Abstract
PurposeTo review our experience in ultrasound fetal weight estimation in our large population of triplet pregnancies.MethodsNinety-seven triplet pregnancies were retrospectively included between January 2003 and January 2017. Sonographic fetal weight estimation using Hadlock’s and Schild’s formulas was compared to actual birth weight in a tertiary-care center in Vienna, Austria. Statistical analyses were performed using a stepwise linear regression model and crosstabs.ResultsThe median discrepancy between the sonographically estimated fetal weight by Hadlock’s formula and the actual birth weight was 106 g (IQR 56–190). The percentage error and its standard deviation were − 2.5 ± 12.1%, and the median percentage error was − 3.6%. Concerning the use of Hadlock’s formula, estimated fetal weight was the most important factor predictive of actual birth weight with an estimate of 0.920 (p < 0.001). Female neonates had been overestimated by a mean of 50.473 g per fetus. The sonographic prediction of small-for-gestational-age neonates was significantly reliable (p < 0.001), with positive and negative predictive values ranging from 81.3 to 100.0%. Similar results were obtained for Schild’s formula.ConclusionEven if sonographically estimated fetal weight in triplet pregnancies has a high overall accuracy of fetal weight estimation, there are some limitations in prediction of intrauterine growth restrictions, especially in female fetuses.
Highlights
In times of increasing number of multiple pregnancies that include triplets [1], clinical knowledge of these issues needs to be expanded
Exact sonographic estimation of fetal weight before delivery is essential in these pregnancies for several reasons: triplet pregnancies are associated with high rates of preterm deliveries [2,3,4,5]; and the teams on the neonatal intensive care units need the information before
Birth-weight discordance is common among multiple pregnancies [6]
Summary
In times of increasing number of multiple pregnancies that include triplets [1], clinical knowledge of these issues needs to be expanded. Accuracy depends on clinical experience, surrounding factors including the time interval between weight estimation and delivery, and quality of the equipment [10]. Birth-weight discordance is common among multiple pregnancies [6]. The question arises whether ultrasound is a reliable method in triplet pregnancies. Evidence about the accuracy of sonographically estimated fetal weight in triplet pregnancies is scarce [8,9,10,11,12,13]. Good correlations between estimated fetal weight and actual birth weight have been
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