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Ultraschall Med 2023; 44(02): 179-187
DOI: 10.1055/a-1968-0018
Original Article

Normal Fetal Growth Profile at 10–41 Weeks of Gestation – An Update Based on 10225 Normal Singleton Pregnancies and Measurement of the Fetal Parameters Using 3D Ultrasound

Das normale fetale Wachstumsprofil zwischen 11 und 41 Schwangerschaftswochen – ein Update anhand von 10225 normalen Einzelschwangerschaften und Messung der fetalen Parameter mittels 3D-Ultraschall
Eberhard Merz
1   Obstetrics & Gynecology, Centre for Ultrasound and Prenatal Medicine, Frankfurt/Main, Germany
,
Sonila Pashaj
1   Obstetrics & Gynecology, Centre for Ultrasound and Prenatal Medicine, Frankfurt/Main, Germany
,
Stefan Wellek
2   Department of Medical Biostatistics, Epidemiology & Informatics, University Medical Center, University of Mainz, D-55101 Mainz, Germany
3   Department of Biostatistics, CIMH Mannheim, Mannheim Medical School of the University of Heidelberg, D-68159 Mannheim, J5, Germany
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Abstract

Objective To construct new growth charts and tables for the following fetal growth parameters: biparietal diameter (BPD), occipitofrontal diameter (OFD), head circumference (HC), abdominal transverse diameter (ATD), abdominal sagittal diameter (ASD), abdominal circumference (AC), femur length (Fe), tibia length (Ti), fibula length (Fi), humerus length (Hu), radius length (Ra), and ulna length (Ul).

Patients and Methods This prospective study was conducted at a level III ultrasound center as a population-based cross-sectional study on 10 225 normal singleton pregnancies with a gestational age between 10 and 41 completed weeks. Gestational age was confirmed in all cases by an ultrasound examination with crown-rump measurement before 10 weeks of gestation. All examinations were performed with 3 D probes. BPD, OFD, ATD, and ASD were measured as outer-to-outer measurements (skin-to-skin) after identifying the exact biometric planes by 3 D multiplanar display. HC was computed using the formula . For AC the approximate elliptical formula AC = (ATD+ASD)/2 × 3.142 was used. Measurements of the limb bones included the entire ossified shaft.

Results Based on a nonlinear regression model for the age-specific mean values, distribution-free reference ranges were calculated for the parameters BPD, OFD, HC, ATD, ASD, AC, Fe, Ti, Fi, Hu, Ra and Ul. The new reference ranges were compared with our reference ranges published in 1996 as well as with different reference charts published by other authors.

Conclusion 3 D ultrasound allows a controlled demonstration of all fetal planes required for exact biometric measurements. The fetal growth profile including the 12 biometric parameters gives a precise overview of normal or abnormal fetal growth.

Zusammenfassung

Ziel Konstruktion neuer Wachstumskurven und -tabellen für die fetalen Wachstumsparameter biparietaler Kopfdurchmesser (BPD), frontookzipitaler Kopfdurchmesser (FOD), Kopfumfang (KU), abdominaler Transversaldurchmesser (ATD), abdominaler Sagittaldurchmesser (ASD), Abdomenumfang (AU), Femurlänge (Fe), Tibialänge (Ti), Fibulalänge (Fi), Humeruslänge (Hu), Radiuslänge (Ra) und Ulnalänge (Ul).

Patienten und Methoden Diese prospektive Studie wurde in einem Level-III-Zentrum als populationsbasierte Querschnittsstudie an 10 225 normalen Einlingsschwangerschaften mit einem Schwangerschaftsalter zwischen 10 und 41 kompletten Schwangerschaftswochen (SSW) durchgeführt. Bei allen Schwangeren war das Gestationsalter mittels sonografischer Messung der Scheitel-Steiß-Länge vor 10 SSW gesichert worden. Alle Untersuchungen erfolgten mit 3D-Ultraschallsonden. BPD, FOD, ATD und ASD wurden in Form einer Außen-Außen-Messung (von Haut zu Haut) erfasst, nachdem die Biometrieebenen im 3D-Multiplanarmodus exakt identifiziert waren. Der KU wurde mit Hilfe der Formel , der Abdomenumfang mittels der adaptierten Ellipsenformel AU = (ATD+ASD)/2 × 3,142 berechnet. Bei den Extremitätenknochen wurde der gesamte ossifizierte Knochenschaft gemessen.

Ergebnisse Basierend auf einem nicht linearen Regressionsmodell für die gestationsbezogenen Mittelwerte wurden verteilungsfreie Referenzbänder für die Parameter BPD, FOD, KU, ATD, ASD, AU, Fe, Ti, Fi, Hu, Ra und Ul berechnet. Die neuen Normkurven wurden mit den Normkurven, die wir 1996 publiziert hatten, wie auch mit verschiedenen in der Literatur publizierten Normkurven anderer Autoren verglichen.

Zusammenfassung 3D-Ultraschall gestattet eine kontrollierte Darstellung aller fetalen Ebenen, die für exakte biometrische Messungen erforderlich sind. Das fetale Wachstumsprofil, bestehend aus den 12 Biometrieparametern, gibt einen präzisen Überblick über ein normales oder abnormales fetales Wachstum.

Key words

fetus - 3 D ultrasound - biometry

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Publication History

Received: 11 February 2022

Accepted: 19 October 2022

Article published online:
01 January 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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