COMPARISON OF THE ESTIMATED FETAL WEIGHT MEASUREMENTS IN 2 AND 3 DIMENSIONAL ULTRASOUND AT TERM PREGNANT WOMEN

Abstract

Aim: To analyze the 2-dimensional and 3-dimensional ultrasound estimation of fetal weight in terms of meas- urements and the accuracy of the formulas used in the comparison of these measurements Materials and Method: 165 pregnant women who were delivered at Zekai Tahir Burak Women's Health Education and Research Hospital Between 01.06.2011 and 0101.2012, were included in the study. Informed consent was obtained from participants and the study was approved by the Hospital Ethics Committee. Pregnant women who participated in the study were selected according to the following criteria: being at 37-42 weeks of gestation without any pregnancy complications and delivering within 48 hours after ultrasonographic evaluation and measurements. 2D and 3D ultrasound measurements were performed by the same physician. Estimated fetal weights EFW were calculated from registered biometric values of the 2D and 3D images of thigh processed EFW programme and Viewpoint PIA 's were calculated. The most widely used 2D measurements EFW Hadlock I BPD, AC, FL , Hadlock II BPD, HC, AC, FL , Shepard BPD, AC formulas were used to es- timate fetal weight. In terms of 3D measurements, EFW were calculated from the formulas of Lee I TVol , Lee II TVol, AC , Lee III TVol, AC, BPD . Statistical analysis of the study was carried out by SPSS 17 SPSS, Chicago, IL USA . The difference between the EFW from the dif- ferent formulas and the birthweight at delivery was obtained and analyzed by using paired sample t-test. Results: Estimated fetal weights for all formulas significantly correlated with birthweights. In comparison of the infant birth weights and estimated fetal weights for each formula no statistically significant difference was detected for Lee I, Hadlock II, Hadlock I; whereas there was significant difference for Lee II, Lee III, Shephard . P values of Lee I , Hadlock II and Hadlock I were 0667, 0.526, 0.016 respectively. Conclusion: Ultrasonographic obstetrician of fetal weight plays an important role in labor management. Clinical estimates of fetal weight in 3-D ultrasound including soft tissue volume seem to be helpful in Lee I formula than the other 2 and 3 D formulas.

Keywords

• Two dimensional ultrasound,tree dimensional ultrasound,fetal weight,term pregnancy

2 ve 3 BOYUTLU ULTRASOUNDDA KULLANILAN FARKLI TAHMiNi FETAL AGIRLIK FORMULLERiNiN TERM GEBELERDE KARŞILASTIRILMASI

Abstract

Arna~: 2 boyutlu ve 3 boyutlu ultrasound ol9iimleri ile bu ol9iimlerde kullamlan formiillerin tahmini fetal agirlık TFA tahmini ay1smdan dogruluklarının karşılaştırılmasi. Gereçler ve Yontem: 01-06-2011 ve 01-01-2012 tarihleri arasında Zekai Tahir Burak Kadm Sağlığı Egitim ve Araştlrma Hastanesi dogum salonunda dogum yapan 165 gebe çalışmaya dahil edildi. Katılımcılardan bilgiendirilmiş onam alındi. Hastane Etik kurulundan 9ah~­ ma ile ilgili olarak onay1 almdi. Çalışmaya katllacak gebelerin seçim kriterleri; Herhangi bir ek hastahgı olmaması, gebeligin 37- 42 haftalar arasmda olması, ultrasound oluşumundan en fazla 48 saat sonra dogurmalan idi. 2D ve 3D ultrasound oluşumları aynı hekim tarafmdan yapildi. Kayıt edilen 2D biometrik degerler ve 3D uyluk görüntüleri Viewpoint PIA programmda işlenerek TFA' Jar hesapland1. 2D ölçümlerle TFA degerlerini bulmak iyin en yaygm kullamlan Hadlock I BPD, AC, FL , Hadlock II BPD, HC, AC, FL , Shepard BPD, AC formüllerinden yararlanıldı. 3D ölçümlerle TFA degerlerini bulmak için Lee I TVol , Lee II TVol, AC , Lee III TVol, AC, BPD kullamldı. Çalışmanın istatiksel veri analizleri SPSS 17 SPSS, Chicago, IL USA kullamlarak yapıldi. Formüller ile hesaplanan TF A ile bebek gerçek dogum agirlığı arasmdaki farklılık paired sample T-Test kullamlarak hesapland1 ve p degerlerine gore s1ralama yapildi. Bulgular: Yapilan istatiksel degerlendirmeler sonrasında bebek dogum agirhklan ile tahmini fetal agirlıkları her formül için istatistiksel olarak korele saptanmıştır. Bebek dogum agirlıkları ile bu formüllerden elde edilen tahmini fetal agirhklar ayn ayn karşılaştıklarında Lee I, Hadlock II, Hadlock I ile bebek dogum agirhklan arasmda anlalı bir fark gorülmezken, Lee II, Lee III, Shephard ile bebek dogum agirhklan arasında istatistiksel olarak anlamh fark saptandı. P degerlerine ba- kild1gmda; bebek dogum agirhklan ile en az fark sirasıyla: Lee I, Hadlock II ve Hadlock I' de Lee 1 = 0.667, Hadlock2= 0.526, Hadlock I= 0,016 goriildii. Sonuç : Ultrasonografik tahmini fetal agirlık, obstetrisyenin dogum eylemi yonetiminde onemli bir yer tutmaktadır. Günümüzde artık daha sık kullanımda olan 3 boyutlu ultrasoundlarla yap1lan fetal agirhk tahminleri klinikte obstetrisyene yardımcı olabilir.

Keywords

• iki boyutlu ultrasound,üç boyutlu ultrasound,fetal ağırlık,term gebe

References

1. Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Kirmeyer S. Births: final data for 2004. Natl Vital Stat Rep. Sep 29 2006;55(1):1
2. Giampaolo Mandruzzato: Intrauterine growth restriction (IUGR): Gu- idelines for definition, recognition and management, ARCH Perinatal Med. 14(4), 7-8, 2008
3. Lee W, Deter RL, Ebersole JD, Huang R, Blanckaert K, Romero R: Birthweight prediction by three dimensional ultrasonography fractional limb volume. J Ultrasound Med 2001; 20: 1283, 92
4. Lee W, Balasubramaniam M, Deter RL, Yeo L, Hassan S, Gotsch F, Kusanovic P, Gonc LF, Alves , Romero R: New fetal weight estimati- on models using fractional limb volume. Ultrasound Obstet Gynecol , 34: 556-65
5. Althabe F, Belizan JF. Caesarean section: The paradox. The Lancet ;368:1472-3.
6. Gherman RB, Chauhan S, Ouzounian JG, et al. Shoulder dystocia: the unpreventable obstetric emergency with empiric management gui- deline. J Obstet Gynecol 2006;195:657-72.
7. Beall MH, Spong C, McKay J, et al. Objective definition of shoulder dystocia: a prospective evaluation. Am J Obstet Gynecol 1998;179:934-7.
8. Athukorala C, Middleton P, Crowther CA. Intrapartum interventi- ons for preventing shoulder dystocia (review). The Cochrane Collabo- ration. Issue 4, 2009.

9. Boyd ME, Usher RH, McLean FH. Fetal macrosomia: prediction, risks, proposed management. Obstet Gynecol. 1983 Jun;61(6):715-22.
10. L.G. Williams. American College of Obstetrics and Gynecology: Macrosomia In: Compendium of Selected Publications Volume II: Prac- tice Bulletins. ACOG, 2008;663-73.
11. Gabbe S.G, Niebyl J.R. Obstetrics normal and abnormal pregnanci- es. Book. Fifth edition. 2009;447-451.
12. Shamley, Kirk, Mark B. Accuracy and modifying Factors for ult- rasonographic determination of fetal weight at term. Obstet Gynecol ; 84,6 Kurmanavicius J, Burkhardt T, Wisser J and Huch R: Ultrasonog- raphic fetal weight estimation: accuracy of formulas and accuracy of examiners by birth weight from 500 to 5000 g. J Perinat Med 2004(32) –61
13. Yang F, Leung KY, Hou YW, Yuan Y, Tang MH: Birth-weight pre- diction using three-dimensional sonographic fractional thigh volu- me at term in a Chinese population. Ultrasound Obstet Gynecol 2011 Oct;38(4):425-33.