Zahran Mehmet, Tohma Yusuf Aytaç, Erkaya Salim, Evliyaoğlu Özlem, Çolak Eser, Çoşkun Bora
Etlik Zübeyde Hanım Womens's Health Teaching and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey.
Başkent University Faculty of Medicine, Department of Obstetrics and Gynecology, Konya, Turkey.
Turk J Obstet Gynecol. 2015 Dec;12(4):220-225. doi: 10.4274/tjod.28044. Epub 2015 Dec 15.
To compare the accuracy of clinical and ultrasonographic (USG) estimation of fetal weight in non-complicated, term pregnancies.
Two hundred term pregnant women were included in the study. We used three formulae for the estimation of fetal weight at term; the Hadlock formula for the USG method, and two different formulas for clinical methods, maternal symphysis-fundal height and abdominal circumference at the level of umbilicus. Accuracy was determined by mean percentage error, mean absolute percentage error and proportion of estimates within 10% of actual birth weight (birth weight ±10%). Patients were divided into two groups according to actual birth weight, the normal birth weight group (2500-3999 g) and high birth weight group (≥4000 g).
All three methods statistically overestimated birth weight for the high and normal birth weight groups (p<0.001, p=1.000, p=0.233) (p=0.037, p<0.001, and p<0.001). For both groups, the mean absolute percentage errors of USG were smaller than for the other two clinical methods and the number of estimates were within 10% of actual birth weight for USG was greater than for the clinical methods; the differences were statistically significant (p<0.001). No statistically significant difference of accuracy was observed for all three methods for the high birth weight group (p=0.365, p=0.768, and p=0.540). However, USG systematically underestimated birth weight in this group.
For estimation of fetal birth weight in term pregnancies, ultrasonography is better than clinical methods. In the suspicion of macrosomia, it must be remembered that no method is better than any other. In addition, if ultrasonography is used, careful management is recommended because ultrasonography overestimates in this group.
比较临床和超声检查（USG）对非复杂足月妊娠胎儿体重估计的准确性。
本研究纳入了200名足月孕妇。我们使用了三种足月胎儿体重估计公式；超声检查法采用哈德洛克公式，临床方法采用两种不同公式，即孕妇耻骨联合上缘至宫底高度以及脐水平腹围。通过平均百分比误差、平均绝对百分比误差以及估计值在实际出生体重±10%范围内的比例来确定准确性。根据实际出生体重将患者分为两组，正常出生体重组（2500 - 3999克）和高出生体重组（≥4000克）。
对于高出生体重组和正常出生体重组，所有三种方法在统计学上均高估了出生体重（p<0.001，p = 1.000，p = 0.233）（p = 0.037，p<0.001，p<0.001）。对于两组，超声检查的平均绝对百分比误差均小于其他两种临床方法，且超声检查估计值在实际出生体重±10%范围内的数量多于临床方法；差异具有统计学意义（p<0.001）。对于高出生体重组，所有三种方法在准确性方面未观察到统计学显著差异（p = 0.365，p = 0.768，p = 0.540）。然而，超声检查在该组中系统性地低估了出生体重。
对于足月妊娠胎儿出生体重的估计，超声检查优于临床方法。在怀疑巨大儿的情况下，必须记住没有一种方法比其他方法更好。此外，如果使用超声检查，建议谨慎处理，因为超声检查在该组中存在高估情况。
