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Published on: June 29, 2013
Fetal upper arm volume in predicting intrauterine growth restriction: a three-dimensional ultrasound study
Chiung-Hsin Chang1, Chen-Hsiang Yu, Huei-Chen Ko
1Department of Obstetrics and Gynecology, National Cheng Kung University Medical College, Taiwan, Taiwan.
Insights
Fetal upper arm volume measured by 3D ultrasound effectively predicts intrauterine growth restriction (IUGR). This method offers high accuracy, aiding in prenatal diagnosis and management of IUGR cases.
Area of Science:
- Perinatology
- Fetal Medicine
- Medical Imaging
Background:
- Intrauterine growth restriction (IUGR) poses significant risks for perinatal morbidity and mortality.
- Accurate prenatal diagnosis of IUGR is crucial for timely intervention and improved outcomes.
Purpose of the Study:
- To evaluate the efficacy of fetal upper arm volume, assessed via quantitative 3D ultrasound, in predicting IUGR.
- To compare the predictive performance of upper arm volume against other common fetal biometric indices.
Main Methods:
- A prospective, cross-sectional study involving 40 fetuses with IUGR and 442 controls.
- Quantitative three-dimensional (3D) ultrasound was used to measure fetal upper arm volume in utero.
- Follow-up to delivery confirmed IUGR status for all participants.
Main Results:
- Fetal upper arm volume effectively differentiates fetuses with IUGR from those without.
- A cutoff at the 10th percentile for upper arm volume yielded high sensitivity (97.5%) and specificity (92.8%).
- Upper arm volume outperformed other biometric indices (BPD, OFD, HC, AC, FL, EFW) in detecting IUGR.
Conclusions:
- Quantitative 3D ultrasound assessment of fetal upper arm volume is a valuable tool for antenatal prediction of IUGR.
- This method demonstrates high accuracy and reliability, supporting its clinical utility in perinatology.
Abstract:
As fetuses with intrauterine growth restriction (IUGR) may have increased risks with perinatal morbidity and mortality, prenatal diagnosis of IUGR is a very important issue in perinatology. To assess the efficacy of fetal upper arm volume in predicting IUGR, we undertook a prospective, cross-sectional study using quantitative three-dimensional (3D) ultrasound (US). In total, 40 fetuses with IUGR and 442 fetuses without IUGR were included for the upper arm volume assessment in utero by 3D US. All the fetuses were singletons and were followed up to delivery to establish whether they were complicated with IUGR or not. Our results showed that fetal upper arm volume assessed by 3D US can differentiate fetuses with IUGR from fetuses without IUGR well. The best predicting threshold for IUGR is at the 10th percentile by upper arm volume. Using the 10th percentile as the cutoff, the sensitivity of fetal upper arm volume in predicting IUGR was 97.5%, with specificity 92.8%, predictive value of positive test 54.9%, predictive value of negative test 99.8% and accuracy 93.1%. Furthermore, upper arm volume is the best parameter for detecting IUGR among the common fetal biometric indices, such as biparietal diameter (BPD), occipitofrontal diameter (OFD), head circumference (HC), abdominal circumference (AC), femur length (FL) and estimated fetal weight (EFW). In conclusion, fetal upper arm volume assessed by quantitative 3D US can be used to predict fetuses with IUGR antenatally. We believe fetal upper arm volume assessment by 3D US would be a useful test in detecting fetuses with IUGR.
