Измерение массы плода с использованием автоматизированной трехмерной модели фракционного объема конечностей

Abstract

Objective. To investigate the efficacy of using an automated three-dimensional (3D) fractional limb volume model to calculate estimated fetal weight (EFW) and predict fetal macrosomia. Patients and methods. This prospective observational study included 66 pregnant women who reached 30+0 to 41+3 weeks’ gestation. All patients underwent ultrasonography with fractional thigh volume (TVol) and fractional arm volume (AVol) measurements using 5D Limb Vol software (Samsung Medison W10 ultrasound system). Mean percentage error (MPE) was determined to assess the accuracy of fetal weight estimation. Results. Fractional thigh and arm volumes had a strong correlation with fetal weight (0.834 and 0.617, respectively) and increased linearly with gestational age. When performing a ROC analysis, TVol was found to be a predictor of fetal macrosomia with a sensitivity of 82.35% and specificity of 84.21%, and an experimental model including fetometric parameters (head circumference, abdominal circumference, and femur length) and TVol explained 83% of the variance in birth weight (p = 0.001). In our study, the formulas that included TVol and AVol to calculate EFW were less accurate than the Hadlock formula, with MPE of -1.25 ± 5.75, whereas when using the 3D model with TVol and AVol, MPE was 9.65 ± 7.84 and -9.16 ± 7.63, respectively. However, the experimental model with TVol produced more accurate EFW values compared to the Hadlock formula: the proportion of measurements with an estimated error ≤5% was 94.4% and 100% with an estimated error ≤10% (p < 0.001). Conclusion. Fractional limb volume is an easily reproducible and promising parameter, and its use may be helpful to increase the accuracy of standard fetometry. Fractional thigh volume demonstrated high predictive ability for macrosomia, and its addition to standard fetometric parameters improved the model for fetal weight estimation. Key words: estimated fetal weight, fractional thigh and arm volumes, macrosomia, 5D Limb VolTM