Prenatal prediction of postnatal large‐for‐dates neonates using a simplified MRI method: comparison with conventional 2D ultrasound estimates

Kadji, Caroline; Cannie, Mieke; Angelis, Riccardo De; Camus, M; Klass, Magdalena; Fellas, Stéphanie; Cecotti, Vera; Dütemeyer, Vivien; Jani, Jacques

doi:10.1002/uog.17523

Cited by 22 publications

(15 citation statements)

References 37 publications

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“…There is some contradictory evidence for whether the precision of EFW can be improved by three-dimensional (3D) ultrasound volumetry [62][63][64] . Recent evidence suggests that EFW using magnetic resonance imaging (MRI) may be more accurate than ultrasound in the prediction of both SGA and LGA neonates 65,66 . Assessments of the value of 3D ultrasound and fetal MRI were beyond the scope of our study.…”

Section: Comparison With Previous Studiesmentioning

confidence: 99%

Ultrasonographic estimation of fetal weight: development of new model and assessment of performance of previous models

Hammami

Zumaeta

Syngelaki

et al. 2018

Ultrasound in Obstet & Gyne

129

128

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The most accurate models, with the lowest Euclidean distance and highest proportion of AE ≤ 10%, were provided by the formulae incorporating ≥ 3 rather than < 3 biometrical measurements. The systematic review identified 45 studies describing a total of 70 models for EFW by various combinations of measurements of fetal head circumference (HC), biparietal diameter, femur length (FL) and abdominal circumference (AC). The most accurate model with the lowest Euclidean distance and highest proportion of AE ≤ 10% was provided by the formula of Hadlock et al., published in 1985, which incorporated measurements of HC, AC and FL; there was a highly significant linear association between EFW and birth weight (r = 0.959; P < 0.0001), and EFW was within 10% of birth weight in 80% of cases. The performance of the best model developed in this study, utilizing HC, AC and FL, was very similar to that of Hadlock et al. CONCLUSION: Despite many efforts to develop new models for EFW, the one reported in 1985 by Hadlock et al., from measurements of HC, AC and FL, provides the most accurate prediction of birth weight and can be used for assessment of all babies, including those suspected to be either small or large. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.

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Section: Comparison With Previous Studiesmentioning

confidence: 99%

Ultrasonographic estimation of fetal weight: development of new model and assessment of performance of previous models

Hammami

Zumaeta

Syngelaki

et al. 2018

Ultrasound in Obstet & Gyne

129

128

View full text Add to dashboard Cite

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“…A more accurate method of EFW could produce better outcomes by restricting interventions such as induction of labour and caesarean section to those fetuses at greatest risk of suspected macrosomia. Some publications have already demonstrated that MRI-derived EFW close to delivery is more accurate than US, with a precision superior to that of US using birth weight as a golden standard,14–23 and a recent meta-analysis has confirmed this promising accuracy 24…”

Section: Introductionmentioning

confidence: 97%

Protocol for the prospective observational clinical study: estimation of fetal weight by MRI to PREdict neonatal MACROsomia (PREMACRO study) and small-for-gestational age neonates

et al. 2019

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IntroductionMacrosomia refers to growth beyond a specific threshold, regardless of gestational age. These fetuses are also frequently referred to as large for gestational age (LGA). Various cut-offs have been used but for research purposes, a cut-off above the 95th centile for birth weight is often preferred because it defines 90% of the population as normal weight. The use of centiles, rather than estimated weights, also accommodates preterm macrosomic infants, although most of the complications, maternal and fetal, arise during the delivery of large babies at term. This means that accurate identification of LGA fetuses (≥95th centile) may play an important role in guiding obstetric interventions, such as induction of labour or caesarean section. Traditionally, identification of fetuses suspected of macrosomia has been based on biometric measurements using two-dimensional (2D) ultrasound (US), yet this method is rather sub-optimal. We present a protocol (V.2.1, date 19 May 2016) for the estimation of fetal weight (EFW) by MRI to PREdict neonatal MACROsomia (PREMACRO study), which is a prospective observational clinical study designed to determine whether MRI at 36 + 0 to 36 + 6 weeks of gestation, as compared with 2D US, can improve the identification of LGA neonates ≥95th centile.Methods and analysisAll eligible women attending the 36-week clinic will be invited to participate in the screening study for LGA fetuses ≥95th centile and will undergo US-EFW and MRI-EFW within minutes of each other. From these estimations, a centile will be derived which will be compared with the centile of birth weight used as the gold standard. Besides birth weight, other pregnancy and neonatal outcomes will be collected and analysed. The first enrolment for the study was in May 2016. As of September 2018, 2004 women have been screened and recruited to the study. The study is due to end in April 2019.Ethics and disseminationThe study will be conducted in accordance with the International Conference on Harmonisation for good clinical practice and the appropriate regulatory requirement(s). A favourable ethical opinion was obtained from the Ethics Committee of the University Hospital Brugmann, reference number CE2016/44. Results will be published in peer-reviewed journals and disseminated at international conferences.Trial registration numberNCT02713568.

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“…In a group of 270 patients who underwent MRI examinations 48 hours before elective birth, the fetal weight was evaluated retrospectively using the semiautomated technique and compared with actual birthweight. The detection rate of LGA (defined as greater than 95th centile for gestation) was 98% for a fixed false positive rate (FFPR) of 10% in comparison with 67% using 2D‐US estimates, while in the SGA group (defined as less than 10th centile for gestation), the rate of detection was 100%, or 18 out of 18 fetuses, for a FFPR of 10% (95% CI, 82‐100) compared with only 78% (95% CI, 52‐94) for 2D‐US …”

Section: Review Of Available Literaturementioning

confidence: 99%

The use of magnetic resonance imaging in the prediction of birthweight

et al. 2019

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Extremes of fetal growth can increase adverse pregnancy outcomes, and this is equally applicable to single and multiple gestations. Traditionally, these cases have been identified using simple two‐dimensional ultrasound which is quite limited by its low precision. Magnetic resonance imaging (MRI) has now been used for many years in obstetrics, mainly as an adjunct to ultrasound for congenital abnormalities and increasingly as part of the post‐mortem examination. However, MRI can also be used to accurately assess fetal weight as first demonstrated by Baker et al in 1994, using body volumes rather than standard biometric measurements. This publication was followed by several others, all of which confirmed the superiority of MRI; however, despite this initial promise, the technique has never been successfully integrated into clinical practice. In this review, we provide an overview of the literature, detail the various techniques and formulas currently available, discuss the applicability to specific high‐risk groups and present our vision for the future of MRI within clinical obstetrics.

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Prenatal prediction of postnatal large‐for‐dates neonates using a simplified MRI method: comparison with conventional 2D ultrasound estimates

Cited by 22 publications

References 37 publications

Ultrasonographic estimation of fetal weight: development of new model and assessment of performance of previous models

Ultrasonographic estimation of fetal weight: development of new model and assessment of performance of previous models

Protocol for the prospective observational clinical study: estimation of fetal weight by MRI to PREdict neonatal MACROsomia (PREMACRO study) and small-for-gestational age neonates

The use of magnetic resonance imaging in the prediction of birthweight

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