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Acta Obstet Gynecol Scand. 2012 Oct;91(10):1218-25. doi: 10.1111/j.1600-0412.2012.01495.x. Epub 2012 Aug 22.

Ultrasound weight estimation of large fetuses.

Author information

1
Department of Obstetrics and Gynecology, Clinical Sciences Lund, Sweden. gun.lindell@med.lu.se

Abstract

OBJECTIVE:

To compare the accuracy of fetal weight estimation in large fetuses using four ultrasound formulae.

DESIGN:

Prospective comparative study.

SETTING:

University Hospital, Lund, Sweden.

POPULATION:

Large-for-gestational age fetuses (n= 114) at a routine ultrasound examination in the third trimester.

METHODS:

The Persson & Weldner two-dimensional formula was compared with the Hart et al. two-dimensional formula incorporating maternal weight and with the Lee et al. and Lindell & Maršál three-dimensional formulae. The formulae are based on two-dimensional measurements of fetal head, abdomen and femur, and three-dimensional volumetry of fetal abdomen and thigh.

MAIN OUTCOME MEASURES:

Accuracy in detection of fetuses with birthweight >4000 and >4500 g.

RESULTS:

For fetuses >4000 g, the Lindell & Maršál three-dimensional formula showed significantly smaller mean absolute percentage error than the Persson & Weldner two-dimensional and the Lee et al. three-dimensional formulae (p= 0.04 and p < 0.001, respectively). No significant difference between the Lindell & Maršál three-dimensional and the Hart et al. two-dimensional formulae was found. A receiver operating characteristic curve showed a higher detection rate for fetuses with birthweight >4500 g using a three-dimensional compared with a two-dimensional technique. The best performance in detecting fetuses with birthweight >4500 g was given by the Lindell & Maršál three-dimensional formula; for estimated fetal weight >4300 g, the detection rate was 93% and false-positive rate 38%.

CONCLUSIONS:

The ability to detect macrosomic fetuses in a preselected high-risk group was higher using fetal weight estimation with a three-dimensional compared with a two-dimensional ultrasound technique, with or without the inclusion of maternal weight.

[Indexed for MEDLINE]

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