الفهرس | Only 14 pages are availabe for public view |
Abstract The quest for precise prediction of fetal birth weight holds paramount importance in obstetrics, primarily for identifying potential complications and planning appropriate interventions. Traditional methods, including various biometric measurements, have been the cornerstone of fetal weight estimation. However, recent advancements have introduced more refined approaches, such as measuring fetal thigh circumference (TC) and fractional thigh volume (TVol), to enhance the accuracy of these predictions. These methods are increasingly being studied for their efficacy and reliability in predicting fetal birth weight. However, the accuracy of TC and TVol can vary based on factors such as gestational age, fetal development, and the presence of anomalies. Studies, including those by Gembicki et al. (2022), have shown that these methods tend to be more accurate at later gestational ages, presumably when the fetus is more developed and its physical parameters are more distinct and measurable. Moreover, fetal anomalies or abnormal growth patterns can significantly affect the accuracy of TC and TVol as predictors. In such cases, these methods may not yield accurate estimates of fetal birth weight, as the typical development trajectory is altered. Despite these challenges, TC and TVol are considered valuable in predicting fetal birth weight in low-risk pregnancies. It is crucial, however, to be aware of their limitations and to use them alongside other methods like fetal biometry for a more comprehensive assessment. Summary 74 This study aimed to further explore and validate the use of TC and TVol in a clinical setting, examining their accuracy in a diverse population and considering factors that might influence their efficacy. This cross-sectional study was conducted over a nine-month period in 2023 at Menoufia University Hospital and Shebeen El-Kom Teaching Hospital. The study’s cohort comprised 60 pregnant women attending routine obstetrics and gynecology clinics at these institutions. The study employed 2-D transabdominal ultrasound scans to measure fetal parameters. These scans, conducted between the 37th and 40th weeks of gestation, included measurements of biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL), and thigh circumference (TC). The data gathered from these measurements were then utilized to estimate fetal weight, applying three different formulas: Hadlock’s, Vintzileos’, and Lee 1’s. The study’s findings were multifaceted: The participants’ average weight was 66.02 kg, and their height was 1.59 m, resulting in a mean Body Mass Index (BMI) of 26.32 Kg/m². Ultrasound measurements revealed mean biparietal diameter (BPD) of 10.77 mm, head circumference of 33.03 mm, abdominal circumference (AC) of 34.10 mm, estimated thigh circumference of 16.17 mm, and femur length of 7.20 mm. The actual thigh circumference averaged at 16.27 mm. The actual mean birth weight was 3552.60 grams. Estimations by Hadlock‘s, Vintzileos‘, and Lee 1‘s formulas, along with a Lee 2 method, varied, with Lee 1‘s formula tending to overestimate and the others generally underestimating fetal weight. Summary 75 Statistically significant differences were found between actual birth weight and estimates from Hadlock‘s method (186.22 grams difference), Vintzileos‘ method (253 grams difference), Lee 1 formula (140.47 grams difference), and Lee 2 method (43.92 grams difference). A high correlation existed between actual birth weight and the estimated weights by the various methods, with particularly strong correlations for estimates from Hadlock‘s, Vintzileos‘, Lee 1‘s methods, and the Lee 2 method. Multiple regression analysis showed that the estimates from the Lee 2 method and the Lee 1 formula were significant predictors of actual birth weight. Receiver Operating characteristic (ROC) analysis was used to evaluate the diagnostic performance of these estimates. Thigh volume and estimates from the Lee 1 formula showed high specificity, while the sensitivity of estimates varied with the method used. The area under the curve (AUC) values indicated good to excellent predictive power of these methods. In conclusion, this study underscores the variability in the accuracy of fetal weight estimation methods. It highlights the Lee 2 method and Lee 1‘s formula as notable predictors of actual birth weight, demonstrating the potential for improved fetal weight estimation through the selection of appropriate models. |