Estimation of fetal weight in pregnancies past term

Introduction: The aim of the study was to investigate the accuracy of estimating fetal weight with ultrasound in pregnancies past term, using the eSnurra algorithm. Material and methods: In all, 419 women with pregnancy length of 290 days, attending a specialist consultation at Stavanger University Hospital, Norway, were included in a prospective observational study. Fetal weight was estimated using biparietal diameter (BPD) and abdominal circumference (AC). The algorithm implemented in an electronic calculation (eSnurra) was used to compute estimated fetal weight (EFW). Results were compared with birthweight (BW). Results: The mean interval between the ultrasound examination and birth was 2 days (SD 1.4). The median difference between BW and EFW was −6 g (CI −40 to +25 g) and the median percentage error was –0.1% (95% CI −1.0 to 0.6%). The median absolute difference was 190 g (95% CI 170–207 g). The BW was within 10% of EFW in 83% (95% CI 79–87%) of cases and within 15% of EFW in 94% (95% CI 92–96%) of cases. Limits of agreement (95%) were from −553 g to +556 g. Using 5% false‐positive rates, the sensitivity in detecting macrosomic and small for gestational age fetuses was 54% (95% CI 35–72%) and 49% (95% CI 35–63%), respectively. Conclusion: The accuracy of fetal weight estimation was good. Clinicians should be aware of limitations related to prediction at the upper and lower end, and the importance of choosing appropriate cut‐off levels.publishedVersio

Correlation between prenatal ultrasound and postmortem findings in 1029 fetuses following termination of pregnancy

Objective: A prenatal ultrasound examination and a postmortem examination provide the basis for correct diagnosis in fetuses terminated due to congenital anomalies. The aim of this study was to correlate fetal anomalies detected by ultrasound examination with those identified at autopsy following termination of pregnancy (TOP) over a 30-year period, and to evaluate the correlation between findings at different gestational ages and assess these trends over time. Methods: The study group consisted of 1029 TOPs performed over a 30-year period, from 1985 to 2014. The gestational age ranged between 11 and 33 weeks. Prenatal ultrasound examinations were performed at the National Center for Fetal Medicine, St Olavs Hospital, Trondheim, Norway. Autopsies were performed at the Department of Pathology and Medical Genetics at the same hospital or a collaborating hospital. Results: There was full agreement between ultrasound and autopsy findings in 88.1% (907/1029) of TOPs, and the main diagnosis was correct in 97.9% (1007/1029). When comparing the 15-year period of 2000–2014 with that of 1985–1999, the difference in the rates of full agreement and agreement in the main diagnosis was statistically significant. In 1.3% (13/1029) of cases, ultrasound findings were not confirmed at autopsy. There were no false-positive diagnoses leading to TOP. Throughout the 30-year period, there was an increase in early TOPs, whereas late TOPs declined. Conclusions: Our study demonstrates that there is a clear correlation between ultrasound and autopsy findings, which is continuously improving. Despite this high correlation, there is reason to continue the practice of validation to ensure the safety of the diagnostic process leading to TOP. The trend towards an earlier termination emphasizes the necessity of such a practice

Severe intrauterine anemia: a new form of ɛγγδβ thalassemia presenting in utero in a Norwegian family

This report describes a type of ɛγγδβ-thalassemia due to a rare private deletion, detected early and successfully treated with intrauterine blood transfusions

Automatic Detection and Measurement of Fetal Biparietal Diameter and Femur Length — Feasibility on a Portable Ultrasound Device

An automatic method able to recognize a presented section through the biparietal plane of the fetal head and a section through the fetal femur in ultrasound images is developed. Once the correct anatomical section for measurement is identified by the machine, the placement of the measurement calipers is automatically determined by fitting an active contour model to the structure of interest. The fetal biparietal diameter (BPD) and femur length (FL) are then measured automatically. The validation data set contained 167 and 197 B-mode images for BPD and FL measurements, respectively. The images were acquired using 4 different ultrasound scanners, which resulted in varied image quality and gain settings. The mean gestational age (GA) of the fetuses was 19.4 weeks, range 16 to 41 weeks. A measurement success rate of 90% was achieved for both BPD and FL. The correlation coefficients between the manual and automatic measurements were 0.995 (BPD) and 0.967 (FL), mean errors were 0.5 mm (BPD) and -1.7 mm (FL) and error range with 95% confidence interval (CI) were ﹣3.8 - 4.8 mm (BPD) and ﹣11.4 - 8.1 mm (FL). The automatic measurement results were consistent in both high and low gain settings. The intraclass correlation coefficients between manual and automatic measurements were 0.995 (95% CI; 0.981 - 0.999) for BPD in high gain, 1.0 (95% CI; 0.998 - 1.0) for BPD in low gain, 0.998 (95% CI; 0.991 - 0.999) for FL in high gain and 0.999 (95% CI; 0.996 - 1.0) for FL in low gain settings. The method was implemented on a prototype, portable ultrasound machine designed to be used in low- and middle-income countries (LMIC). The overall performance of the method supports our hypothesis that automated methods can be used and are beneficial in a clinical setting

Estimation of fetal weight in pregnancies past term

Introduction: The aim of the study was to investigate the accuracy of estimating fetal weight with ultrasound in pregnancies past term, using the eSnurra algorithm. Material and methods: In all, 419 women with pregnancy length of 290 days, attending a specialist consultation at Stavanger University Hospital, Norway, were included in a prospective observational study. Fetal weight was estimated using biparietal diameter (BPD) and abdominal circumference (AC). The algorithm implemented in an electronic calculation (eSnurra) was used to compute estimated fetal weight (EFW). Results were compared with birthweight (BW). Results: The mean interval between the ultrasound examination and birth was 2 days (SD 1.4). The median difference between BW and EFW was −6 g (CI −40 to +25 g) and the median percentage error was –0.1% (95% CI −1.0 to 0.6%). The median absolute difference was 190 g (95% CI 170–207 g). The BW was within 10% of EFW in 83% (95% CI 79–87%) of cases and within 15% of EFW in 94% (95% CI 92–96%) of cases. Limits of agreement (95%) were from −553 g to +556 g. Using 5% false‐positive rates, the sensitivity in detecting macrosomic and small for gestational age fetuses was 54% (95% CI 35–72%) and 49% (95% CI 35–63%), respectively. Conclusion: The accuracy of fetal weight estimation was good. Clinicians should be aware of limitations related to prediction at the upper and lower end, and the importance of choosing appropriate cut‐off levels