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Predicting periviable birthweight and survival: bedside ultrasound versus anatomy scan gestational adjusted age
Nathan A Keller1, Craig M Zelig2
1a Department of Obstetrics and Gynecology , Albany Medical Center , Albany, NY, USA.
Objective:
Two methods of birthweight (BW) prediction in the periviable period: bedside ultrasound proximate to delivery versus gestation-adjusted-projection (GAP) method was compared.
Methods:
Periviable births were identified over a 6-year period. The GAP method was applied to the estimated fetal weight (EFW) from anatomy scans and the gestational age at delivery to predict BW, designated EFWGAP. EFW from the bedside ultrasound (EFWUS), and the EFWGAP were compared to actual BW to calculate absolute values of error in BW estimates. Neonatal survival estimates were made utilizing a National Institute of Child Health and Human Development calculator.
Results:
EFWUS was more accurate than EFWGAP in predicting BW as the mean absolute value of error with bedside ultrasound ǀEFWUS-BWǀ was significantly lower than mean absolute value of error with GAP method ǀEFWGAP-BWǀ, 75.32 ± 74.64 g versus 125.68 ± 130.62 g, p = 0.01. Predicted neonatal survival based on EBWUS was closer to reference than predicted survival based on EBWGAP 9.66% ± 9.43% versus 7.76% ± 7.78% p = 0.26.
Conclusions:
EFWUS is more accurate than EFWGAP for predicting BW in this period. However, the GAP technique could have utility in survival predictions when timely performance of ultrasound is not feasible.
