EJMS

Abstract

Background: Lean mass of the fetus is one of the parameters that should be included in the EFW as it is more accurate to diagnose abnormal fetal growth. Estimated fetal weight is important to be identified to avoid the morbidity and mortality. One of the most important benefits of the ultrasound is to obtain the estimated fetal weight especially during labor. Methods: The study was conducted from November 2013 to November 2014 in department of obstetrics and gynecology Kasr Al Ainy Hospital including 352 pregnant women where 47 patients dropped out due to missing data. Patients included in this study were pregnant at term pregnancy (≥ 37 wks of gestation confirmed by 1st day of LMP and documented by early pregnancy US to determine the CRL) candidate for delivery within 48hrs. singletone, cephalic and adequate liquor. exclusion criteria includes patients unsure of dates, rupture of membrane, breech presentation and medical disorders that may affect the intrauterine fetal weight as hypertension or diabetes mellitus. Patients recruited from the emergency department or inpatient departments where candidate for elective CS or induction of labor or active stage of labor. Results: The mean FL 72.7±3.3, the mean mid thigh STT 13.16±2.34. the mean EFW using Hadlock et al 3288gm ranged between 2.432 to 4212 gm. The mean EFW using novel formula 3254 gm ranged from 2381 to 3959gm while the mean Actual birth weight 3373gm ranged from 2350 to 4123 gm. There were significant linear relationship between FL and mid thigh STT. Also between the mid thigh STT and actual birth weight. There were significant linear relationship between the Estimated Fetal Weight using novel formula and Actual birth weight. The novel formula and Hadlock can be considered satisfactory in ability to estimate fetal weight with absolute mean error <15% in >95% of cases. Also there is significant correlation between the Estimated Fetal weight using novel formula and actual birth weight with significant P value using pearson's correlation (r=0.8541, r²= 0.7295, p=0.001). significant correlation between the Estimated Fetal weight using novel formula and EFW using Hadlock formula using pearson's correlation (r=0.9807, r²=0.9618, p=0.001) Conclusion:FL and mid thigh STT novel formula is a good and accurate predictor of EFW during labor, more easy , more rapid and applicable. Abbreviations: EFW: Estimated fetal weight, FL: Femur Length, STT: Soft Tissue Thickness, IUGR: Intrauterine growth retardation, BPD: Biparital Diameter, HC: Head Circumference, AC: Abdominal Circumference, ROM: Rupture of Membrane