Ultrasonic fetal fe mur length (FL) measurement provides an accurate fetal length . Combined with cross-sectional dimensions such as the biparietal diameter (BPD) and abdominal circumference (AC), FL provides a three-dimensional profile of the fetus. The usefulness of incorporating FL measurements into weight-predicting regression equations containing the BPD and AC was assessed. Multiple regression equations containing these three parameters us a function of logl 0 birthweight were constructed from data obtained from 125 patients wit 1in 48 hours of delivery. The mean errors in fetal weight prediction derived from five of these equations were assessed in another 92 patients. The coefficients of multiple correlation were marginally better in those equations that contained FL. The mean differences were also slightly lower with these equations compared with those that did not contain FL. However, the mean differences derived from all the equations were not significantly different from each other (P > 0.05). Therefore, despite theoretical considerations, the results from this study do not justify the routine clinical use of these new equations containing FL to estimate intrauterine fetal weight, in replacement of existing cha rts based on BPD and AC. (Key words: fetal weight estimation; biparietal diameter; abdominal circumference; femur length; regression equation) Assessment of intrauterine fetal weight based on ultrasonically detected fetal parameters, such as the biparietal diameter (BPD) and abdominal circumference (AC), is now commonly practiced in many high-risk obstetric centers. The percentage error in weight prediction in most reports is quite acceptable throughout the whole range of fetal weight. 1 • 7 taining this parameter in addition to cross-sectional measurements of the fetal head and trunk.The fetal femur length (FL) has recently been found to be an accurate indicator of gestational age.li-J!! Its value in the assessment of intrauterine fetal weight, however, has not been reported. The femur length provides a longitudinal measurement of the fetus, and therefore a better correlation with fetal weight might be expected from equations conReceived March 27, 1984. from the Department of Obstetrics and Gynaecology, University of Hong Kong, Hong Kong. Accepted for publication July 2, 1984.Address correspondence and reprint requests to Dr. Woo: De· partment of Obstetrics and Gynaecology, Queen Mary Hospital, Pokfulam Road, Hong Kong.In the present study, we have tried to evaluate the usefulness of incorporating FL measurements into multiple regression equations containing BPD and AC in order to provide a better prediction of intrauterine fetal weight based on ultrasonically measured parameters. MATERIALS AND METHODSTo generate the various regression equations, measurements of the BPD, AC, and FL were made in 125 patients within 48 hours of delivery. All the patients were of Chinese descent and no congenital anomalies were evident in the infants. A Picker SOL static scanner with a 3.5-MHz transducer was ...
Intrauterine growth standards for Hong Kong Chinese were derived from birth-weight data between 28 and 42 weeks' gestation in 15,815 livebirths delivered in 1982 to 1984 at 2 maternity teaching hospitals in Hong Kong. Normal distribution of birth-weights was noted in each of the gestational weeks studied. The mean birth-weight was 3,237g at 40 weeks which was similar to the mean weights reported in other populations for this gestation. The trend of the median weight curve was also similar to that in other Caucasian and Asian reports. The growth pattern for males and females were similar and males were on the whole heavier than females throughout the gestational period studied. At 40 weeks, the 10th percentile weight also showed wide variations between reports, which would have important bearing on the studying of intrauterine growth retardation. When the mean weight at term as derived from the present study was compared to a previous report on birth-weight data in 1970-1972 in the same hospital, a significant increase in birth-weight was observed over the 12-year period. The importance of having up-to-date intrauterine weight standards for a specific population is discussed.
The accuracy of sonographic fetal weight estimation based on five published regression equations and two new equations generated from data at the authors' institution was evaluated on 41 small-for-gestational age (SGA) fetuses and 57 appropriate-for-gestational age (AGA) fetuses. Equations which contained the fetal femur length (FL) in addition to the biparietal diameter (BPD) and abdominal circumference (AC) yielded lower systematic and random errors in the SGA group but not in the AGA group. These findings support the contention that consideration of the FL is important in sonographic estimation of fetal weight in the growth-retarded fetus as head and limb growth may be affected to different degrees in different fetuses. A new equation, where birthweight in grams = 1.4 X (BPD(cm) X AC(cm) X FL(cm)) - 200, was developed which had a standard deviation of 98 g/kg in SGA fetuses and 68 g/kg in AGA fetuses. This equation yielded significantly lower random errors in the SGA but not in the AGA fetuses when compared with another linear equation without the FL. The new model is simple and practical to use, which makes it a viable alternative to more elaborate models containing three parameters.
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