COMPARATIVE STUDY FOR ESTIMATION OF FETAL WEIGHT BY CLINICAL & ULTRASONOGRAPHICAL METHODS IN TERM PATIENTS

Abstract

BACKGROUND: Accurate determination of fetal birth weight prior to delivery can have significant bearing on management decision in labor, thereby markedly improving perinatal outcome. OBJECTIVE: To assess fetal weight in term pregnancy by different clinical and ultrasonographical methods. MATERIALS AND METHODS: The study was conducted in Obstetrics and Gynecology department of Dr. D.Y. Patil Medical College, Pimpri, Pune. Two hundred (200) women were selected and studied for a period of one year based on convenience sampling from October 2011 to September 2013.The fetal weight was estimated a week prior to the delivery by both ultrasound and clinical examination. Various formulae's for estimation of fetal weight were applied based on Ultrasound and clinical parameters. All results arising from different formulas were studied and suitable statistics was applied and compared to have clear idea regarding results. RESULTS: All results arising from different formulas were studied by Descriptive statistics and compared with Actual weight at the time of delivery (gold standard). A box plot was used to differentiate various methods used for estimation of fetal weight, It shows that Johnson, Dawn formula and weight in gms (Dare's) formula corresponds with the base line indicating that they can predict birth weight correctly and among these Johnson showed promising results, whereas formulas like Campbell, Comb's, Hadlock and Warsof didn't predict birth weight as accurately as the three clinical methods used, thus in our study it can be seen that clinical methods are better predictors of birth weight than ultrasonographic methods. CONCLUSIONS: In our study it was observed that Clinical methods used for estimation of fetal birth weight was found to be by far simple and reliable methods in estimation of fetal birth weight than Ultrasonographic estimation methods and thus holds importance in day to day practice especially in countries like us where still a large group of population resides in rural areas. INTRODUCTION: Fetal weight, in conjunction with gestational age, is an important indicator of pregnancy outcome. 1 During the last decade, estimated fetal weight has been incorporated into the standard routine antepartum evaluation of high risk pregnancies and deliveries. For instance, management of diabetic pregnancy, vaginal birth after a previous caesarean section and intrapartum management of fetuses presenting by breech will be greatly influenced by estimated fetal weight. 2 It has become increasingly important especially for the prevention of prematurity, evaluation of pelvic disproportion before induction of labor and detection of intrauterine growth restriction. 3 Categorization of fetal weight into either small or large for gestational age may lead to timed obstetric interventions that collectively represent significant departure from routine antenatal care. 4, 5, 6 There are different algorithms based on combination of various ultrasound parameters like biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length