Influence of body mass index on clinical estimation of fetal weight

Authors

  • Sabeena Parveen Department of Obstetrics and Gynaecology, Al-Ameen Medical College and Hospital, Vijapura, Karnataka, India
  • Balwani Manishaben Department of Obstetrics and Gynaecology, Al-Ameen Medical College and Hospital, Vijapura, Karnataka, India
  • Priya Ballal K. Department of Obstetrics and Gynaecology, Kasturba Medical College, Mangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20242690

Keywords:

Fetal weight estimation, Symphysiofundal height, Maternal body mass index, Clinical methods, Ultrasound, Prenatal care

Abstract

Background: Estimation of fetal weight is essential for prenatal care and delivery management. Clinical methods, such as symphysiofundal height (SFH) assessment, and ultrasound-based techniques are commonly used for this purpose. Maternal body mass index (BMI) can influence fetal weight estimation accuracy, particularly in obese patient. In periphery where ultrasound facilities are not available clinical estimation of fetal weight plays very important role in antenatal care. This study was aimed to examine the impact of maternal BMI on the accuracy of clinical fetal weight estimation.

Methods: This cross-sectional study included 800 pregnant women. Anthropometric measurements were collected, including weight, height, SFH, abdominal girth, and double abdominal fold thickness (DAFT). Fetal weight was estimated using clinical methods and compared with actual birth weight. Statistical analysis was performed using statistical package for the social sciences (SPSS) version 26.0.

Results: Participants had a mean weight of 46.4 kg, height of 154.5 cm, and body mass index of 19.4 kg/m2. SFH×AG method yielded a mean birth weight estimation of 3.0 kg with an absolute error of 136 grams, while Johnson's formula estimated 3.3 kg with an absolute error of 478 grams. double abdominal fold thickness measurements also showed variations in fetal weight estimation accuracy across different ranges. It was observed that as body mass index increased, the absolute error also increased. It was also noted that the SFH×AG formula was more accurate compared to Johnson's formula.

Conclusions: Relying solely on clinical estimation of fetal weight, especially in mothers with high body mass index, may be limited in accuracy. The SFH×AG method outperformed Johnson's formula, particularly in cases influenced by body mass index. Complementary methods, such as ultrasound-based techniques, are recommended to enhance accuracy, especially in obese pregnant women.

References

Ray EM, Alhusen JL. The suspected Macrosomic fetus at term: a clinical Dilemma. J Midwifery Womens Health. 2018;61:263-9.

Frick AP, Syngelaki A, Zheng M, Poon LC, Nicolaides KH. Prediction of large for-gestational-age neonates: screening by maternal factors and biomarkers in the three trimesters of pregnancy. Ultrasound Obstet Gynecol. 2018;47:332-9.

Hadlock FP, Harrist RB, Sharman RS, Deter RL, Park SK. Estimation of fetal weight with the use of head, body, and femur measurements-a prospective study. Am J Obstet Gynecol. 1985;151:333-7.

Deter RL, Hadlock FP. Use of ultrasound in the detection of macrosomia: a review. J Clin Ultrasound. 1985;13:519-24.

Hammami A, Mazer Zumaeta A, Syngelaki A, Akolekar R, Nicolaides KH. Ultrasonographic estimation of fetal weight: development of new model and assessment of performance of previous models. Ultrasound Obstet Gynecol. 2018;52:35-43.

Yadav R, Sharma B, Deokota R, Rahman H. Assessment of clinical methods and ultrasound in predicting fetal birth weight in term pregnant women. Int J Reprod Contraception Obstet Gynecol. 2016;5(8):2775-9.

Chauhan KP, Patel UJ. Comparative study of various methods of fetal weight estimation at term pregnancy. J Integ Health Sci. 2013;1(1):3-6.

Lanowski JS, Lanowski G, Schippert C, Drinkut K, Hillemanns P, Staboulidou I. Ultrasound versus clinical examination to estimate fetal weight at term. Geburtshilfe Frauenheilkd. 2017;77:276-83.

Paganelli S, Soncini E, Comitini G, Palomba S, La Sala GB. Sonographic fetal weight estimation in normal and overweight/obese healthy term pregnant women by gestation-adjusted projection (GAP) method. Arch Gynecol Obstet. 2016;293:775-81.

Aksoy H, Aksoy Ü, Karadağ Öİ, Yücel B, Aydın T, Babayiğit MA. Influence of maternal body mass index on sonographic fetal weight estimation prior to scheduled delivery. J Obstet Gynaecol Res. 2015;41:1556-61.

Ojwang S, Ouko BC. Prediction of fetal weight in utero by fundal height/girth measurements. J Obstet Gynecol East Central Afr. 1984;3:111.

Shittu AS, Kuti O, Orji EO, Makinde NO, Ogunniy SO, Ayoola OO, et al. Clinical versus sonographic estimation of foetal weight in southwest Nigeria. J Health Popul Nutr. 2007;25(1):14-23.

Prechapanich J, Thitadilok W. Comparison of the accuracy of fetal weight estimation using clinical and sonographic methods. J Med Assoc Thai. 2004;87(3):S1-7.

Insler V, Bernstein D, Rikover M, Segal T. Estimation of fetal weight in utero by simple external palpation. Am J Obstet Gynecol. 1967;98(2):292-3.

Ong HC, Sen DK. Clinical estimation of fetal weight. Am J Obstet Gynecol. 1972;112(7):877-80.

Herrero RL, Fitzsimmons J. Estimated fetal weight. Maternal vs. physician estimate. J Reprod Med. 1999;44(8):674-8.

Dawn CS, Modale GC, Galosh A. A simple procedure for determination of antenatal fetal weight. J Obstet Gynecol. 1983;33:133-7.

Dahiya V, Rathees. Compositive evaluation of fetal weight estimation in utero by Dawns with Johnsons formulas. J Obstet Gynecol India. 1987;54-58.

Belete W, Gaym A. Clinical estimation of fetal weight in low resource settings: comparison of Johnson’s formula and the palpation method. Ethiop Med J. 2008;46(1):37-46.

Numprasert W. A Study in Johnson’s Formula: Fundal Height Measurement for Estimation of Birth Weight. AUJT. 2004;8(1):15-20.

Numprasert C. Lira study in Johnson’s formula: fundal height measurement for estimation of birth weight. AU JT. 2004;8(1):15-20.

Carranza Lira S, Haro González LM, Biruete Correa B. Comparison between clinical and ultrasonographic measurements to estimate fetal weight during labor: a new clinical calculation formula. Ginecol Obstet Mex. 2007;75(10):582-7.

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Published

2024-09-20

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Original Research Articles