Correlação entre peso fetal estimado por ultrassonografia e peso neonatal

Freire, Djacyr Magna Cabral; Cecatti, José Guilherme; Paiva, Cláudio Sérgio Medeiros

doi:10.1590/s0100-72032010000100002

Cited by 7 publications

(8 citation statements)

References 26 publications

(36 reference statements)

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“…However, a high linear correlation between EFW and neonatal weight (r = 0.94) was found in this subsample, which was considered to be more than enough to ascertain a strong association. 11 Therefore, this fi nding supported the classifi cation of EFW as the gold standard to diagnose fetal growth deviation in this study. Another limitation is regarding its cross-sectional design.…”

Section: Discussionsupporting

confidence: 84%

“…However, studies have found inconsistent performance results. 4,9,11,19,21 Despite the lack of a single reliable method to identify fetal growth deviations, combined clinical and ultrasound methods improve diagnosis. 5,6,15,18 As for the diagnosis of fetal growth restriction, newborn's weight is only a fi nal measurement which does not allow any kind of intervention to manage fetal weight gain.…”

Section: Resultsmentioning

confidence: 99%

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Symphysis-fundal height curve in the diagnosis of fetal growth deviations

2010

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OBJECTIVE:To validate a new symphysis-fundal curve for screening fetal growth deviations and to compare its performance with the standard curve adopted by the Brazilian Ministry of Health. METHODS:Observational study including a total of 753 low-risk pregnant women with gestational age above 27 weeks between March to October 2006 in the city of João Pessoa, Northeastern Brazil. Symphisys-fundal was measured using a standard technique recommended by the Brazilian Ministry of Health. Estimated fetal weight assessed through ultrasound using the Brazilian fetal weight chart for gestational age was the gold standard. A subsample of 122 women with neonatal weight measurements was taken up to seven days after estimated fetal weight measurements and symphisys-fundal classifi cation was compared with Lubchenco growth reference curve as gold standard. Sensitivity, specifi city, positive and negative predictive values were calculated. The McNemar χ 2 test was used for comparing sensitivity of both symphisys-fundal curves studied. RESULTS:The sensitivity of the new curve for detecting small for gestational age fetuses was 51.6% while that of the Brazilian Ministry of Health reference curve was signifi cantly lower (12.5%). In the subsample using neonatal weight as gold standard, the sensitivity of the new reference curve was 85.7% while that of the Brazilian Ministry of Health was 42.9% for detecting small for gestational age. CONCLUSIONS:The diagnostic performance of the new curve for detecting small for gestational age fetuses was signifi cantly higher than that of the Brazilian Ministry of Health reference curve.

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Section: Discussionsupporting

confidence: 84%

Section: Resultsmentioning

confidence: 99%

Symphysis-fundal height curve in the diagnosis of fetal growth deviations

2010

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“…The study characteristics are presented in Appendix 5, Table 24. Five studies 105,114,120,123,138 (n = 8088) included unselected pregnancies, nine studies 110,116,118,119,122,129,131,139,140 (n = 6436) included only low-risk pregnancies and 26 studies [102][103][104][106][107][108][109][111][112][113]115,117,121,[124][125][126][127][128]130,[132][133][134][135][136][137]141 (n = 51,663) included mixed-risk pregnancies.…”

Section: Resultsmentioning

confidence: 99%

“…Finally, three studies 110,134,140 included prolonged (> 41 weeks' gestation) pregnancies only, which were classified as having 'high applicability concerns because of patient selection'. 37 The most commonly reported outcomes were birthweight of > 4000 g (29 studies [103][104][105][106][110][111][112][113][118][119][120][121][122][123][125][126][127][128][129][130][131][132][133][134][135][138][139][140][141] ) followed by birthweight > 90th centile (seven studies 102,107,109,114,115,124,138 ), both of which we classified as LGA. We defined severe LGA as a birthweight of > 4500 g (six studies 113,117,131,137,138,141 ) or > 95th or 97th centiles (tw...…”

Section: Resultsmentioning

confidence: 99%

Universal late pregnancy ultrasound screening to predict adverse outcomes in nulliparous women: a systematic review and cost-effectiveness analysis

Smith

Moraitis

Wastlund

et al. 2021

Health Technol Assess

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Background Currently, pregnant women are screened using ultrasound to perform gestational aging, typically at around 12 weeks’ gestation, and around the middle of pregnancy. Ultrasound scans thereafter are performed for clinical indications only. Objectives We sought to assess the case for offering universal late pregnancy ultrasound to all nulliparous women in the UK. The main questions addressed were the diagnostic effectiveness of universal late pregnancy ultrasound to predict adverse outcomes and the cost-effectiveness of either implementing universal ultrasound or conducting further research in this area. Design We performed diagnostic test accuracy reviews of five ultrasonic measurements in late pregnancy. We conducted cost-effectiveness and value-of-information analyses of screening for fetal presentation, screening for small for gestational age fetuses and screening for large for gestational age fetuses. Finally, we conducted a survey and a focus group to determine the willingness of women to participate in a future randomised controlled trial. Data sources We searched MEDLINE, EMBASE and the Cochrane Library from inception to June 2019. Review methods The protocol for the review was designed a priori and registered. Eligible studies were identified using keywords, with no restrictions for language or location. The risk of bias in studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Health economic modelling employed a decision tree analysed via Monte Carlo simulation. Health outcomes were from the fetal perspective and presented as quality-adjusted life-years. Costs were from the perspective of the public sector, defined as NHS England, and the costs of special educational needs. All costs and quality-adjusted life-years were discounted by 3.5% per annum and the reference case time horizon was 20 years. Results Umbilical artery Doppler flow velocimetry, cerebroplacental ratio, severe oligohydramnios and borderline oligohydramnios were all either non-predictive or weakly predictive of the risk of neonatal morbidity (summary positive likelihood ratios between 1 and 2) and were all weakly predictive of the risk of delivering a small for gestational age infant (summary positive likelihood ratios between 2 and 4). Suspicion of fetal macrosomia is strongly predictive of the risk of delivering a large infant, but it is only weakly, albeit statistically significantly, predictive of the risk of shoulder dystocia. Very few studies blinded the result of the ultrasound scan and most studies were rated as being at a high risk of bias as a result of treatment paradox, ascertainment bias or iatrogenic harm. Health economic analysis indicated that universal ultrasound for fetal presentation only may be both clinically and economically justified on the basis of existing evidence. Universal ultrasound including fetal biometry was of borderline cost-effectiveness and was sensitive to assumptions. Value-of-information analysis indicated that the parameter that had the largest impact on decision uncertainty was the net difference in cost between an induced delivery and expectant management. Limitations The primary literature on the diagnostic effectiveness of ultrasound in late pregnancy is weak. Value-of-information analysis may have underestimated the uncertainty in the literature as it was focused on the internal validity of parameters, which is quantified, whereas the greatest uncertainty may be in the external validity to the research question, which is unquantified. Conclusions Universal screening for presentation at term may be justified on the basis of current knowledge. The current literature does not support universal ultrasonic screening for fetal growth disorders. Future work We describe proof-of-principle randomised controlled trials that could better inform the case for screening using ultrasound in late pregnancy. Study registration This study is registered as PROSPERO CRD42017064093. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 15. See the NIHR Journals Library website for further project information.

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“…The study characteristics are presented in S1 Table . Six studies [ 18 , 27 , 33 , 36 , 37 , 52 ] ( N = 53,935) included unselected pregnancies, nine [ 23 , 29 , 31 – 33 , 35 , 43 , 45 , 53 , 54 ] ( N = 6,436) were confined to low-risk pregnancies, and 26 [ 15 – 17 , 9 – 22 , 24 – 26 , 28 , 30 , 34 , 38 – 42 , 44 , 46 – 51 , 55 ] ( N = 51,663) recruited pregnancies at mixed risk. The list of the excluded studies and the reasons for the exclusion are presented in S2 Table .…”

Section: Resultsmentioning

confidence: 99%

Universal third-trimester ultrasonic screening using fetal macrosomia in the prediction of adverse perinatal outcome: A systematic review and meta-analysis of diagnostic test accuracy

et al. 2020

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Background The effectiveness of screening for macrosomia is not well established. One of the critical elements of an effective screening program is the diagnostic accuracy of a test at predicting the condition. The objective of this study is to investigate the diagnostic effectiveness of universal ultrasonic fetal biometry in predicting the delivery of a macrosomic infant, shoulder dystocia, and associated neonatal morbidity in low-and mixed-risk populations. Methods and findings We conducted a predefined literature search in Medline, Excerpta Medica database (EMBASE), the Cochrane library and ClinicalTrials.gov from inception to May 2020. No language restrictions were applied. We included studies where the ultrasound was performed as part of universal screening and those that included low-and mixed-risk pregnancies and excluded studies confined to high risk pregnancies. We used the estimated fetal weight (EFW) (multiple formulas and thresholds) and the abdominal circumference (AC) to define suspected large for gestational age (LGA). Adverse perinatal outcomes included macrosomia (multiple thresholds), shoulder dystocia, and other markers of neonatal morbidity. The risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Meta-analysis was carried out using the hierarchical summary receiver

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Correlação entre peso fetal estimado por ultrassonografia e peso neonatal

Cited by 7 publications

References 26 publications

Symphysis-fundal height curve in the diagnosis of fetal growth deviations

Symphysis-fundal height curve in the diagnosis of fetal growth deviations

Universal late pregnancy ultrasound screening to predict adverse outcomes in nulliparous women: a systematic review and cost-effectiveness analysis

Universal third-trimester ultrasonic screening using fetal macrosomia in the prediction of adverse perinatal outcome: A systematic review and meta-analysis of diagnostic test accuracy

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