Comparison of three clinical and three ultrasonic equations in predicting fetal birth weight
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20151627Keywords:
Expected fetal birth weight, Actual birth weight, Johnsons formulae, Dare formulae, Obstetrical equation, Hadlock equation, Warsoff equation, Shephard equationAbstract
Background: Antenatal assessment of fetal weight is important part in the management decisions during labour, thereby improving perinatal outcome. There are a large number of clinical methods and ultrasonic formulae for predicting fetal birth weight (EBW) with varying degrees of accuracy. This study was an attempt to compare the accuracy of three clinical and three ultrasonic methods in Indian population. The method with highest accuracy can be used in high and low resource setting in a country like ours with diverse resource settings.
Methods: This was a prospective non randomized cohort study done on 100 antenatal patients in PGIMER, Dr. RML Hospital; New Delhi from Nov 2011 to Jan 2013 EBW (Expected Birth Weight) was calculated applying the 6 formulae three clinical and three ultrasonic and statistical analysis done after delivery comparing with ABW (Actual Birth Weight).
Results: Accuracy in all ABW within 10% of ABW was 94 % with Johnson's method, 92 %with Dares method and 62 % with obstetrical equation. It was 100% with Hadlock 2 equation, 96% with Shepherd's and 86% with Warsoff equation Sensitivity for IUGR i.e. wt <2.5 kg was low in clinical methods, highest was only 46.2% with Johnsons. In ultrasonic methods all the three equations had 100% sensitivity making ultrasound the preferred modality in diagnosing macrosomia.
Conclusions: The major finding of this study is that clinical estimation of fetal weight is as accurate as ultrasonographic method of estimation within normal range of birth weight Ultrasonographic methods was statistically more accurate with smaller mean errors and more within 10% of actual birth weight. Johnson formula gave most accuracy in clinical methods Ultrasound should be used to confirm clinical methods if IUGR or Macrosomia is suspected. No single method should be used if EBW is a part of decision but two or more methods should be combined.
References
Johnson RW, Toshach CE. Estimation of fetal weight using longitudinal mensuration. Am J Obstet Gynecol. 1954;68(3):891-6.
Dare FO, Ademowore AS, Ifaturoti OO. The value of symphysio-fundal height/abdominal girth measurements in predicting fetal weight. Int J Gynaecol. 1990;31:243-8.
Shittu AS, Kutti O, Orji EO. Clinical versus sonographic estimation of fetal weight in south west Nigeria. Jhealth popul nutr. 2007;25(1):14-23.
Hadlock FP, Harrist RB, Sharman RS. Estimation of fetal weight with the use of head, body, and femur measurements-a prospective study. Am J Obstet Gynecol. 1985;151(3):333-7.
Kacem Y, Cannie MM, Kadji C et al. Fetal weight estimation: comparison of two-dimensional US and MR imaging assessments Radiology. 2013;267(3):902-10.
Chauhan SP, Lutton PM, Bailey KJ. Intrapartum clinical, sonographic, and parous patients' estimates of newborn birth weight. Obstet Gynecol. 1992;79(6):956-8.
Raman S, Urquhart R, Yusof M. Clinical versus ultrasound estimation of fetal weight. Aust N Z J Obstet Gynaecol. 1992;32(3):196-9.
Banerjee K, Mittal S, Kumar S. Clinical vs. ultrasound evaluation of fetal weight. Int J Gynaecol Obstet. 2004;86(1):41-3.
Chauhan SP, Hendrix NW, Magann EF. Limitations of clinical and sonographic estimates of birth weight: experience with 1034 parturients. Obstet Gynecol. 1998;91(1):72-7.
Fernández-Castro F, Laredo-Rodríguez A, Hernández-Herrera R. Sensitivity and predictive value of the Johnson and Toshach method to estimate fetal weight. Rev Med Inst Mex Seguro Soc. 2006;44(4):309-12.
Valenzuela Tinoco E, Puente González H, de Dios Maldonado Alvarado J. Prediction of fetal weight by the Johnson-Toshach method. Ginecol Obstet Mex. 1998;66:420-2.
Bhandary Amritha A, Pinto patric J, Shetty Ashwin P. Comparative study of various methods of fetal weight estimation at term pregnancy. J Obstet Gynecol Ind. 2004;54(4):336-9.
Japarath P, Wiboolphan T. Comparison of the accuracy of fetal weight estimation using clinical and sonographic methods. J Med Assoc Thai. 2004;87(3).
Kumari A, Goswami S, Mukherjee P. Comparative Study of Various Methods of Fetal Weight Estimation in Term Pregnancy. J South Asian Feder Obst Gynae. 2013;5(1):22-5.
Nahar N, Akhter N, Hoque ME et al. Comparative study between clinical and sonographic, estimation of weight in third trimester of pregnancy and its relationship with actual birth weight. Mymensingh Med j. 2008;17(2):157-63.
Torloni MR, Sass N, Sato JL, Renzi AC, Fukuyama M, Rubia de Lucca P. Clinical formulas, mother’s opinion and ultrasound in predicting birth weight. Sao Paulo Med J. 2008;126(3):145-9.
Mehdizadeh A, Alaghehbandan R, Horsan H. Comparison of clinical versus ultrasound estimation of fetal Weight. Amj Perinatol. 2000;17(5):233-6.
Titapant V, Chawanpaiboon S, Mingmitpatanakul K. A comparison of clinical and estimation of fetal Weight. J Med Assoc Thai. 2001;84(9):1251-7.
Sherman DJ, Arleli S, Tovbin J. A comparison of clinical and ultra sonic estimation of fetal weight. Obstet Gynecol. 1998;91(2):212-7.
Dudley NJ. A systematic review of the ultrasound estimation of fetal weight. Ultrasound Obstet Gynecol. 2005;25(1):80-9.
Ugwa EA. Advances in clinical estimation of fetal weight before delivery. Niger J Basic Clin Sci. 2015;12:67-73.
Burd, Srinivas. Is sonographic assessment of fetal weight influenced by formula selection? J Ultrasound Med. 2009;28(8):1019-24.
Hargreaves K, Cameron M, Edwards H, Gray R. Is use of symphysis-fundal height measurement and ultrasound examination effective in detecting small or large fetuses? Journal of obstetrics and Gynaecology. 2011;31(5):380-3.
Lee W, Balasubramaniam M, Russel L, Yeo L. New Fetal Weight Estimation Models Using Fractional Limb Volume Ultrasound in Obstetrics & Gynecology. 2009:556-65.
