Disadvantages of a weight estimation formula for macrosomic fetuses: the Hart formula from a clinical perspective

Weiss, Christoph; Oppelt, Peter; Mayer, RB

doi:10.1007/s00404-018-4917-z

Cited by 7 publications

(11 citation statements)

References 34 publications

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“…On one hand, normal-weight fetuses are massively overestimated, and on the other hand, fetuses with the highest birth risk (BW > 4500 g) will not be detected. The same problem applies to the formula for macrosomic fetuses published by Hart et al in 2010 [22,23].…”

Section: Discussionmentioning

confidence: 93%

Does the Porter formula hold its promise? A weight estimation formula for macrosomic fetuses put to the test

Weiss¹,

Enengl²,

Enzelsberger³

et al. 2019

Arch Gynecol Obstet

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Purpose Estimating fetal weight using ultrasound measurements is an essential task in obstetrics departments. Most of the commonly used weight estimation formulas underestimate fetal weight when the actual birthweight exceeds 4000 g. Porter et al. published a specially designed formula in an attempt to improve detection rates for such macrosomic infants. In this study, we question the usefulness of the Porter formula in clinical practice and draw attention to some critical issues concerning the derivation of specialized formulas of this type. Methods A retrospective cohort study was carried out, including 4654 singleton pregnancies with a birthweight ≥ 3500 g, with ultrasound examinations performed within 14 days before delivery. Fetal weight estimations derived using the Porter and Hadlock formulas were compared. Results Of the macrosomic infants, 27.08% were identified by the Hadlock formula, with a false-positive rate of 4.60%. All macrosomic fetuses were detected using the Porter formula, with a false-positive rate of 100%; 99.96% of all weight estimations using the Porter formula fell within a range of 4300 g ± 10%. The Porter formula only provides macrosomic estimates. Conclusions The Porter formula does not succeed in distinguishing macrosomic from normal-weight fetuses. High-risk fetuses with a birthweight ≥ 4500 g in particular are not detected more precisely than with the Hadlock formula. For these reasons, we believe that the Porter formula should not be used in clinical practice. Newly derived weight estimation formulas for macrosomic fetuses must not be based solely on a macrosomic data set.

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Section: Discussionmentioning

confidence: 93%

Does the Porter formula hold its promise? A weight estimation formula for macrosomic fetuses put to the test

Weiss¹,

Enengl²,

Enzelsberger³

et al. 2019

Arch Gynecol Obstet

Self Cite

View full text Add to dashboard Cite

show abstract

“…In recent years several EFW prediction models have been developed, but none of these models were practiced in routine clinical applications or recommended according to the current guidelines. Hadlock’s formula is still thus far one of the best-established weight estimation formulas and the one most widely used in everyday routine work, despite recent studies indicating potential ways to decrease MAPE, the especially in macrosomic fetuses and other deviant cases [ 8 , 23 ]. Although, due to the drastic difference in the number of participants, the MAPE in this study was slightly higher than that calculated by Konwar [ 8 ] or Weiss [ 23 ] (5.79% for DNN estimation and 6.46% for Hadlock’s formula), the DNN model still predicted the EFW more accurately compared to the Hadlock’s formula.…”

Section: Discussionmentioning

confidence: 99%

Fetal weight estimation based on deep neural network: a retrospective observational study

Wang

Shi

Zhang

et al. 2023

BMC Pregnancy Childbirth

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Background Improving the accuracy of estimated fetal weight (EFW) calculation can contribute to decision-making for obstetricians and decrease perinatal complications. This study aimed to develop a deep neural network (DNN) model for EFW based on obstetric electronic health records. Methods This study retrospectively analyzed the electronic health records of pregnant women with live births delivery at the obstetrics department of International Peace Maternity & Child Health Hospital between January 2016 and December 2018. The DNN model was evaluated using Hadlock’s formula and multiple linear regression. Results A total of 34824 live births (23922 primiparas) from 49896 pregnant women were analyzed. The root-mean-square error of DNN model was 189.64 g (95% CI 187.95 g—191.16 g), and the mean absolute percentage error was 5.79% (95%CI: 5.70%—5.81%), significantly lower compared to Hadlock’s formula (240.36 g and 6.46%, respectively). By combining with previously unreported factors, such as birth weight of prior pregnancies, a concise and effective DNN model was built based on only 10 parameters. Accuracy rate of a new model increased from 76.08% to 83.87%, with root-mean-square error of only 243.80 g. Conclusions Proposed DNN model for EFW calculation is more accurate than previous approaches in this area and be adopted for better decision making related to fetal monitoring.

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“…53,54 Likewise, Hadlock's formula remained the top choice for LGA detection. 52,55,56 It has been suggested that the accuracy of fetal weight estimation may have reached a maximum using traditional biometric parameters. 57 Significant advances can probably only come from new ultrasonography technology.…”

Section: Challenges and Future Directionsmentioning

confidence: 99%

“…performed better than others if the presence of a brain-sparing effect was identified 53,54 . Likewise, Hadlock's formula remained the top choice for LGA detection 52,55,56 . It has been suggested that the accuracy of fetal weight estimation may have reached a maximum using traditional biometric parameters 57 .…”

Section: How To Establish a Chinese Fetal Growth Standardmentioning

confidence: 99%

Establishing Chinese Fetal Growth Standards: Why and How

Zeng

Zhu

Zhang

2022

Maternal-Fetal Medicine

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Choosing a fetal growth standard or reference is crucial when defining normal and abnormal fetal growth. We reviewed the recently published standards and compared them with a customized fetal growth chart based on a nationwide population in China. There were substantial discrepancies in the fetal growth pattern, suggesting that these standards may not be applicable to Chinese fetuses. Developing a Chinese-specific standard may better meet our clinical requirements. We also discuss the steps to establish a Chinese fetal growth standard and the potential challenges, including regional disparities and accuracy of sonographic estimated fetal weight. Standardized ultrasound measurement protocol and the introduction of new ultrasonography technology may be helpful in developing a more precise standard than existing ones for the Chinese population.

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Disadvantages of a weight estimation formula for macrosomic fetuses: the Hart formula from a clinical perspective

Cited by 7 publications

References 34 publications

Does the Porter formula hold its promise? A weight estimation formula for macrosomic fetuses put to the test

Does the Porter formula hold its promise? A weight estimation formula for macrosomic fetuses put to the test

Fetal weight estimation based on deep neural network: a retrospective observational study

Establishing Chinese Fetal Growth Standards: Why and How

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