Abstract
Objective:To compare the accuracy of clinical and ultrasonographic (USG) estimation of fetal weight in non-complicated, term pregnancies.Materials and Methods:Two hundred term pregnant women were included in the study. We used three formulae for the estimation of fetal weight at term; the Hadlock formula for the USG method, and two different formulas for clinical methods, maternal symphysis-fundal height and abdominal circumference at the level of umbilicus. Accuracy was determined by mean percentage error, mean absolute percentage error and proportion of estimates within 10% of actual birth weight (birth weight ±10%). Patients were divided into two groups according to actual birth weight, the normal birth weight group (2500-3999 g) and high birth weight group (≥4000 g).Results:All three methods statistically overestimated birth weight for the high and normal birth weight groups (p<0.001, p=1.000, p=0.233) (p=0.037, p<0.001, and p<0.001). For both groups, the mean absolute percentage errors of USG were smaller than for the other two clinical methods and the number of estimates were within 10% of actual birth weight for USG was greater than for the clinical methods; the differences were statistically significant (p<0.001). No statistically significant difference of accuracy was observed for all three methods for the high birth weight group (p=0.365, p=0.768, and p=0.540). However, USG systematically underestimated birth weight in this group.Conclusion:For estimation of fetal birth weight in term pregnancies, ultrasonography is better than clinical methods. In the suspicion of macrosomia, it must be remembered that no method is better than any other. In addition, if ultrasonography is used, careful management is recommended because ultrasonography overestimates in this group.
Highlights
Over the last two or three decades, fetal weight estimation has almost become a routine antepartum test in the management of high-risk pregnancies and birth
In the group where actual birth weight was less than 4000 g, and fetal weights were estimated with USG, formula 1 and formula 2 were statistically significantly higher (p=0.037, p
In studies of fetal weight estimation, generally two statistical parameters have been used in the evaluation of effectiveness; Mean absolute percentage error (MAPE) and estimation rates were within ±5-10% of actual birth weight
Summary
Over the last two or three decades, fetal weight estimation has almost become a routine antepartum test in the management of high-risk pregnancies and birth. Studies have shown that 80-85% of clinical estimations were between ±500 grams of the actual birth weight (ABW) and 69% were between ±10%(1,2). Studies in the literature that compared the two methods found different results[9,10,11] These studies often involved estimations through evaluation of uterus size externally with use of a physician’s hands. This method is the oldest and most popular method and there have been doubts about its use because it is not objective. The purpose of this study was to compare the accuracy of clinical and USG estimation of fetal weight in non-complicated term pregnancies
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