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Published on: June 29, 2013
Evaluation of gestational age based on ultrasound fetal growth measurements
F Varol1, A Saltik, P B Kaplan
1Department of Obstetrics and Gynecology, Trakya University School of Medicine, Edirne, Turkey. feyzavarol99@usa.net
Insights
Accurate fetal growth prediction is vital for antenatal care. This study developed a new equation using fetal measurements (AC, BPD, FL) to estimate gestational age (GA), contributing to national fetal growth standards.
Area of Science:
- Obstetrics and Gynecology
- Fetal Medicine
- Medical Imaging
Background:
- Accurate prediction of gestational age (GA) and birth weight (BW) is crucial for effective antenatal care management.
- Evaluating existing fetal growth standards, like Hadlock's, is necessary to ensure their validity for diverse populations.
- Developing national fetal growth standards is essential for localized and accurate fetal assessments.
Purpose of the Study:
- To evaluate Hadlock's standard growth data and contribute to the development of national fetal growth standards.
- To mathematically model fetal growth using ultrasound measurements and assess their predictive capabilities for GA and BW.
- To derive a reliable regression equation for estimating gestational age based on fetal biometry.
Main Methods:
- Examined ultrasound measurements (AC, BPD, FL) from 1411 normally growing fetuses.
- Assessed gestational age (GA) using menstrual history confirmed by ultrasonography.
- Applied simple and multivariate regression analysis to model relationships between fetal biometry and GA/BW.
Main Results:
- Abdominal circumference (AC), biparietal diameter (BPD), and femur length (FL) were confirmed as strong predictors of GA.
- A multivariate regression model demonstrated high accuracy (adj. R2=0.937) for estimating GA: GA = 4.945 + 0.606*AC + 0.105*BPD + 0.286*FL.
- The study could not establish a reliable equation for predicting birth weight (BW) with the available data.
Conclusions:
- The developed regression equation provides a valuable tool for estimating gestational age, potentially serving as a contribution to national standards.
- While Hadlock's standards may accurately evaluate fetal development, the need for population-specific national standards is highlighted.
- Further research involving comprehensive cohort groups is recommended to refine fetal growth prediction models and establish robust national standards.
Abstract:
Monitoring fetal growth and assessing its predictors have important place in antenatal care management. Accurate prediction of gestational age (GA) and birth weight (BW) is clinically important. Standard growth curve chosen should be evaluated to see if it satisfies the criteria for a valid assesment. In this paper, for the purpose of contributing to develop national standards and to evaluate Hadlock's standard data pertaining to 1411 fetuses were examined. Of 1411 normally growing fetuses, one measurement for AC, BPD and FL was taken by ultrasound. GA was assessed via menstrual history which is also confirmed by ultrasonography. Several variables, AC, BPD, FL, FL/AC, BPD/FL and dependent variables (GA & BW) were modelled mathematically. Percentile values, correlation coefficients were calculated and well functioning regression equations were produced for the fetal growth evaluation. Simple correlation model re-confirmed that AC, BPD and FL were well predictors of GA. Via modelling by multivariate regression analysis (adj. R2=937), GA=4.945 (95% CI: 4.661- 5.654) + .606 AC + .105 BPD + .286 FL can be estimated. It couldn't be possible establishing an appropriate equation for prediction of BW with current data. Our study is intended to draw an attention on requirement of national standards although Hadlock's standard growth curve may evaluate fetal development accurately. Forming comprehensive cohort group is under our consideration. The equation we developed (shown in the results), might be a working contribution.
