Simcox, LE;
Myers, JE;
Cole, TJ;
Johnstone, ED;
(2017)
Fractional Fetal Thigh Volume in the prediction of normal and abnormal fetal growth during the third trimester of pregnancy.
Am J Obstet Gynecol
10.1016/j.ajog.2017.06.018.
(In press).
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Abstract
BACKGROUND: Currently 2D ultrasound (US) estimation of fetal size rather than fetal growth is used to define fetal growth restriction (FGR), but single estimates in late pregnancy lack sensitivity and may identify small for gestational age rather than growth restriction. Single or longitudinal measures of 3D fractional thigh volume may address this problem. OBJECTIVES: To derive normal values for 3D fractional thigh volume (TVol) in the third trimester, determine if TVol is superior to 2D ultrasound biometry alone for detecting FGR and whether individualised growth assessment parameters have the potential to identify FGR remote from term delivery. STUDY DESIGN: This was a longitudinal prospective cohort study of 115 unselected pregnancies in a tertiary referral unit (St Mary's Hospital Manchester UK). Standard 2D US biometry measurements were obtained, along with fractional thigh volume (TVol) measurements (based on 50% of the femoral diaphysis length). Measurements were used to calculate estimated fetal weight (EFW; Hadlock). Individualised growth assessment parameters and percentage deviations in longitudinally measured biometrics were determined using iGAP (http://iGAP. RESEARCH: bcm.edu). Small for gestational age (SGA) was defined <10(th) and FGR <3(rd) customised birthweight centile. Logistic regression was used to compare EFW (Hadlock), EFW (BPD-AC-TVol), TVol and AC for the prediction of SGA or FGR at birth. Screening performance was assessed using the area under the ROC curve (AUC). RESULTS: There was a better correlation between TVol and EFW (BPD-AC-TVol) obtained at 34-36 weeks with birthweight than between 2D biometry measures such as AC and EFW Hadlock. There was also a modest improvement in the detection of both SGA and FGR using TVol derived measures compared to standard 2D measurements (AUC= 0.86 (95% CI 0.79-0.94,), and 0.92 (95% CI 0.85-0.99), respectively. CONCLUSION: TVol measurements offer some improvement over 2D biometry for the detection of late-onset FGR at 34-36 weeks.
| Type: | Article |
|---|---|
| Title: | Fractional Fetal Thigh Volume in the prediction of normal and abnormal fetal growth during the third trimester of pregnancy. |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.ajog.2017.06.018 |
| Publisher version: | https://doi.org/10.1016/j.ajog.2017.06.018 |
| Language: | English |
| Additional information: | © 2017 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/). http://dx.doi.org/10.1016/j.ajog.2017.06.018 |
| Keywords: | Three-dimensional ultrasound, estimated fetal weight, fetal growth restriction, fractional thigh volume, small for gestational age |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/1562257 |
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