Saini Rashi, Bachani Sumitra, Suri Jyotsna, Gupta Monika, Gupta Aprajita, Sharma Poornima, Debata Pradeep
Department of Obstetrics and Gynecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND.
Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND.
Cureus. 2025 Mar 28;17(3):e81333. doi: 10.7759/cureus.81333. eCollection 2025 Mar.
Introduction Early identification of growth abnormalities is crucial in preventing fetal death and ensuring optimal care for fetuses requiring close monitoring and timely delivery. Sonographic estimation of fetal weight must be quantified in centiles according to gestational age reference charts to assess fetal growth velocity and size. These measurements can categorize the fetus as small, appropriate, or large for gestational age. Recent discussions have highlighted the increasing need for evidence-based guidelines for selecting the most suitable growth charts. Objectives The objective of this study is to compare the diagnostic accuracy of Hadlock versus INTERGROWTH 21st (IG 21) growth charts for estimating fetal weight. Methods This is a prospective cohort study conducted on 277 pregnant women with singleton fetuses at 32-34 weeks of gestation in the Department of Obstetrics and Gynecology at a tertiary care referral center in North India. The participants underwent two ultrasound scans, first at the 32- to 34-week period of gestation (POG) and then a second ultrasound scan at the 38- to 40-week POG or one week before delivery. Labor and delivery outcomes were noted, and neonatal weight was recorded. The mother and neonate were observed for any perinatal complications till discharge from the hospital. Results The mean POG at the first scan was 33.00 weeks. At the first scan, the mean of estimated fetal weight (EFW) by Hadlock was 1966.96 g. The mean of EFW by IG 21 was 1861.50 g. There was a strong positive correlation between EFW by IG 21 and EFW by Hadlock in the first scan, and this correlation was statistically significant (r = 0.78, p ≤ 0.001). The mean POG at the second scan was 38.63 weeks. The mean of EFW in the second scan by Hadlock was 2905.24 g. The mean of EFW in the second scan by IG 21 was 2829.32 g. There was a strong positive correlation between EFW by IG 21 and EFW by Hadlock in the second scan, and it was statistically significant (r = 0.71, p ≤ 0.001). For every 1 g increment in EFW on the second scan by Hadlock, the birth weight (g) increases by 0.86 g. For every 1 g increment in EFW on the second scan by IG 21, the birth weight increases by 0.82 g. Conclusion Both Hadlock and IG 21 charts have a fair agreement with EFW in early and late trimester scans. Hence, either one of the two can be used for fetal biometry.
引言
早期识别生长异常对于预防胎儿死亡以及确保对需要密切监测和及时分娩的胎儿提供最佳护理至关重要。必须根据孕周参考图表将超声估计的胎儿体重以百分位数进行量化，以评估胎儿的生长速度和大小。这些测量结果可将胎儿分类为小于孕周、适于孕周或大于孕周。最近的讨论强调了越来越需要基于证据的指南来选择最合适的生长图表。
目的
本研究的目的是比较哈德洛克（Hadlock）生长图表与INTERGROWTH 21st（IG 21）生长图表在估计胎儿体重方面的诊断准确性。
方法
这是一项前瞻性队列研究，在印度北部一家三级医疗转诊中心的妇产科对277名单胎妊娠孕妇进行，妊娠周数为32 - 34周。参与者接受了两次超声扫描，第一次在妊娠32至34周期间（POG），然后在妊娠38至40周POG或分娩前一周进行第二次超声扫描。记录分娩结局和新生儿体重。观察母亲和新生儿直至出院的任何围产期并发症。
结果
第一次扫描时的平均POG为33.00周。在第一次扫描时，哈德洛克法估计的胎儿体重（EFW）平均值为1966.96克。IG 21法估计的EFW平均值为1861.50克。第一次扫描时IG 21法的EFW与哈德洛克法的EFW之间存在强正相关，且这种相关性具有统计学意义（r = 0.78，p≤0.001）。第二次扫描时的平均POG为38.63周。第二次扫描时哈德洛克法的EFW平均值为2905.24克。第二次扫描时IG 21法的EFW平均值为2829.32克。第二次扫描时IG 21法的EFW与哈德洛克法的EFW之间存在强正相关，且具有统计学意义（r = 0.71，p≤0.001）。在第二次扫描中，哈德洛克法的EFW每增加1克，出生体重（克）增加0.86克。在第二次扫描中，IG 21法的EFW每增加1克，出生体重增加0.82克。
结论
哈德洛克和IG 21图表在孕早期和孕晚期扫描中与EFW均有较好的一致性。因此，两者中的任何一个都可用于胎儿生物测量。
