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[Assessment of fetal growth using the humerus and femur in ultrasound fetometry]
1Klinik und Poliklinik für Gynäkologie und Geburtshilfe, Martin-Luther-Universität Halle-Wittenberg.
Insights
This study precisely stages fetal development using humerus and femur measurements from ultrasound scans. This method improves accuracy in identifying conditions like intrauterine growth restriction and macrosomia.
Area of Science:
- Obstetrics and Gynecology
- Fetal Medicine
- Medical Imaging
Context:
- Accurate fetal growth assessment is crucial for optimal pregnancy outcomes.
- Traditional fetal biometry may have limitations in specific growth disorders.
- Prospective studies are essential for validating new diagnostic parameters.
Purpose:
- To evaluate the precision of fetal humerus and femur measurements in staging fetal development.
- To compare the diagnostic accuracy of humerus and femur measurements against established fetal growth parameters.
- To develop and validate a standardized sonographic approach for assessing fetal growth trajectories.
Summary:
- A prospective study involving 1618 patients utilized serial ultrasound measurements of fetal humerus and femur length.
- Prenatal ultrasound data were categorized into seven groups and compared with postnatal newborn values.
- The study demonstrated typical curve patterns for various fetal growth scenarios, including intrauterine growth restriction (IUGR) and macrosomia, achieving high staging accuracy (78%).
- Humerus and femur measurements were found to be below normal ranges in IUGR and above normal ranges in severe macrosomia, outperforming previous methods in detection rates.
Impact:
- The proposed sonographic scheme incorporating humerus and femur measurements enhances the precision of fetal development assessment.
- Improved accuracy in diagnosing fetal growth abnormalities can lead to timely interventions and better neonatal outcomes.
- This method offers a valuable tool for obstetricians and sonographers in managing high-risk pregnancies.
Abstract:
In a prospective study process curves of fetal development were done for 1618 patients using humerus and femur with at least 5 ultrasound investigations per patient. These prenatal ultrasound values were divided in 7 groups and compared with the postnatal values of newborns to get a reliable statement. Typical curve processes have been demonstrated for low-profile development, mild and severe intrauterine growth-retardation, a macrosomy, and for a diabetic fetopathy. The following results have been gained from ultrasound values of prospective staging of fetal development. From 1618 cases 1263 cases (78.0%) have been staged exactly. 333 cases (20.6%) were not total exact. 22 cases (1.4%) have been evaluated wrong. From 121 cases of IUGR 95 cases (78.5%) have been staged correctly. Humerus and femur values are below the normal range in for IUGR group. 77 cases (62.1%) from the 124 macrosomal newborns have been detected right. Only 2 cases (4.9%) from the 41 cases of diabetic fetopathy have been evaluated lower. Humerus and femur values in severe macrosomia were over the normal range in contrast to the diabetic fetopathy. Our scheme for control of fetal development which use humerus and femur as additional parameters shows higher precision.