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Fetal Abdominal Circumference

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181. Estimation of Fetal Weight (Diagnosis)

Herrero et al, 1999 9.5; 61 NA; NA 9.5; 62 Hendrix et al, 2000 10.6; 58 16.5; 32 NA; NA Dar et al, 2000 8.5; 61 5.9; 83 NA; NA Nahum et al, 2002 9.9; 51 8.3; 71 11.5; 55 Total 7.2-10.6; 51-73 5.9-16.5; 32-83 8.7-11.5; 55-70 * Sonographic prediction algorithms used to estimate fetal weight were those of Shepard, [ ] Hadlock, [ , ] Sabbagha, [ ] and Warsof, [ , ] in addition to the best of 8 algorithms based on various combinations of abdominal circumference (AC), femoral length (FL), biparietal (...) diameter (BPD), and head circumference (HC), both singly and in combination. Obstetric ultrasonography The most modern method for assessing fetal weight in utero involves the use of fetal measurements obtained during obstetrical ultrasonography. The advantage of this technique is that it relies on linear and/or planar measurements of in utero fetal dimensions that are objectively definable and generally reproducible. Findings from multiple studies have shown that ultrasonographic estimates of fetal

2014 eMedicine.com

182. Fetal Growth Restriction (Treatment)

measurements and individual parameters. Assessing individual values is important to identify a fetus that is growing asymmetrically. In the presence of normal head and femur measurements, abdominal circumference (AC) measurements of less than 2 standard deviations below the mean appear to be a reasonable cutoff to consider a fetus asymmetric. Baschat and Weiner showed that a low AC percentile had the highest sensitivity (98.1%) for diagnosing IUGR (birth weight < 10th percentile). The sensitivity of EFW (...) of these therapies was lacking. However, they did suggest that further trials of maternal hyperoxygenation seem warranted. Additional therapies that have been proposed and may warrant further study are maternal hemodilution and intermittent abdominal negative pressure. These are also poorly studied, carry potential maternal and fetal harm, and should be considered experimental. The only intervention that has been shown to decrease neonatal morbidity and mortality is the administration of steroids to premature

2014 eMedicine.com

183. Estimation of Fetal Weight (Treatment)

Herrero et al, 1999 9.5; 61 NA; NA 9.5; 62 Hendrix et al, 2000 10.6; 58 16.5; 32 NA; NA Dar et al, 2000 8.5; 61 5.9; 83 NA; NA Nahum et al, 2002 9.9; 51 8.3; 71 11.5; 55 Total 7.2-10.6; 51-73 5.9-16.5; 32-83 8.7-11.5; 55-70 * Sonographic prediction algorithms used to estimate fetal weight were those of Shepard, [ ] Hadlock, [ , ] Sabbagha, [ ] and Warsof, [ , ] in addition to the best of 8 algorithms based on various combinations of abdominal circumference (AC), femoral length (FL), biparietal (...) diameter (BPD), and head circumference (HC), both singly and in combination. Obstetric ultrasonography The most modern method for assessing fetal weight in utero involves the use of fetal measurements obtained during obstetrical ultrasonography. The advantage of this technique is that it relies on linear and/or planar measurements of in utero fetal dimensions that are objectively definable and generally reproducible. Findings from multiple studies have shown that ultrasonographic estimates of fetal

2014 eMedicine.com

184. Estimation of Fetal Weight (Follow-up)

Herrero et al, 1999 9.5; 61 NA; NA 9.5; 62 Hendrix et al, 2000 10.6; 58 16.5; 32 NA; NA Dar et al, 2000 8.5; 61 5.9; 83 NA; NA Nahum et al, 2002 9.9; 51 8.3; 71 11.5; 55 Total 7.2-10.6; 51-73 5.9-16.5; 32-83 8.7-11.5; 55-70 * Sonographic prediction algorithms used to estimate fetal weight were those of Shepard, [ ] Hadlock, [ , ] Sabbagha, [ ] and Warsof, [ , ] in addition to the best of 8 algorithms based on various combinations of abdominal circumference (AC), femoral length (FL), biparietal (...) diameter (BPD), and head circumference (HC), both singly and in combination. Obstetric ultrasonography The most modern method for assessing fetal weight in utero involves the use of fetal measurements obtained during obstetrical ultrasonography. The advantage of this technique is that it relies on linear and/or planar measurements of in utero fetal dimensions that are objectively definable and generally reproducible. Findings from multiple studies have shown that ultrasonographic estimates of fetal

2014 eMedicine.com

185. Fetal Growth Restriction (Follow-up)

measurements and individual parameters. Assessing individual values is important to identify a fetus that is growing asymmetrically. In the presence of normal head and femur measurements, abdominal circumference (AC) measurements of less than 2 standard deviations below the mean appear to be a reasonable cutoff to consider a fetus asymmetric. Baschat and Weiner showed that a low AC percentile had the highest sensitivity (98.1%) for diagnosing IUGR (birth weight < 10th percentile). The sensitivity of EFW (...) of these therapies was lacking. However, they did suggest that further trials of maternal hyperoxygenation seem warranted. Additional therapies that have been proposed and may warrant further study are maternal hemodilution and intermittent abdominal negative pressure. These are also poorly studied, carry potential maternal and fetal harm, and should be considered experimental. The only intervention that has been shown to decrease neonatal morbidity and mortality is the administration of steroids to premature

2014 eMedicine.com

186. The Fetus as a Patient: Prenatal Diagnosis and Fetal Therapy (Diagnosis)

at the level of the thalami, including the cavum septum pellucidum, should not be used in cases of hydrocephalus or abnormal head shape or late in the third trimester when the head may be engaged. Measures such as a corrected BPD have been devised to take into account differences in head shape. Abdominal circumference is the length of the outer perimeter of the fetal abdomen measured at the level of the stomach and intrahepatic umbilical vein on a transverse scan. This measure should not be used in cases (...) patterns Serial US can be used to monitor the rate of increase in fetal BPD, abdominal circumference, and femoral length, thereby helping to identify a growth-restricted fetus with intrauterine growth restriction (IUGR). In the third trimester, ratios of morphometric measures such as abdominal circumference and femoral length are used to diagnose IUGR. Oligohydramnios and a poor biophysical score support the diagnosis of growth restriction secondary to uteroplacental insufficiency. This is most

2014 eMedicine Pediatrics

187. The Fetus as a Patient: Prenatal Diagnosis and Fetal Therapy (Follow-up)

at the level of the thalami, including the cavum septum pellucidum, should not be used in cases of hydrocephalus or abnormal head shape or late in the third trimester when the head may be engaged. Measures such as a corrected BPD have been devised to take into account differences in head shape. Abdominal circumference is the length of the outer perimeter of the fetal abdomen measured at the level of the stomach and intrahepatic umbilical vein on a transverse scan. This measure should not be used in cases (...) patterns Serial US can be used to monitor the rate of increase in fetal BPD, abdominal circumference, and femoral length, thereby helping to identify a growth-restricted fetus with intrauterine growth restriction (IUGR). In the third trimester, ratios of morphometric measures such as abdominal circumference and femoral length are used to diagnose IUGR. Oligohydramnios and a poor biophysical score support the diagnosis of growth restriction secondary to uteroplacental insufficiency. This is most

2014 eMedicine Pediatrics

188. The Fetus as a Patient: Prenatal Diagnosis and Fetal Therapy (Treatment)

at the level of the thalami, including the cavum septum pellucidum, should not be used in cases of hydrocephalus or abnormal head shape or late in the third trimester when the head may be engaged. Measures such as a corrected BPD have been devised to take into account differences in head shape. Abdominal circumference is the length of the outer perimeter of the fetal abdomen measured at the level of the stomach and intrahepatic umbilical vein on a transverse scan. This measure should not be used in cases (...) patterns Serial US can be used to monitor the rate of increase in fetal BPD, abdominal circumference, and femoral length, thereby helping to identify a growth-restricted fetus with intrauterine growth restriction (IUGR). In the third trimester, ratios of morphometric measures such as abdominal circumference and femoral length are used to diagnose IUGR. Oligohydramnios and a poor biophysical score support the diagnosis of growth restriction secondary to uteroplacental insufficiency. This is most

2014 eMedicine Pediatrics

189. The Fetus as a Patient: Prenatal Diagnosis and Fetal Therapy (Overview)

at the level of the thalami, including the cavum septum pellucidum, should not be used in cases of hydrocephalus or abnormal head shape or late in the third trimester when the head may be engaged. Measures such as a corrected BPD have been devised to take into account differences in head shape. Abdominal circumference is the length of the outer perimeter of the fetal abdomen measured at the level of the stomach and intrahepatic umbilical vein on a transverse scan. This measure should not be used in cases (...) patterns Serial US can be used to monitor the rate of increase in fetal BPD, abdominal circumference, and femoral length, thereby helping to identify a growth-restricted fetus with intrauterine growth restriction (IUGR). In the third trimester, ratios of morphometric measures such as abdominal circumference and femoral length are used to diagnose IUGR. Oligohydramnios and a poor biophysical score support the diagnosis of growth restriction secondary to uteroplacental insufficiency. This is most

2014 eMedicine Pediatrics

190. Sonographic prediction of fetal macrosomia: the effect of sonographic fetal weight estimation model and threshold used. (PubMed)

Sonographic prediction of fetal macrosomia: the effect of sonographic fetal weight estimation model and threshold used. To compare the accuracy of 21 sonographic fetal weight-estimation models and abdominal circumference (AC) as a single measure for the prediction of fetal macrosomia (> 4000 g) using either fixed or optimal model-specific thresholds.A total of 4765 sonographic weight estimations performed within 3 days prior to delivery were analyzed. The predictive accuracy of 21 published (...) sonographic fetal weight-estimation models was calculated using three different thresholds: a fixed threshold of 4000 g; a model-specific threshold obtained from the inflexion point of the receiver-operating characteristics (ROC) curve; and a model-specific threshold associated with the highest overall accuracy. Cluster analysis was used to determine whether a certain combination of fetal biometric indices is associated with a higher predictive accuracy than others.For a fixed threshold of > 4000 g

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2011 Ultrasound in Obstetrics and Gynecology

191. Abdominal Hernias (Diagnosis)

by the rectus sheath. Proof that umbilical hernias persist from childhood to present in adulthood is only hinted at by an increased incidence among black Americans. Multiparity, increased abdominal pressure, and a single midline decussation are associated with umbilical hernias. Congenital hypothyroidism, fetal hydantoin syndrome, Freeman-Sheldon syndrome, Beckwith-Wiedemann syndrome, and disorders of collagen and polysaccharide metabolism (such as Hunter-Hurler syndrome, osteogenesis imperfecta, and Ehlers (...) -Danlos syndrome), should be considered as possibilities in children with large umbilical hernias. Richter hernia A Richter hernia occurs when only the antimesenteric border of the bowel herniates through the fascial defect. This hernia involves only a portion of the circumference of the bowel. Thus, the bowel may not be obstructed, even if the hernia is incarcerated or strangulated, and the patient may not present with vomiting. A Richter hernia can occur with any of the abdominal hernias

2014 eMedicine Surgery

192. Abdominal Hernias (Overview)

by the rectus sheath. Proof that umbilical hernias persist from childhood to present in adulthood is only hinted at by an increased incidence among black Americans. Multiparity, increased abdominal pressure, and a single midline decussation are associated with umbilical hernias. Congenital hypothyroidism, fetal hydantoin syndrome, Freeman-Sheldon syndrome, Beckwith-Wiedemann syndrome, and disorders of collagen and polysaccharide metabolism (such as Hunter-Hurler syndrome, osteogenesis imperfecta, and Ehlers (...) -Danlos syndrome), should be considered as possibilities in children with large umbilical hernias. Richter hernia A Richter hernia occurs when only the antimesenteric border of the bowel herniates through the fascial defect. This hernia involves only a portion of the circumference of the bowel. Thus, the bowel may not be obstructed, even if the hernia is incarcerated or strangulated, and the patient may not present with vomiting. A Richter hernia can occur with any of the abdominal hernias

2014 eMedicine Surgery

193. Does 17-α-hydroxyprogesterone caproate affect fetal biometry and birth weight in twin pregnancy? (PubMed)

been previously included in a randomized clinical trial comparing the effectiveness of 17-OHPC and placebo on neonatal outcomes and preterm birth rates in multiple pregnancy. In the present study, the individual growth patterns of femur length, head circumference and abdominal circumference were compared between fetuses of women who had been randomized to receive weekly injections of either 17-OHPC (n = 52) or placebo (n = 58) at between 16-20 and 36 weeks' gestation.The three biometric variables (...) Does 17-α-hydroxyprogesterone caproate affect fetal biometry and birth weight in twin pregnancy? Increasingly, maternal administration of 17-α-hydroxyprogesterone caproate (17-OHPC) is utilized to prevent preterm birth, but the fetal safety of 17-OHPC is still a matter of concern. This study aimed to assess whether exposure to 17-OHPC during the second and third trimesters of pregnancy affects fetal biometry in twin gestations.This study included a subset of women with a twin pregnancy who had

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2013 Ultrasound in Obstetrics and Gynecology

194. The use of ultrasound measurements in environmental epidemiological studies of air pollution and fetal growth. (PubMed)

by ultrasound measurements.The six studies published to date found that exposure to certain ambient air pollutants during pregnancy is negatively associated with the growth rates and average attained size of fetal parameters belonging to the growth profile. Fetal parameters may respond to maternal air pollution exposures uniquely, and this response may vary by pollutant and timing of gestational exposure. Current literature suggests that mean changes in head circumference, abdominal circumference, femur (...) The use of ultrasound measurements in environmental epidemiological studies of air pollution and fetal growth. Recently, several international research groups have suggested that studies about environmental contaminants and adverse pregnancy outcomes should be designed to elucidate potential underlying biological mechanisms. The purpose of this review is to examine the epidemiological studies addressing maternal exposure to air pollutants and fetal growth during gestation as assessed

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2013 Current Opinion in Pediatrics

195. Maternal Smoking During Pregnancy and Fetal Biometry: The INMA Mother and Child Cohort Study. (PubMed)

that was established between 2003 and 2008. Biparietal diameter, femur length, abdominal circumference, and estimated fetal weight were evaluated at 12, 20, and 34 weeks of gestation. Fetal size and growth were assessed by standard deviation scores adjusted by maternal and fetal characteristics. Maternal smoking was assessed using questionnaire and a sample of urinary cotinine at week 32 of gestation. Associations were estimated using multiple regression analysis. Smokers at week 12 of gestation showed decreased (...) fetal growth as reflected by all growth parameters at 20-34 weeks, leading to a reduced fetal size at week 34. The reduction was greatest in femur length, at -9.4% (95% confidence interval -13.4, -5.4) and least in abdominal circumference, at -4.4% (95% CI: -8.7, -0.1). Fetuses of smokers who quit smoking before week 12 showed reduced growth only in femur length (-5.5; 95% CI: -10.1, -0.9). Dose-response curves for smoking versus fetal growth parameters (abscissa: log2 cotinine) were linear

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2013 American Journal of Epidemiology

196. Does 17-α-hydroxyprogesterone caproate affect fetal biometry and birth weight in twin pregnancy? (PubMed)

been previously included in a randomized clinical trial comparing the effectiveness of 17-OHPC and placebo on neonatal outcomes and preterm birth rates in multiple pregnancy. In the present study, the individual growth patterns of femur length, head circumference and abdominal circumference were compared between fetuses of women who had been randomized to receive weekly injections of either 17-OHPC (n = 52) or placebo (n = 58) at between 16-20 and 36 weeks' gestation.The three biometric variables (...) Does 17-α-hydroxyprogesterone caproate affect fetal biometry and birth weight in twin pregnancy? Increasingly, maternal administration of 17-α-hydroxyprogesterone caproate (17-OHPC) is utilized to prevent preterm birth, but the fetal safety of 17-OHPC is still a matter of concern. This study aimed to assess whether exposure to 17-OHPC during the second and third trimesters of pregnancy affects fetal biometry in twin gestations.This study included a subset of women with a twin pregnancy who had

Full Text available with Trip Pro

2013 Ultrasound in Obstetrics and Gynecology

197. Evaluation of fetal anthropometric measures to predict the risk for shoulder dystocia. (PubMed)

, biparietal diameter (BPD), occipitofrontal diameter (OFD), head circumference, abdominal diameter (AD), abdominal circumference (AC) and femur length were analyzed. The influences of independent risk factors were calculated and their combination used in a predictive model.The incidence of shoulder dystocia was 1.14%. Different combinations of sonographic parameters showed comparable ROC curves without advantage for a particular combination. The difference between AD and BPD (AD - BPD) (area under (...) Evaluation of fetal anthropometric measures to predict the risk for shoulder dystocia. To evaluate the quality of anthropometric measures to improve the prediction of shoulder dystocia by combining different sonographic biometric parameters.This was a retrospective cohort study of 12,794 vaginal deliveries with complete sonographic biometry data obtained within 7 days before delivery. Receiver-operating characteristics (ROC) curves of various combinations of the biometric parameters, namely

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2013 Ultrasound in Obstetrics and Gynecology

198. Fetal biometry: how well can offline measurements from 3D volumes substitute real time 2D measurements? (PubMed)

measurements was similar to that for 2D measurements. Planes from some volumes could not be extracted (7% for head circumference, 9% for abdominal circumference and 11% for femur length). The median time required to perform a full fetal biometric scan was significantly higher for 3D than for 2D (3:04 min vs 1:57 min, respectively; P < 0.001).Fetal measurements derived from 3D volume acquisitions exhibited good agreement with those obtained by real-time 2D scanning, with no extra systematic or random error (...) Fetal biometry: how well can offline measurements from 3D volumes substitute real time 2D measurements? To assess the feasibility, accuracy and reproducibility of manipulating three-dimensional (3D) volume sets in order to reconstruct optimal two-dimensional (2D) planes for fetal biometry throughout gestation and compare them with those derived from real-time 2D scanning.Sixty-five fetuses were evaluated at a gestational age of 14-41 weeks. For each fetus a duplicate set of seven standard fetal

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2013 Ultrasound in Obstetrics and Gynecology

199. Longitudinal measurement of fetal thigh soft tissue parameters and its role in the prediction of birth weight. (PubMed)

abdominal circumference, femur length, biparietal diameter, and head circumference.The fetal abdominal subcutaneous tissue (FAST) and thigh muscle and fat show an increase with gestation. At 28 weeks gestation, the abdominal circumference, thigh fat, FAST, and EFW percentile were found to be significant predictors of BW. A combination of EFW percentile and thigh fat were found to be the optimal multivariate model at 28 weeks for predicting BW. At 37 weeks, BW prediction using EFW percentile, FAST (...) Longitudinal measurement of fetal thigh soft tissue parameters and its role in the prediction of birth weight. The aim of this study was to profile longitudinal changes in thigh muscle and fat with gestation and to determine whether thigh measurements can improve the prediction of birth weight (BW).A prospective longitudinal study of subcutaneous soft tissue measurements was conducted in 328 singleton fetuses at 28 and 37 weeks gestation. Estimated fetal weight (EFW) was calculated using

2013 Prenatal diagnosis

200. Fetal isolated short femur in the second trimester and adverse pregnancy outcomes. (PubMed)

from the earliest scan of singleton pregnancies was selected. An ISF was defined as a FL less than the tenth percentile in a fetus with an abdominal circumference greater than or equal to the tenth percentile. The primary outcomes were small for gestational age (SGA), birth weight below the third and fifth percentiles, low birth weight (LBW), preterm birth (PTB) and preeclampsia (PE). A 5-min Apgar score of less than 7 and a neonatal intensive care unit admission were secondary outcomes.Of the 4992 (...) Fetal isolated short femur in the second trimester and adverse pregnancy outcomes. This study aims to evaluate the association of isolated short femur (ISF) in the second trimester ultrasound with adverse pregnancy outcomes.All obstetric scans between 16 and 24 weeks of gestation from 1 January 2006 to 1 June 2012 were retrospectively evaluated. Multiple pregnancies, major congenital or chromosomal anomalies and subjects with incomplete outcome data were excluded. Femur length (FL) measurement

2013 Prenatal diagnosis

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