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Analysis of the Performance of 11 Formulae for Fetal Weight Estimation in Preterm Fetuses with Abnormal Doppler

Alessandra Martins Heringer de Lima1, Paulo Roberto Nassar de Carvalho1,2, Saint Clair Gomes Junior2

  • 1Diagnostic Center, Clínica Perinatal Laranjeiras, Rio de Janeiro, RJ, Brazil.

Revista Brasileira De Ginecologia E Obstetricia : Revista Da Federacao Brasileira Das Sociedades De Ginecologia E Obstetricia
|September 21, 2018
PubMed

Insights

The Hadlock I and IV formulae accurately estimate fetal weight in premature infants with placental insufficiency. These formulas, using three or four biometric parameters, showed the lowest error in this specific patient group.

Area of Science:

  • Perinatology
  • Fetal Medicine
  • Medical Imaging

Background:

  • Early-onset placental insufficiency can lead to abnormal fetal growth and Doppler velocimetry.
  • Accurate fetal weight estimation is crucial for managing high-risk pregnancies, particularly those with suspected placental insufficiency.

Purpose of the Study:

  • To evaluate the performance of 11 common fetal weight estimation formulas.
  • To identify the most accurate formulas for preterm fetuses with abnormal Doppler findings due to placental insufficiency.

Main Methods:

  • A retrospective analysis of 194 preterm fetuses with abnormal Doppler velocimetry.
  • Inclusion of fetuses from three Brazilian hospitals between 2002 and 2013.
  • Evaluation of Campbell, Hadlock (I-V), Shepard, Warsof, Weiner (I-II), and Woo III formulas.

Main Results:

  • Hadlock formulas utilizing three or four biometric parameters demonstrated the lowest absolute percentage error in estimated fetal weight.
  • Abnormal Doppler findings, including absent/reversed diastolic flow in umbilical arteries and abnormal ductus venosus flow, were prevalent.
  • The accuracy of the best-performing Hadlock formulas was not significantly affected by common clinical or ultrasound parameters associated with placental insufficiency.

Conclusions:

  • Hadlock I (four parameters) and Hadlock IV (three parameters) formulas are recommended for fetal weight estimation in preterm fetuses with abnormal Doppler studies.
  • These formulas provide reliable estimates despite the challenges posed by early-onset placental insufficiency.
Abstract

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