Factors Influencing the Accuracy of Fetal Weight Estimation with a Focus on Preterm Birth at the Limit of Viability: A Systematic Literature Review

Huber, Chantal; Zdanowicz, Jarmila A.; Mueller, Martin; Surbek, Daniel

doi:10.1159/000358518

Cited by 21 publications

(29 citation statements)

References 32 publications

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“…One factor not assessed by any of the studies and one systemic literature review involving 29 studies stated "No results were obtained on the impact of active labor" (13). In our study, active labor was not found to affect the accuracy of EFW.…”

Section: Discussioncontrasting

confidence: 54%

“…When we see the other studies mentioned previously in the literature review, the only factor that persistently affected EFW accuracy was the time interval between estimation and delivery i.e. 0-7 days vs. 8-14 days (13,17). But our study only included scans done within 7 days of delivery and the EFW was not affected among the scans done in this interval.…”

Section: Discussionmentioning

confidence: 67%

“…Fetal weight, the time interval between estimation and delivery, and the use of different formulas seem to have an evident effect on EFW accuracy. No results were obtained on the impact of active labor (13).…”

Section: Introductionmentioning

confidence: 98%

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Accuracy of Ultrasound Estimation of Fetal Weight at Three Teaching Hospitals in Addis Ababa

Ibrahim¹,

Weldetensaye²

2020

Preprint

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Abstract BackgroundUltrasound examination and measurement of fetal weight have become an integral part of modern obstetric care. Knowing the accuracy of the ultrasound estimation of fetal weight (EFW) and what factors affect it helps make a more informed decision. Fetal weight estimation is thought to help predict fetal survival and make management decisions in the low birth weight group and in managing the delivery of the large baby, where complications may occur.ObjectiveTo assess the accuracy of ultrasound estimation of fetal weight.MethodsThe study design was a facility-based prospective cross-sectional study comparing sonographic EFW with actual birth weight, involving 384 women admitted to the study hospitals. And assessed 12 factors that might affect accuracy (place of delivery/scan, level of the operator, time of scan (working vs. non-working hours), fetal presentation, liquor volume, placental location, days passed between scan and delivery, time of the scan to labor (antepartum vs. intrapartum), fetal sex, maternal BMI, gestational age, and fetal weight. Data were collected using structured questionnaires, developed based on study variables and available literature, and analyzed using SPSS software.ResultThe EFW that is within 10% of the actual birth weight is 62.4%. The overall mean error of EFW was 9.1%, with an SD of ± 7.1%. Of the 12 factors assessed, it was found that the place of delivery/scan (p = 0.017) and the level of resident experience (p = 0.47) significantly affected the accuracy. When R4 was compared to R1’s OR = 4.656(95%CI, [1.111–19.506], p = 0.035) and R2’s OR = 2.112(95%CI,[1.062–4.201],p = 0.033) but not significant when compared to R3’s OR = 1.227(95%CI,[0.563–1.191],p = 0.607). A paired sample t-test was applied (P = 0.14).Conclusion and recommendationThe EFW of R4’s was significantly different from that of R1’s and R2’s, but not R3’s we recommend that all ultrasound scans whose weight estimation can affect the management plan of the patient to be done by the senior residents rather than the junior residents i.e. the R3’s and R4’s.

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Section: Discussioncontrasting

confidence: 54%

Section: Discussionmentioning

confidence: 67%

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Accuracy of Ultrasound Estimation of Fetal Weight at Three Teaching Hospitals in Addis Ababa

Ibrahim¹,

Weldetensaye²

2020

Preprint

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“…No influence of BMI was described in the article by Hellebust et al [28] either. The accuracy of fetal weight estimation is not affected by BMI, which was put forward by other authors and also described in a systematic review of influencing factors by Huber et al [29,30,31,32]. …”

Section: Discussionmentioning

confidence: 74%

Update Reference Charts: Fetal Biometry between the 15th and 20th Week of Gestation

Kubiak

Koch²,

Klockenbusch³

et al. 2016

Fetal Diagn Ther

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Objective: The aim of this study was to derive reference charts between the 15th and 20th week of gestation for biparietal diameter (BPD), occipito-frontal diameter (OFD), head circumference (HC), abdominal circumference (AC) and femur length (FL) compared to commonly used curves and to evaluate the impact of maternal body mass index (BMI), ultrasound equipment, fetal gender and nicotine abuse. Methods: In a cross-sectional study of 4,265 low-risk pregnancies, biometric data were obtained between the 15th and 20th week of gestation. The statistical analysis included descriptive data, fitting regression curves for the 5th, 50th and 95th quantile as well as multivariate quantile regression analyses. Results: Reference curves for BPD, OFD, HC, AC and FL showed a linear increase between the 15th and 20th week of gestation. New equations and reference charts are presented in this study. In a comparison of influence factors sex, BMI and ultrasound systems have an impact. Conclusion: As a result of the study, we determined current growth curves for BPD, OFD, HC, AC and FL for both sexes as well as for males and females separately. The updated growth curves for all biometric parameters differ from the curves used commonly in the last two decades.

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“…The accuracy of EFW at the limit of viability is susceptible to a variety of confounding factors [9] . We performed a retrospective analysis to determine the accuracy of EFW in the delivery room setting, and how inaccuracy may adversely affect neonatal morbidity and mortality by influencing clinical decisions.…”

Section: Methodsmentioning

confidence: 99%

Impact of Fetal Weight Estimation on the Prediction of Neonatal Morbidity and Mortality at the Limit of Viability

Zdanowicz

Huber²,

Gerull³

et al. 2016

Fetal Diagn Ther

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Introduction: To determine the accuracy of estimated fetal weight (EFW) at the limit of viability in a delivery room setting and its impact on the prediction of neonatal outcome. Material and Methods: In this retrospective, single-center cohort study we included patients with preterm birth between 23⁰/₇ and 26⁰/₇ weeks of gestation. Neonates were divided into 3 groups according to birth weight at delivery (accuracy index 90-110%, <90%, >110%). Neonatal outcome for each group was categorized into survival with and without impairment and death, with a follow-up period of 6 weeks. Results: Eighty-seven newborns were included, with 62.1% accurately estimated. Gestational age at birth, fetal sex, maternal body mass index, and time interval between birth and ultrasound affected the accuracy of EFW. Chances of survival were significantly higher in the underestimated group for birth weight at delivery compared with estimated weight (p < 0.001), with risk of death being significantly lower (p < 0.001). The reverse was true for overestimated infants, for both risk of death and chances of survival. At 6 weeks' follow-up, there were significantly more deceased overestimated infants (p = 0.041). Discussion: Our study shows that inaccuracy of EFW at the limit of viability occurs frequently in a delivery room setting with a potential impact on neonatal outcome.

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Factors Influencing the Accuracy of Fetal Weight Estimation with a Focus on Preterm Birth at the Limit of Viability: A Systematic Literature Review

Cited by 21 publications

References 32 publications

Accuracy of Ultrasound Estimation of Fetal Weight at Three Teaching Hospitals in Addis Ababa

Accuracy of Ultrasound Estimation of Fetal Weight at Three Teaching Hospitals in Addis Ababa

Update Reference Charts: Fetal Biometry between the 15th and 20th Week of Gestation

Impact of Fetal Weight Estimation on the Prediction of Neonatal Morbidity and Mortality at the Limit of Viability

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