Fetal Weight Estimation Using Automated Fractional Limb Volume With <scp>2‐Dimensional</scp> Size Parameters in Diabetic Pregnancies

Lee, Wesley; Mack, L.M.; Gandhi, R.; Sangi‐Haghpeykar, Haleh

doi:10.1002/jum.15397

Cited by 7 publications

(10 citation statements)

References 23 publications

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Section: Discussionmentioning

confidence: 98%

“…Automated FLV has been proven to work with diabetic pregnancies 22 . Random errors for the AVol (6.2%) and TVol (6.9%) models were significantly more precise than the other prediction models: Hadlock et al (7.8%), INTERGROWTH‐21st (8.0%), and Schild et al (8.6%) 22 . The greatest proportion of cases with BW ±10% was also classified by the AVol (91.1%) and TVol (91.1%) models, followed by the Hadlock (83.3%), INTERGROWTH‐21st (78.9%), and Schild (76.7%) predictions 22 .…”

Section: Discussionmentioning

confidence: 99%

“…Our study investigates the performance of this software in routine clinical practice, comparing the results generated by the recently introduced modified FLV models with the Hadlock model, because recent studies demonstrated a significant higher precision and a not significant lower accuracy of the new FLV models based on semiautomatic FLV calculations 21,22 . We compared semiautomatic FLV estimates of fetal weight to Hadlock estimates of fetal weight in an unselected population.…”

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confidence: 99%

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Semiautomatic Assessment of Fetal Fractional Limb Volume for Weight Prediction in Clinical Praxis

Gembicki

Offerman

Weichert

2021

J of Ultrasound Medicine

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Objectives Semiautomatic fractional limb volume (FLV) models have recently produced promising results for fetal birth weight (BW) estimation. We tested those models in a more unselected population hypothesizing that the FLV models would improve accuracy and precision of fetal BW estimation compared to the Hadlock model. Methods We compared the performance of different BW prediction models: Hadlock (biparietal diameter [BPD], abdominal circumference (AC), femur diaphysis length) and modified Lee thigh volume (TVol) and arm volume (AVol) (BPD, AC, automated fractional TVol, and AVol). Accuracy (systematic errors, mean percent differences) and precision (random errors, ± 1 SD of percent differences) were calculated. Results A total of 75 fetuses were included for final analysis. The Hadlock model showed the most consistent results with accurate BW estimation not significantly different from zero (−0.37 ± 8.53%). The modified fractional thigh and arm volume models were less accurate but trended toward more precise results (−2.63 ± 7.69% and −3.85 ± 7.47%, respectively). In addition, the modified TVol model showed the trend to predict more BWs within ±10% of the actual BW compared to the Hadlock model (81.3 versus 74.67%, ns). Conclusions Based on our results, fetal weight estimation using the modified semiautomatic FLV models generates less accurate results in third‐trimester fetuses compared to the Hadlock model. Those models recently published might improve the results of BW prediction by showing a higher precision than conventional models, especially in small and large fetuses. Further studies are needed to investigate the clinical usefulness of the new models.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Semiautomatic Assessment of Fetal Fractional Limb Volume for Weight Prediction in Clinical Praxis

Gembicki

Offerman

Weichert

2021

J of Ultrasound Medicine

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“…Diagnostic thresholds that use a cut-off of 4500 grams to designate macrosomia in the newborn are also likely to underestimate the frequency of fetal overgrowth in this population or for other populations where delivery before term is undertaken [ 10 ]. The need to explore improved models of estimated fetal weight or novel markers of fetal body composition, particularly amongst women with pregestational type 2 diabetes, is necessary to better refine risk prediction of intrapartum complications in this high-risk group [ 32 , 34 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

The Relationship between Fetal Abdominal Wall Thickness and Intrapartum Complications amongst Mothers with Pregestational Type 2 Diabetes

Isabey

Pylypjuk

2021

Journal of Diabetes Research

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Objectives. To evaluate the utility of fetal abdominal wall thickness (AWT) for predicting intrapartum complications amongst mothers with pregestational type 2 diabetes. Methods. This was a historical cohort study of pregnant mothers with pregestational type 2 diabetes delivering at a Canadian tertiary-care center between January 1, 2014, and December 31, 2018. Delivery records were reviewed to collect information about demographics and peripartum complications. Stored fetal ultrasound images from 36 weeks’ gestation were reviewed to collect fetal biometry and postprocessing measurement of AWT performed in a standardized fashion by 2 blinded and independent observers. The relationship between fetal AWT was then correlated with risk of intrapartum complications including emergency Caesarean section (CS) and shoulder dystocia. Results. 216 pregnant women with type 2 diabetes had planned vaginal deliveries and were eligible for inclusion. Mean maternal age was 31.3 years, and almost all were overweight or obese at the time of delivery (96.8%). Overall, the incidence of shoulder dystocia and emergency intrapartum CS was 7.4% and 17.6%, respectively. There was no difference in mean fetal AWT between those having a spontaneous vaginal delivery (8.2 mm (95% CI 7.9-8.5)) and those needing emergency intrapartum CS (8.1 mm (95% CI 7.4-8.8); p = 0.71 ) or shoulder dystocia (8.7 mm (95% CI 7.9-9.5); p = 0.23 ). There was strong interobserver correlation of AWT measurements ( r = 0.838 ; p < 0.00001 ). The strongest association with intrapartum complications was birthweight ( p = 0.003 ): with birthweight > 4000 grams, the relative risk of shoulder dystocia or CS is 2.75 (95% CI 1.74-4.36; p < 0.001 ). Conclusions. There was no obvious benefit of AWT measurement at 36 weeks for predicting shoulder dystocia or intrapartum CS amongst women with type 2 diabetes in our population. The strongest predictor of intrapartum complications remained birthweight, and so studies for improving estimation of fetal weight and evaluating the role of intrapartum ultrasound for predicting risk of delivery complications are still needed.

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“…In a recent publication that investigated the growth of fetal limb volumes in fetuses with maternal gestational diabetes, AVol but not TVol was larger in the GDM group, indicating the ability of AVol to detect alterations of fetal body composition associated with gestational diabetes [16]. Another recent study of automated FLV and weight prediction in diabetic pregnancies also suggested slightly lower random error for weight models using AVol (6.2%), when compared to conventional 2D fetal weight estimation procedures using the TVol parameter (6.9%) [17].…”

Section: Discussionmentioning

confidence: 99%

Correlation of Fractional Limb Volume Measurements with Neonatal Morphometric Indices

Cinar

Sezi̇k

2021

Gynecol Obstet Invest

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Objectives: Fractional thigh volume (TVol) and fractional arm volume (AVol) measurements by three-dimensional (3D) ultrasound can reveal valuable information on fetal soft tissue development. However, it is not clear whether TVol or AVol provides better estimates of fetal body proportion and adiposity, independent of routine two-dimensional (2D) ultrasound biometry. The primary objective of the current study was to determine the correlations between fractional limb volumes (FLVs) and neonatal anthropometric parameters. Design: In this cross-sectional study, fetal FLVs were obtained within 24 h before term delivery from 40 medically and obstetrically uncomplicated pregnancies scheduled for elective cesarean section. TVol and AVol were determined using offline software. Postnatal morphometric data including birth weight; crown-heel, arm, and leg lengths; head, abdominal, mid-thigh, and mid-arm circumferences; and anterior thigh, biceps, and subscapular skinfold thicknesses were obtained. Pearson and partial correlation analyses were used to determine the relationships across antenatal volume calculations and neonatal indices. Correlation coefficients (r) were calculated. Results: Mean maternal age, BMI, and parity were 29.1 ± 5.4 years, 29.7 ± 3.5 kg/m2, and 1.0 ± 1.3, respectively. AVol showed moderate correlations with most of the neonatal parameters, including mid-thigh circumference (r = 0.683), mid-arm circumference (r = 0.627), birth weight (r = 0.583), head circumference (HC, r = 0.560), and abdominal circumference (r = 0.542). However, TVol was weakly related to only some of the indices. After controlling for gestational age, maternal age, BMI, parity, and 2D ultrasound biometry, TVol was no longer associated with any of the parameters, while AVol was independently correlated with mid-thigh (r = 0.724) and mid-arm circumference (r = 0.560), birth weight (r = 0.502), ponderal index (r = 0.402), HC (r = 0.382), biceps (r = 0.384), and subscapular skinfold thickness (r = 0.350). Limitations: The current design includes limited number of pregnancies with only scheduled cesarean deliveries. Neonatal percent body fat was not calculated, and air-displacement plethysmography was not used to assess neonatal body composition. The study population was Caucasian with a relatively high maternal BMI, which may limit extrapolation of the results to other settings. Conclusions: AVoL measurements by 3D ultrasound before delivery are significantly correlated with most of the neonatal morphometric indices, independent of maternal characteristics and 2D biometric parameters. AVol may have advantages over TVol for assessing limb soft tissue development in term fetuses. Future research can focus on feasibility and predictive ability of AVol measurements in prospective studies that include serial biometry over time.

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Fetal Weight Estimation Using Automated Fractional Limb Volume With 2‐Dimensional Size Parameters in Diabetic Pregnancies

Cited by 7 publications

References 23 publications

Semiautomatic Assessment of Fetal Fractional Limb Volume for Weight Prediction in Clinical Praxis

Semiautomatic Assessment of Fetal Fractional Limb Volume for Weight Prediction in Clinical Praxis

The Relationship between Fetal Abdominal Wall Thickness and Intrapartum Complications amongst Mothers with Pregestational Type 2 Diabetes

Correlation of Fractional Limb Volume Measurements with Neonatal Morphometric Indices

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