Analysis of the Performance of 11 Formulae for Fetal Weight Estimation in Preterm Fetuses with Abnormal Doppler Velocimetry – A Retrospective Multicenter Study

Alessandra Martins Heringer de Lima; Paulo Roberto Nassar de Carvalho; Saint Clair Gomes Junior; Ana Carolina Costa Carioca; José Maria de Andrade Lopes

doi:10.1055/s-0038-1670643

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics, Table of Contents

CC BY 4.0 · Rev Bras Ginecol Obstet 2018; 40(10): 580-586
DOI: 10.1055/s-0038-1670643

Original Article

Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Analysis of the Performance of 11 Formulae for Fetal Weight Estimation in Preterm Fetuses with Abnormal Doppler Velocimetry – A Retrospective Multicenter Study

Análise do desempenho de 11 fórmulas de estimativa de peso fetal em conceptos prematuros com Dopplervelocimetria alterada – um estudo retrospectivo multicêntrico

Alessandra Martins Heringer de Lima

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

,

Paulo Roberto Nassar de Carvalho

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

²Fetal Medicine Center, Instituto Nacional Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil

,

Saint Clair Gomes Junior

²Fetal Medicine Center, Instituto Nacional Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil

,

Ana Carolina Costa Carioca

²Fetal Medicine Center, Instituto Nacional Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil

,

José Maria de Andrade Lopes

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

²Fetal Medicine Center, Instituto Nacional Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil

› Author Affiliations

Abstract

Objective To assess 11 formulae commonly used to estimate fetal weight in a population of premature fetuses who had abnormal Doppler velocimetry due to early-onset placental insufficiency. The performance of each formula was evaluated in subgroups of fetuses with expected growth and intrauterine growth restriction.

Methods Data were collected from fetuses and mothers who delivered at three Brazilian hospitals between November 2002 and December 2013. We used the following formulae: Campbell; Hadlock I, II, III, IV and V; Shepard; Warsof; Weiner I and II; and Woo III.

Results We analyzed 194 fetuses. Of these, 116 (59.8%) were considered appropriate for gestational age (AGA), and 103 (53.1%) were male. The amniotic fluid volume was reduced in 87 (44.8%) fetuses, and the umbilical artery Doppler revealed absence or inversion of diastolic flow in 122 (62.9%) cases, and the analysis of the ductus venosus revealed abnormal flow in 60 (34.8%) fetuses. The Hadlock formulae using three or four fetal biometric parameters had low absolute percentage error in the estimated fetal weight among preterm fetuses with abnormal Doppler studies who were born within 5 days of the ultrasound evaluation. The results were not influenced by the clinical and ultrasound parameters often found in early-onset placental insufficiency.

Conclusion In this study, the formulae with the best performance for fetal weight estimation in the analyzed population were Hadlock I and IV, which use four and three fetal biometric parameters respectively to estimate the weight of preterm fetuses with abnormal Doppler studies.

Resumo

Objetivo Avaliar o desempenho de 11 fórmulas comumente utilizadas para estimativa de peso fetal em uma população de fetos prematuros com dopplervelocimetria alterada devido a insuficiência placentária de início precoce. O desempenho de cada fórmula foi avaliado em subgrupos de fetos com crescimento adequado e com crescimento intrauterino restrito.

Métodos Foram coletados os dados de mães e fetos cujos partos foram acompanhados em 3 instituições brasileiras entre novembro de 2002 e dezembro de 2013. As fórmulas selecionadas para análise foram: Campbell; Hadlock I, II, III, IV e V; Shepard; Warsof; Weiner I e II; e Woo III.

Resultados Foram analisados os pesos de 194 fetos, dos quais 116 (59,8%) foram considerados adequados para a idade gestacional, 103 (53,1%) eram do sexo masculino, em 87 (44,8%) havia redução do volume de líquido amniótico, em 122 (62,9%) o Doppler de artéria umbilical demonstrou ausência ou inversão do fluxo na diástole, e em 60 (34,8%) a análise do duto venoso indicou fluxo anormal. A média do erro percentual absoluto (EPA) demonstrou que as fórmulas de Hadlock que utilizam 3 ou 4 parâmetros biométricos fetais apresentaram o melhor desempenho. Os resultados obtidos para essas fórmulas não sofreram influência dos parâmetros clínicos e ultrassonográficos frequentemente encontrados na insuficiência placentária de início precoce.

Conclusão O presente estudo demonstrou o melhor desempenho das fórmulas de Hadlock que contêm 3 ou 4 parâmetros da biometria para estimativa de peso de fetos prematuros com anormalidades ao mapeamento Doppler.

Keywords

fetal weight - birth weight - premature birth - ultrasound - prenatal ultrasound - doppler ultrasound - fetal growth retardation - placental insufficiency

Palavras-chave

peso fetal - peso ao nascer - parto prematuro - ultrassonografia - ultrassonografia pré-natal - ultrassonografia doppler - retardo do crescimento fetal - insuficiência placentária

Full Text

References

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