Estimation of Fetal Weight during Labor: Still a Challenge

Barros, Joana; Reis, Inês; Pereira, Ivana Cardoso; Clode, Nuno; Graça, Luís

doi:10.1055/s-0035-1570110

Cited by 5 publications

(8 citation statements)

References 29 publications

(40 reference statements)

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“…While 56.6% of the participants gave birth by cesarean delivery (CD), 43.4% had vaginal delivery (VD). The indications for patients with cesarean delivery are as follows: previous cesarean section (38), malpresentation (18), cephalopelvic disproportion (18), fetal distress (5), placenta previa (5), preeclampsia (4), oligohydramnios (2), prolonged first stage (2), and macrosomia (1). The mean second-trimester clavicle length was 25.17 ± 1.69 mm and the mean third trimester clavicle length was 38.77 ± 3.00 mm.…”

Section: Resultsmentioning

confidence: 99%

“…Accurate estimation of birth weight (BW) is important for predicting and preventing birth complications. However, this issue is still an unresolved problem in obstetrics [1]. Macrosomia, defined as excessive weight at birth, is a serious risk factor for a complicated delivery [2].…”

Section: Introductionmentioning

confidence: 99%

“…However, dystocia can occur not only in macrosomic but also nonmacrosomic fetuses [22]. For this reason, researchers are seeking new antenatal parameters to predict shoulder dystocia [1,23].…”

Section: Introductionmentioning

confidence: 99%

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A new approach to predicting shoulder dystocia: fetal clavicle measurement

Terzi¹

2021

Turk J Med Sci

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Background/aim: This study aimed to evaluate the relationship between second-and third-trimester clavicle lengths and birth weight and shoulder dystocia. Materials and methods:This prospective observational study included 181 patients who presented to the Private Etlik Lokman Hekim Hospital for routine pregnancy visits between March 2019 and March 2020. In addition to routine pregnancy examinations, the patients also underwent ultrasonography twice at weeks 20-23 and 33-36 to determine the length of the fetal clavicle. The patients were evaluated for shoulder dystocia in the second stage of labor. The birth weight of the neonates was recorded. The primary objective of this study was to establish the relationship between third-trimester clavicle length and shoulder dystocia.Results: Fetal clavicle length increases in the second trimester with the advancing gestational week but does not significantly change in the third trimester. We did not observe any significant difference for second trimester clavicle length between the type of delivery, birth weight, or shoulder dystocia. Moreover, we did not observe any significant difference for third trimester clavicle length between types of delivery. However, we found a significant relationship between third trimester clavicle length and birth weight and shoulder dystocia. The median third-trimester clavicle length was 39.5 mm (range: 30.7-43.9) in neonates who did not develop shoulder dystocia and 42.5 mm (range: 41.4-43.1) in the 3 neonates who developed shoulder dystocia. The third-trimester clavicle length cut-off for shoulder dystocia was calculated as 41.35 mm (sensitivity: 100.00%, specificity: 83.82%, accuracy: 84.5%). The third-trimester clavicle length cut-off for macrosomia (defined as birth weight of ≥4100 g) was 40.75 mm (sensitivity: 87.50%, specificity: 77.56%, accuracy: 78.05%). Conclusion:Third-trimester fetal clavicle length, an important component of biacromial diameter, as measured by ultrasonography, is a practical and significant method for predicting macrosomia and shoulder dystocia.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A new approach to predicting shoulder dystocia: fetal clavicle measurement

Terzi¹

2021

Turk J Med Sci

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“…published in 2016 do not confirm this. They observed a weak correlation for weight estimated using the Scioscia formula, which is based only on FL and FTSTT ( 21 ) . They also found that using this formula leads to overestimation of larger fetuses and underestimation of smaller ones.…”

Section: Use Of Fetal Soft Tissue Measurementsmentioning

confidence: 99%

Current knowledge on the use of ultrasound measurements of fetal soft tissues for the assessment of pregnancy development

et al. 2018

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Ultrasonography, with its detailed imaging of the fetus, is very widely used in obstetrics. The primary aim of ultrasound scanning in pregnancy is to limit the risk of obstetric complications by early detection of abnormalities, such as intrauterine growth restriction and macrosomia. Currently, morphometric formulae are used for estimating fetal weight. They utilize basic biometric parameters. However, Hadlock formula, used for fetal weight estimation, has an error rate of 20%. For this reason, researchers all over the world have been looking for other sonographic parameters correlating with fetal weight, with a higher predictive value. The current scientific reports indicate that new sonographic parameters, such as soft tissue thickness values, are useful for fetal weight assessment. The measurements can be conducted in various parts of the fetus’s body, e.g. thigh, upper arm, abdomen or the subscapular area. Different types of measurements are characterized by different levels of correlation with other sonographic and anthropometric parameters as well as body mass and gestational age. Based on the reports, numerous studies proposing new fetal weight calculation formulae have been produced. Apart from soft tissue, some more advanced and detailed measurements are taken, such as those involving adipose and lean tissue or using three-dimensional ultrasound (3D), for determining fetal weight. Ultrasound measurement of subcutaneous tissue thickness in various parts of the body may prove to be a strong predictor of fetal weight, which is useful for sonographic assessment of pregnancy.

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“…It is also associated with an increased risk of shoulder dystocia, and in some cases permanent brachial plexus injury, humerus or clavicle fractures, asphyxia at birth, and fetal death [3]. Over the years, the trend of fetal macrosomia has been shown to be increasing worldwide [6][7][8] and is a growing problem in most developing countries. It is evident that macrosomic delivery is related to health problems in adulthood since the concept of fetal origin of adult diseases establishes that both infants with limited growth and macrosomic are highly predisposed to coronary heart disease, hypertension, obesity, and insulin resistance in adulthood [9,10].…”

Section: Introductionmentioning

confidence: 99%

Higher Concordance in Clinical Assessment versus Ultrasound to Estimate Fetal Weight when it compares with Birth Weight in Full-Term Newborns

Velastegui-Ayala

González-Andrade

2021

REV-SEP

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Introduction: the aim of this trial was to estimate fetal weight by clinical and ultrasound methods and to compare with the weight at birth in full-term newborns. Methods: This is an epidemiological, observational, cross-sectional study of a cohort of healthy full-term newborns. The sample size was 102 neonates born at the Pablo Arturo Suarez Hospital, in Quito, Ecuador, from November 2019 to January 2020. Results: In full-term neonates, the estimate on ultrasound was 80.00%, while in the clinical assessment was 72.29%. The profile of newborn analyzed is man, mestizo, Ecuadorian, born in the highlands region, with a mean gestational age of 38.67 weeks and a mean birth weight of 3,023 grams, in whom it estimated the fetal weight through ultrasound and clinical assessment. The estimation of the absolute error in both methods analyzed was 2.43% to ultrasound and -4.65% to clinical assessment, and both showed moderate concordance, 78.2% to ultrasound, and 85.6% to clinical assessment. Multivariate analysis showed the neonates with modified weight by ultrasound are 13.44 times more likely to show altered weight at birth, while neonates with modified weight by the clinical assessment are 11.95 times more likely to show altered weight at birth. Conclusions: Accuracy in the clinical assessment was always higher than in the ultrasound method, especially in low weight newborns.

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Estimation of Fetal Weight during Labor: Still a Challenge

Cited by 5 publications

References 29 publications

A new approach to predicting shoulder dystocia: fetal clavicle measurement

A new approach to predicting shoulder dystocia: fetal clavicle measurement

Current knowledge on the use of ultrasound measurements of fetal soft tissues for the assessment of pregnancy development

Higher Concordance in Clinical Assessment versus Ultrasound to Estimate Fetal Weight when it compares with Birth Weight in Full-Term Newborns

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