Ultrasonography for Fetal Weight Estimation: The Birnholz Equation

1987 ◽  
Vol 9 (3) ◽  
pp. 195-202 ◽  
Author(s):  
David B. Acker ◽  
Benjamin P. Sachs ◽  
Bernard J. Ransil ◽  
Emanuel A. Friedman

In the population of 563 normal live births, subject to the selection criteria of this study, the mean ultrasonographically-estimated fetal weight calculated using the Birnholz equation accurately predicts the mean true birth weight with less than 1 percent error. However, on a pairwise basis, the error was found to be systematic (rather than random) with a large standard error of the estimate (± 300 g). The equation consistently underestimated the mean birth weight between 1500–3750 g and consistently overestimated it thereafter.

2019 ◽  
Vol 17 (2) ◽  
pp. 228-232
Author(s):  
Peru Pradhan ◽  
Binita Neupane ◽  
Sona Shrestha ◽  
Ganesh Dangal

Background: Fetal weight estimation is of utmost need to determine the course of labour and complications for its management. This study intents to compare the fetal weight determined through Johnson’s method and Hadlock’s method with actual birth weight in term pregnancies. Methods: This is an observational study carried out over a period of six months in Kirtipur Hospital among 200 samples of term, singleton pregnancy with cephalic presentation using convenience sampling technique.Results: The mean maternal age was 25.9±4.3 years whereas mean gestational age was 39.1 weeks. Less than half (49.1%) of the babies’ weight ranged between 3.0 - 3.5 kgs. The mean error of estimated weight by Johnson’s method was less compared to Hadlock’s method 185.1±191.1 grams and 355.8±225.7 grams respectively. It was also observed that estimation of fetal weight by Johnson’s method was closer to the actual birth weight than by Hadlock’s method.Conclusions: Johnson’s method requires some basic skills and knowledge with flexibility to apply as and where needed beyond the health facilities irrespective of the availability of the equipment. Furthermore, it was also observed to be slightly more specific in its estimation of birth weight among the term pregnancies compared to Hadlock’s method. Hence, it should be promoted widely among the clinicians. However, Hadlock’s method is equally important for detection of anomalies and high-risk factors coupled with confirmation of the estimation made through Johnson’s method.Keywords: Actual birth weight; estimated fetal weight; hadlock’s method; johnson’s method.


2019 ◽  
Vol 11 (1) ◽  
pp. 32-38
Author(s):  
Naznin Rashid Shewly ◽  
Menoka Ferdous ◽  
Hasina Begum ◽  
Shahadat Hossain Khan ◽  
Sheema Rani Debee ◽  
...  

Background: In obstetric management fetal weight estimation is an important consideration when planning the mode of delivery in our day to day practice. In Bangladesh low birth weight is a major public health problem & incidence is 38% - 58%. Neonatal mortality and morbidity also yet high. So accurate antenatal estimation of fetal weight is a good way to detect macrosomia or small for date baby. Thus to improve the pregnancy outcome and neonatal outcome decreasing various chance of neonatal mortality and morbidity antenatal fetal weight prediction is an invaluable parameter in some situation where to identify the at risk pregnancy for low birth weight become necessary. Reliable method for prenatal estimation of fetal weight two modalities have got popularity - Clinical estimation and another one is ultrasonic estimation. This study was designed to determine the accuracy of clinical versus ultrasound estimated fetal weight detecting the discrepancy with actual birth weight at third trimester. So that we can verify more reliable and accurate method. Objectives: To find out more accurate and reliable modality of fetal weight estimation in antenatal period during obstetric management planning. To compare clinical versus ultrasound estimated fetal weight & to determine discrepancy of both variable with actual birth weight. Method: This prospective, cross sectional analytical study was carried out in Dhaka Medical College Hospital from January 2006 to December 2006. By purposive sampling 100 pregnant women fulfilling inclusion criteria were included in my study in third trimester (29wks-40wks). In clinical weight estimation procedure SFH (Symphysio Fundal Height) was measured in centimeter. On pervaginal finding whether vertex below or above the ischial spine was determined. By Johnson’s formula fetal weight in grams was estimated. Then by ultrasound scan different biometric measurements were taken and finally by Hadlock’s formula fetal weight was estimated. Eventually actual birth weight was taken after birth by Globe Brand weighing machine. Accuracy of both modalities were compared and which one was more reliable predictor was determined by statistical analysis. Results: After data collection were analyzed by computer based software (SPSS). There was gradual and positive relationship between symphysiofundal height and estimated birth weight. Discrepancy between clinical and actual birth weight at third trimester was statistically significant – Paired Student’s ‘t’ test was done where p value was <0.001. Whereas discrepancy between sonographically estimated fetal weight with actual birth weight was not statistically significant (by paired ‘t’ test where p value was >0.05). That implies discrepancy between ultrasound estimated fetal weight and actual birth weight was significantly less than that of clinically estimated fetal weight. 14% clinically and 46% sonographically estimated fetal weight were observed within £ 5% of actual birth weight. 31% clinical and 42% sonographically estimates observed within 6% to 10% of actual birth weight and 55% clinical and 12% sonographically estimate were >10% of actual birth weight. That is about 88% sonographical versus 45% clinical estimates were within 10% of actual birth weight. Conclusion: There is no doubt about importance of fetal weight in many obstetric situations. Clinical decisions at times depends on fetal weight. Whether to use oxytocin, to use forceps or vacuum for delivery or extend of trial or ended by Caesarian section immediately or no scope of trial to be largely depend on fetal size and weight. So more accurate modality for antenatal fetal weight estimation has paramount importance. In my study sonographically estimated weight have more accuracy than that of clinical estimate in predicting actual birth weight. Sonographically estimated fetal weight is more reliable, accurate and reproducible rather than other modality. J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 32-38


2019 ◽  
Author(s):  
Nurbaiti . ◽  
Sri Haryati Gofar ◽  
Samsun . ◽  
Guntur Winarno ◽  
Akhmadi .

The purpose of this study is to analyze the result of the calculation of fetal weight estimation based on Hadlock’s formula with baby birth weight. The design of this research is quantitative analytic. The data is analyzed by the t-test. The results of this study showed that the analysis of the average comparison between TBJ (Fetal Weight Estimation) and BBL (Fetal Birth Weight) is 2623,60 with 2946,67. There is a significant difference with the value of sig.(2-tailed) 0,000 <0,05, which means there is a significant difference between the estimated fetal weight based on Hadlock’s formula with baby birth weight. Based on the result of the study of fetal weight interpretation using Hadlock’s formula, an accuracy of 89,34% was seen.


2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Emre Erdem Tas ◽  
Edip Alptug Kir ◽  
Gamze Yilmaz ◽  
Ayse Filiz Yavuz

Objectives: To investigate the factors which might influence the sonographic fetal weight estimation (SFWE) accuracy. Methods: This prospective study was conducted among 949 singleton term pregnant women who delivered at a tertiary center, from January 2017 to December 2017. All participants’ maternal (i.e. parity, age, body mass index and gestational weight gain during pregnancy), fetal sonographic (i.e. fetal presentation, amniotic fluid index, localization of placenta and estimated fetal weight) and neonatal (birth weight and gender) characteristics were recorded. A p<0.05 was considered significant. Results: The mean absolute percent error (APE) values of SFWE was 8.2±6.5 percent, and overall failure ratio (APE >10%) was 33%. In failure group, primiparous woman and cephalic presentation fetus were significantly more common compared to accuracy group (55.9% vs.44.8%; p=0.001 and 98% vs. 95.2%; p=0.03, respectively). In contrast, the mean neonatal birth weight (NBW) value was significantly lower in failure group compared to success group (3250±565 gr vs. 3404±410 gr; p=0.001). The correlation between SFWE and NBW was linear, however negative, and significant (p=0.001). Logistic regression analysis revealed that primiparous woman, cephalic presentation fetus and <3300 gr NBW were independent risk factors for the SFWE failure (relative risks were 1.6, 2.8 and 2.4 respectively, p<0.05). Conclusion: SFWE has a high correlation with NBW, however it’s accuracy is still unsatisfactory, and depend on many unpredictable and inconsistent factors. How to cite this:Tas EE, Kir EA, Yilmaz G, Yavuz AF. Accuracy of sonographic fetal weight estimation in full-term singleton pregnant women. Pak J Med Sci. 2019;35(1):34-38. doi: https://doi.org/10.12669/pjms.35.1.373 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Author(s):  
Dwi Pratika Anjarwati ◽  
Yudhistya Ngudi Insan Ksyatria ◽  
Widardo Widardo

abstract Objective: to investigate the accuracy of estimated fetal weight using Hadlock II formula in RSUD Dr Moewardi. Methods: This cross-sectional study was conducted at RSUD Dr Moewardi in June 2017. Subjects were women who gave birth at RSUD Dr Moewardi from August 2014 to March 2017. The method of collecting data by quoting the medical record as required. Data analysis was done by using linear regression statistic test. Result: By distribution, the number of samples that, according to the standard, is 81.67 %. With the value of R = 0.706 which means that the relationship between two research variables are strong and the value of R Square = 0.499 which means that estimated fetal weight using Hadlock II formula has contribution 49.9 % on fetal birth weight and 50.1 % others by other factors. Conclusion: Fetal weight estimation using Hadlock II formula in RSUD Dr Moewardi has low accuracy. Operator skills training is required to improve the accuracy of estimated fetal weight. Keywords:  fetal birth weight,  fetal weight estimation, Hadlock II   abstrak Tujuan : Mengetahui keakuratan taksiran berat janin menggunakan rumus Hadlock II di RSUD Dr Moewardi. Metode : Penelitian ini adalah penelitian observasional analitik. Penelitian ini dilaksanakan di RSUD Dr Moewardi pada Juni 2017. Subjek penelitian ini adalah data rekam medis dari ibu hamil yang mengalami partus di RSUD Dr Moewardi pada Agustus 2014 – Maret 2017. Metode pengumpulan data dengan mengutip data rekam medis pasien sesuai ketentuan. Analisis data dilakukan dengan uji statistik regresi linier. Hasil : Secara distribusi, jumlah sampel yang memenuhi standar yaitu   81,67 %. Dengan nilai R = 0,706 yang artinya bahwa hubungan kedua variabel penelitian ada dalam kategori kuat dan nilai R Square = 0,499 yang berarti taksiran berat janin menggunakan rumus Hadlock II memiliki pengaruh kontribusi sebesar 49,9% terhadap berat bayi lahir sedangkan 50.1 % lainnya dipengaruhi oleh faktor lain. Kesimpulan : Taksiran berat janin menggunakan rumus Hadlock II  di RSUD Dr Moewardi kurang akurat. Perlu dilakukan pelatihan ketrampilan operator sehingga diharapkan dapat meningkatkan keakuratan taksiran berat janin.  Kata kunci:   berat bayi lahir , Hadlock II, , taksiran berat janin


2017 ◽  
Vol 12 (4) ◽  
pp. 174-178 ◽  
Author(s):  
V Natraj Prasad ◽  
Pratik Poudel ◽  
Pramod Kumar Chhetry

Background & Objectives: Among the various methods used in the estimation of intrauterine fetal weight, sonographic fetal weight estimation is the one and has become an important component of antenatal care. The study was conducted with objective to assess the accuracy and reliability of ultrasound estimation of fetal weight in women with a singleton term pregnancy. Materials & Methods: This was a prospective cross-sectional study of 120 women with singleton term pregnancies. Ultrasound estimated fetal weight was calculated by measuring the biparietal diameter and abdominal circumference. The estimated fetal weight was compared to the actual birth weight post delivery. The correlation between estimated fetal weight and actual birth weight was assessed by Pearson's correlation coefficient and the accuracy of sonographic fetal weight estimation was measured using mean error, mean absolute error, mean percentage error, mean absolute percentage error and proportion of estimates within 10% of actual birth weight. Results were tested at error level set at p ≤ 0.05.Results: Mean estimated and actual birth weights were 2863.5 ± 441.9 g and 2822.5 ± 407.7 g respectively. There was a strong positive correlation between estimated fetal weight and actual birth weight (r= 0.71, p <0.001). The mean percentage error and mean absolute percentage error of ultrasound fetal weight estimations were 1.9 ± 11.4% and 8.8 ± 7.5% respectively. Conclusion: Sonographically estimated fetal weight had strong positive correlation with actual birth weight and thus sonography can be used in the estimation of fetal weight for the better perinatal outcome. 


2005 ◽  
Vol 58 (11-12) ◽  
pp. 548-552 ◽  
Author(s):  
Ljiljana Mladenovic-Segedi ◽  
Dimitrije Segedi

Introduction Former investigations have shown that the accuracy of fetal weight estimation is significantly higher if several ultrasonic fe?tal parameters are measured, because the total body mass depends on the size of fetal head, abdominal circumference and femur length. The aim of this investigation was to establish the best regression model, that is a number of combinations of fetal parameters providing the most accurate fetal weight estimation in utero in our population. Material and methods This prospective study was carried out at the Gynecology and Obstetrics Clinic of the Clinical Center Novi Sad. It included 270 pregnant women with singleton pregnancies within 72 hours of delivery who underwent ultrasound measurements of the biparietal diameter (BPD), head circumference (HC), ab?dominal circumference (AC) and femur length (FL). Results In regard to fetal weight estimation formulas, the deviation was lowest using regression models that simultaneously analyzed four fetal parameters (0.55%) with SD ?7.61%. In these models the estimates of fetal weights were within ?5% of actual birth weight in 48.89%, and within ?10% of actual birth weight in 81.48%. Good results were also obtained using AC, FL measurements (0.92% ? 8.20) as well as using AC, HC, FL measurements (-1.45% ? 7.81). In our sample the combination of AC and FL model gave better results in fetal weight estimation (0.92 ? 8.20%) than the one using BPD and AC (2.97 ? 8.83%). Furthermore, the model using parameters AC, HC and FL showed a lower error in accuracy (-1.45 ? 7.81%) than the model using BPD, AC and FL (2.51 ? 7.82%). Conclusion This investigation has confirmed that the accuracy of fetal weight estimation increases with the number of measured ultra?sonic fetal parameters. In our population the greatest accuracy was obtained using BPD, HC, AC and FL model. In cases when fast estimation of fetal weight is needed, AC, HC, FL model may be appropriate, but if fetal head circumference cannot be measured (amnion rupture and/or fetal head already in the pelvis) the AC, FL model should be used.


Author(s):  
Shripad Hebbar ◽  
Sukriti Malaviya ◽  
Sunanda Bharatnur

Objective: The objective of the study was to find whether incorporation of MTSTT in fetal weight estimation formulae which are traditionally based on biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) improves birth weight (BW) estimation. Methods: In a prospective observational study, MTSTT was measured within 1 week of delivery in 100 women with term singleton pregnancy along with other standard biometric parameters, i.e. BPD, HC, AC and FL, and MTSTT. Multiple regression analysis was carried out using PHOEBE regression software using different combinations of biometric variables to find out the best fit model of fetal weight estimation. The predicted BW was compared with actual neonatal BW soon after delivery and regression coefficients (R2) were determined for each of prediction models for comparing the accuracies. Results: Mean gestational age at delivery was 38.4±1.08 weeks and the BW of neonates varied between 2.18 kg and 4.38 kg (mean ± standard deviation: 3.07±0.43 kg). By adding MTSTT to BPD, HC, AC, and FL, we obtained the formula Log 10 (BW) = −0.14783+0.00725 *BPD +0.00043 *HC +0.00436 *AC +0.01942 *FL +0.16299 *MTSTT, which had a very good Pearson regression coefficient ((r2: 0.89 p<0.001) compared to conventional models based on standard fetal biometry. All prediction models had better strength of correlation when combined with MTSTT (p<0.001). The routine four parameter formula could identify 45% and 80% of fetuses within 5% and 10% weight range; pick up rate was further increased to 61% and 95% by addition of MTSTT. Conclusion: It is evident that addition of MTSTT to other biometric variables in models of fetal weight estimation improves neonatal BW prediction (r2=0.89).


Author(s):  
Harald Abele ◽  
Markus Hoopmann ◽  
Norbert Wagner ◽  
Markus Hahn ◽  
Diethelm Wallwiener ◽  
...  

2017 ◽  
Vol 45 (2) ◽  
Author(s):  
Sertac Esin ◽  
Mutlu Hayran ◽  
Yusuf Aytac Tohma ◽  
Mahmut Guden ◽  
Ismail Alay ◽  
...  

AbstractObjective:To compare different ultrasonographic fetal weight estimation formulas in predicting the fetal birth weight of preterm premature rupture of membrane (PPROM) fetuses.Methods:Based on the ultrasonographic measurements, the estimated fetal weight (EFW) was calculated according to the published formulas. The comparisons used estimated birth weight (EBW) and observed birth weight (OBW) to calculate the mean absolute percentage error [(EBW–OBW)/OBW×100], mean percentage error [(EBW–OBW)/OBW×100)] and their 95% confidence intervals.Results:There were 234 PPROM patients in the study period. The mean gestational age at which PPROM occured was 31.2±3.7 weeks and the mean gestational age of delivery was 32.4±3.2 weeks. The mean birth weight was 1892±610 g. The median absolute percentage error for 33 formulas was 11.7%. 87.9% and 21.2% of the formulas yielded inaccurate results when the cut-off values for median absolute percentage error were 10% and 15%, respectively. The Vintzileos’ formula was the only method which had less than or equal to 10% absolute percentage error in all age and weight groups.Conclusions:For PPROM patients, most of the formulas designed for sonographic fetal weight estimation had acceptable performance. The Vintzileos’ method was the only formula having less than 10% absolute percentage error in all gestational age and weight groups; therefore, it may be the preferred method in this cohort. Amniotic fluid index (AFI) before delivery had no impact on the performance of the formulas in terms of mean percentage errors.


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