Background Ultrasound estimation of fetal weight at term provides vital information for the skilled birth attendants to make decisions on the possible best route of delivery of the fetus. This is more pertinent in a setting where women book late for antenatal care. Aim and Objectives The study evaluated the accuracy of estimation of fetal weight with ultrasound machine at term. Methods This was a cross sectional study conducted at a private specialist hospital in Nigeria. A coded questionnaire was used to retrieve relevant information which included the last menstrual period, gestational age, parity, and birth weight. Other information obtained includes Ultrasound-delivery interval, maternal weight, and route of delivery. The ultrasound was used to estimate the fetal weight. The actual birth weight was determined using a digital baby weighing scale. The data were inputted into Microsoft excel and analyzed using STATA version 14. Statistical significance was considered at p-values less than 0.05. Measures of accuracy evaluated in the statistical analysis included mean error, mean absolute error, mean percentage error, and mean absolute percentage error. Pearson correlation was done between the estimated ultrasound fetal weight and the actual birth weight. The proportion of estimates within ±10% of actual birth weight was also determined. ResultA total of 170 pregnant women participated in the study. The mean maternal age was 30.77 years ± 5.54. The mean birth weight was 3.47 kg ± 0.47, while the mean estimated ultrasound weight was 3.43 kg ± 0.8. There was positive correlation between the ultrasound estimated weight and the actual birth weight. The mean ultrasound scan to delivery interval was 0.8 days (with range of 0–2 days). The study recorded a mean error of estimation of 41.17 grams and mean absolute error of 258.22 grams. The mean percentage error was 0.65%, while the mean absolute error of estimation was 7.56%. About 72.54% of the estimated weights were within 10% of the actual birth weight. Conclusion The ultrasound estimated fetal weight correlated with the actual birth weight. Ultrasound estimation of fetal weight should be done when indicated to aid the clinician in making decisions concerning routes of delivery.

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