Mlodawski Jakub, Wolder Daniel, Niziurski Piotr, Adamczyk-Gruszka Olga, Głuszek Stanisław, Rokita Wojciech
Collegium Medicum, Jan Kochanowski University, Kielce, Poland.
Department of Obstetrics and Gynecology, Provincial Combined Hospital, Kielce, Poland.
Arch Med Sci. 2020 Jan 31;18(1):79-83. doi: 10.5114/aoms.2020.92711. eCollection 2022.
Ultrasonographic estimation of fetal weight (EFW) is a standard obstetrical procedure in daily clinical practice. Formulas for calculating EFW most commonly are a combination of two-dimensional measurements. A relatively new approach is the use of three-dimensional measurements such as fractional thigh volume (TVol) incorporated into specific regression equations. The objective of this study was to compare the Lee formula based on three-dimensional ultrasonographic TVol in the estimation of fetal weight before delivery in term pregnancies to the Hadlock I formula.
2D/3D abdominal ultrasonography was performed in 104 women, 37-41 gestational weeks, and measurements of biparietal diameter, head circumference, abdomen circumference, and femur length, TVol were taken. Using these measurements, we compared the Lee to the Hadlock formulas in EFW. The timing of procedures was measured in 20 randomly chosen patients by an independent observer.
Mean percentage errors of formulas, Lee vs. Hadlock, were 2.13 ±9.31% vs. -2.02 ±8.79%, ( = 0.001). There was no statistically significant difference in median absolute percentage errors between the two formulas (6.09% vs. 6.10%, = 0.56). The proportion of newborns with estimated birth weights (BW) within ±10% of actual BW was not significantly different between the two formulas (73% vs. 71%, = 0.11). There was a significant difference in the proportion of the newborns with estimated BW within ±5% (33% vs. 42%, = 0.000006). Statistical measurements for test performance in detecting fetuses with BW ≥ 4000 g were sensitivity 85% vs. 60%, specificity 88% vs. 96%, and accuracy 88% vs. 89%. There was no significant difference in the time to perform the measurements (69 s for Lee formula vs. 58 s for Hadlock formula, = 0.16).
Thigh volume measurement incorporated into the Lee single parameter formula is comparable to the Hadlock I formula in terms of accuracy in predicting fetal weight before delivery. There was no significant difference in the time needed for taking necessary measurements between the two groups.
超声估计胎儿体重（EFW）是日常临床实践中的一项标准产科操作。计算EFW的公式最常见的是二维测量的组合。一种相对较新的方法是使用三维测量，如将大腿体积分数（TVol）纳入特定回归方程。本研究的目的是将基于三维超声TVol的Lee公式与Hadlock I公式在足月妊娠分娩前估计胎儿体重方面进行比较。
对104名孕周为37 - 41周的女性进行二维/三维腹部超声检查，测量双顶径、头围、腹围、股骨长度及TVol。利用这些测量值，我们在EFW方面将Lee公式与Hadlock公式进行比较。由一名独立观察者对20名随机选择的患者进行操作时间测量。
公式的平均百分比误差，Lee公式与Hadlock公式分别为2.13±9.31%与 - 2.02±8.79%，（P = 0.001）。两种公式的中位数绝对百分比误差无统计学显著差异（6.09%对6.10%，P = 0.56）。估计出生体重（BW）在实际BW±10%范围内的新生儿比例在两种公式之间无显著差异（73%对71%，P = 0.11）。估计BW在±5%范围内的新生儿比例存在显著差异（33%对42%，P = 0.000006）。检测BW≥4000g胎儿的测试性能统计测量结果为，敏感性85%对60%，特异性88%对96%，准确性88%对89%。测量所需时间无显著差异（Lee公式69秒对Hadlock公式58秒，P = 0.16）。
纳入Lee单参数公式的大腿体积测量在预测分娩前胎儿体重的准确性方面与Hadlock I公式相当。两组进行必要测量所需时间无显著差异。
