).
Materials and methods
This retrospective, cross-sectional study included 1958 singleton pregnancies. Inclusion criteria were singleton pregnancy with cephalic presentation, vaginal delivery and ultrasound examination with complete biometric parameters performed on the day of delivery during the latent or active phase of labor, and absence of chromosomal or structural anomalies. The accuracy of intrapartum WE was compared to a control group of fetuses delivered by primary cesarean section at our perinatal center and an ultrasound examination with complete biometric parameters performed within 3 days before delivery (n = 392). Otherwise, the same inclusion criteria as in the study group were applied. The accuracy of WE was compared between five commonly applied formulas using means of percentage errors (MPE), medians of absolute percentage errors (MAPE), and proportions of estimates within 10 % of actual birth weight.
Results
In the whole study group, all equations showed a systematic underestimation of fetal weight (negative MPEs). Overall, best MAPE and MPE values were found with the Hadlock II formula, using BPD, AC and FL as biometric parameters (Hadlock II, MPE: −1.28; MAPE: 6.52). MPEs differed significantly between WE in the study and control group for all evaluated formulas: in the control group, either no systematic error (Hadlock III, IV and V) or a significant overestimation (Hadlock I, II) was found. Regarding MAPEs, application of the Hadlock III (HC, AC, FL) and V (AC) formula resulted in significant lower values in the control group (Hadlock III, MAPE: 7.48 vs. 5.95, p = 0.0008 and Hadlock V, MAPE: 8.79 vs. 7.52, p = 0.0085). No significant differences were found for the other equations.
Conclusions
A systematic underestimation of fetal weight has to be taken into account in sonographic WE performed intrapartum. Overall, the best results can be achieved with WE formulas using the BPD as the only head measurement.
Similar content being viewed by others
References
Brieger GM, Rogers MS, Rushton AW et al (1997) Are Hong Kong babies getting bigger? Int J Gynaecol Obstet 57:267–271
Orskou J, Kesmodel U, Henriksen TB et al (2001) An increasing proportion of infants weigh more than 4000 grams at birth. Acta Obstet Gynecol Scand 80:931–936
Boulet SL, Alexander GR, Salihu HM et al (2003) Macrosomic births in the united states: determinants, outcomes, and proposed grades of risk. Am J Obstet Gynecol 188:1372–1378
Doctor BA, O’Riordan MA, Kirchner HL et al (2001) Perinatal correlates and neonatal outcomes of small for gestational age infants born at term gestation. Am J Obstet Gynecol 185:652–659
Ott WJ (1995) Small for gestational age fetus and neonatal outcome: reevaluation of the relationship. Am J Perinatol 12:396–400
Bernstein IM, Horbar JD, Badger GJ et al (2000) Morbidity and mortality among very-low-birth-weight neonates with intrauterine growth restriction. The Vermont Oxford Network. Am J Obstet Gynecol 182:198–206
Baschat AA, Cosmi E, Bilardo CM et al (2007) Predictors of neonatal outcome in early-onset placental dysfunction. Obstet Gynecol 109:253–261
Dudley NJ (2005) A systematic review of the ultrasound estimation of fetal weight. Ultrasound Obstet Gynecol 25:80–89
Dammer U, Raabe E, Kehl S, Schmid M, Mayr A, Schild RL, Beckmann MW, Faschingbauer F (2014) Sonographic weight estimation in small-for-gestational-age fetuses. Ultraschall Med [Epub ahead of print]
Hadlock FP, Harrist RB, Sharman RS et al (1985) Estimation of fetal weight with the use of head, body, and femur measurements—a prospective study. Am J Obstet Gynecol 151:333–337
Shepard MJ, Richards VA, Berkowitz RL et al (1982) An evaluation of two equations for predicting fetal weight by ultrasound. Am J Obstet Gynecol 142:47–54
Scioscia M, Scioscia F, Scioscia G et al (2015) Statistical limits in sonographic estimation of birth weight. Arch Gynecol Obstet 291:59–66
Merz E, Lieser H, Schicketanz KH et al (1988) Intrauterine fetal weight assessment using ultrasound. A comparison of several weight assessment methods and development of a new formula for the determination of fetal weight. Ultraschall Med 9:15–24
Siemer J, Egger N, Hart N et al (2008) Fetal weight estimation by ultrasound: comparison of 11 different formulae and examiners with differing skill levels. Ultraschall Med 29:159–164
Hadlock FP, Harrist RB, Carpenter RJ et al (1984) Sonographic estimation of fetal weight. The value of femur length in addition to head and abdomen measurements. Radiology 150:535–540
Schild RL, Sachs C, Fimmers R et al (2004) Sex-specific fetal weight prediction by ultrasound. Ultrasound Obstet Gynecol 23:30–35
Basha AS, Abu-Khader IB, Qutishat RM, Amarin ZO (2012) Accuracy of sonographic fetal weight estimation within 14 days of delivery in a Jordanian population using Hadlock formula 1. Med Princ Pract 21(4):366–369. doi:10.1159/000335539
Heer IM, Kumper C, Vogtle N et al (2008) Analysis of factors influencing the ultrasonic fetal weight estimation. Fetal Diagn Ther 23:204–210
Faschingbauer F, Dammer U, Raabe E et al (2014) Sonographic weight estimation in fetal macrosomia: influence of the time interval between estimation and delivery. Arch Gynecol Obstet. doi:10.1007/s00404-014-3604-y
Baum JD, Gussman D, Wirth JC 3rd (2002) Clinical and patient estimation of fetal weight vs. ultrasound estimation. J Reprod Med 47:194–198
Hendrix NW, Grady CS, Chauhan SP (2000) Clinical vs. sonographic estimate of birth weight in term parturients. A randomized clinical trial. J Reprod Med 45:317–322
Farrell T, Holmes R, Stone P (2002) The effect of body mass index on three methods of fetal weight estimation. BJOG Int J Obstet Gynaecol 109:651–657
Noumi G, Collado-Khoury F, Bombard A et al (2005) Clinical and sonographic estimation of fetal weight performed during labor by residents. Am J Obstet Gynecol 192:1407–1409
Peregrine E, O’Brien P, Jauniaux E (2007) Clinical and ultrasound estimation of birth weight prior to induction of labor at term. Ultrasound Obstet Gynecol 29:304–309
American College of Obstetricians and Gynecologists (2009) ACOG Practice Bulletin No. 101: ultrasonography in pregnancy. Obstet Gynecol 113(2 Pt 1):451–461. doi:10.1097/AOG.0b013e31819930b0
Eichhorn KH, Schramm T, Bald R et al (2006) DEGUM grade I quality standards in obstetric ultrasound diagnosis during the 19th to 22nd week of pregnancy. Ultraschall Med 27:185–187
Merz E, Eichhorn KH, Hansmann M et al (2002) Quality demands on continuing differential diagnostic sonography in prenatal diagnostics (DEGUM stage II) during the 18th to 22nd weeks of gestation. Ultraschall Med 23:11–12
Snedecor GW, Cochran WG (1989) Comparison of two correlated variances in paired samples in statistical methods. Iowa State University Press, Ames, pp 192–193
Melamed N, Ben-Haroush A, Meizner I et al (2011) Accuracy of sonographic weight estimation as a function of fetal sex. Ultrasound Obstet Gynecol 38:67–73
Schmidt U, Temerinac D, Bildstein K et al (2014) Finding the most accurate method to measure head circumference for fetal weight estimation. Eur J Obstet Gynecol Reprod Biol. doi:10.1016/j.ejogrb.2014.03.047
Sherman DJ, Arieli S, Tovbin J et al (1998) A comparison of clinical and ultrasonic estimation of fetal weight. Obstet Gynecol 91:212–217
Conflict of interest
None of the authors has any conflicts of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Faschingbauer, F., Dammer, U., Raabe, E. et al. Intrapartum sonographic weight estimation. Arch Gynecol Obstet 292, 805–811 (2015). https://doi.org/10.1007/s00404-015-3720-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-015-3720-3