Bezmialem Vakif University, Department of Obstetric and Gynecology, Istanbul, Turkey.
Koc University School of Medicine, Department of Obstetric and Gynecology, Istanbul, Turkey.
J Obstet Gynaecol Res. 2021 May;47(5):1727-1734. doi: 10.1111/jog.14728. Epub 2021 Mar 1.
Birth weight (BW) estimation with ultrasound is of great importance in delivery decision and management of complications of delivery. The aim was to evaluate the effect of femur, humerus, and clavicular soft tissue thickness on BW and developed a formula for proper estimation of fetal weight.
This prospective cohort study, included 231singleton pregnancies, with 34 and 42 weeks of gestation, delivered within 48 h after ultrasound examination. In addition to four biometric ultrasound measures, shoulder soft tissue thickness, thigh and arm soft tissue thickness were measured from outer margin of skin to outer margin of bone shaft by same investigator. Spearman correlation test was used to assess correlations between soft tissue thickness measurements and BW. Linear regression model was used and R to test accuracy of the new formula.
The mean humerus soft tissue thickness (HSTT) was 12 ± 3.5 mm (6-23.9 mm), mean femur soft tissue thickness (FSTT) was 15.9 ± 3.8 mm (7.3-32 mm), mean clavicular soft tissue thickness (CSTT) was 12.9 ± 3.2 mm (7.3-24 mm). There was a low correlation between BW and FSTT (r = 0.21, p = 0.001) and CSTT (r = 0.18, p = 0.005). Best fit formula was Log (BW) = -5697 + 7.2 (HC) + 15.3 (AC) + 22.6 (FL) + 17 (CSTT), was significantly correlated with BW (R = 0.60).
BW increased as the ultrasound shoulder soft tissue thickness increased. Adding soft tissue thickness measurements to fetal biometry is similar in terms of estimating fetal weight from the existing estimated fetal weight formula.
超声测量胎儿体重对于分娩决策和处理分娩并发症具有重要意义。本研究旨在评估股骨、肱骨和锁骨软组织厚度对胎儿体重的影响，并建立一个合适的胎儿体重估计公式。
本前瞻性队列研究纳入了 231 例单胎妊娠，其中 34 周和 42 周的孕妇分别在超声检查后 48 小时内分娩。除了四项超声生物测量指标外，还由同一位研究者测量了肩周软组织厚度、大腿和手臂软组织厚度，从皮肤外缘到骨轴外缘进行测量。采用 Spearman 相关检验评估软组织厚度测量值与 BW 的相关性。采用线性回归模型，通过 R 检验新公式的准确性。
平均肱骨软组织厚度（HSTT）为 12±3.5mm（6-23.9mm），平均股骨软组织厚度（FSTT）为 15.9±3.8mm（7.3-32mm），平均锁骨软组织厚度（CSTT）为 12.9±3.2mm（7.3-24mm）。BW 与 FSTT（r=0.21，p=0.001）和 CSTT（r=0.18，p=0.005）呈低度相关。最佳拟合公式为 Log（BW）=-5697+7.2（HC）+15.3（AC）+22.6（FL）+17（CSTT），与 BW 显著相关（R=0.60）。
随着超声肩周软组织厚度的增加，BW 增加。与现有胎儿体重估计公式相比，将软组织厚度测量值添加到胎儿生物测量中，在估计胎儿体重方面具有相似的效果。
