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Fetal Abdominal Circumference

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221. Prospective Validation of Fetal Weight Estimation Using Fractional Limb Volume. Full Text available with Trip Pro

from 390 to 5426 g. Fetal measurements were extracted using volume datasets for biparietal diameter, abdominal circumference, femur diaphysis length, fractional arm volume and fractional thigh volume. Fractional limb volumes were manually traced from a central portion of the humerus or femur diaphysis. Mean percentage differences and SDs of the percentage differences were calculated for EFW. The proportion of newborns with EFW within 5 or 10% of BW were compared with an estimate obtained using (...) a Hadlock formula that was modified using model coefficients from the same local population sample.Ultrasound scans were performed between 21.7 and 42 weeks' menstrual age. Optimal model performance (1.9 ± 6.6%) resulted from using a combination of biparietal diameter, abdominal circumference and fractional thigh volume. The precision of this model was superior to results obtained using a modified Hadlock model (1.1 ± 8.4%), although accuracy of these predictions was slightly decreased for female

2012 Ultrasound in Obstetrics and Gynecology

222. Fetal and Infant Growth and Asthma Symptoms in Preschool Children. The Generation R Study. (Abstract)

, abdominal circumference, and weight) were estimated by repeated ultrasounds. Infant growth (head circumference, length, and weight) was measured at birth and at the ages of 3, 6, and 12 months. Parental report of asthma symptoms until the age of 4 years was yearly obtained by questionnaires.Both fetal restricted and accelerated growth, defined as a negative or positive change of more than 0.67 standard deviation score, were not associated with asthma symptoms until the age of 4 years. Accelerated weight (...) Fetal and Infant Growth and Asthma Symptoms in Preschool Children. The Generation R Study. Low birth weight is associated with an increased risk of wheezing in childhood.We examined the associations of longitudinally measured fetal and infant growth patterns with the risks of asthma symptoms in preschool children.This study was embedded in a population-based prospective cohort study among 5,125 children. Second- and third-trimester fetal growth characteristics (head circumference, femur length

2012 American Journal of Respiratory and Critical Care Medicine

223. Sildenafil Citrate Rescues Fetal Growth in the Catechol-O-Methyl Transferase Knockout Mouse Model. Full Text available with Trip Pro

with preeclampsia. The ability of sildenafil citrate to increase uterine artery vasodilation, thereby decreasing uterine artery resistance and, hence, ameliorated preeclampsia and fetal growth restriction, was tested in a mouse model of preeclampsia, the catechol-O-methyl transferase knockout mouse (COMT(-/-)). COMT(-/-) and C57BL/6J mice were treated (0.2 mg/mL in drinking water, n=6-12) from gestational day 12.5 to 18.5. Measures of pup growth, including body weight, crown/rump length, and abdominal (...) Sildenafil Citrate Rescues Fetal Growth in the Catechol-O-Methyl Transferase Knockout Mouse Model. Preeclampsia and fetal growth restriction are responsible for the majority of maternal and perinatal morbidity and mortality associated with complicated pregnancies. Although their etiologies are complex and multifactorial, both are associated with increased uterine artery resistance. Sildenafil citrate is able to rescue the dysfunction observed ex vivo in uterine arteries of women

2012 Hypertension

224. The role of maternal gut hormones in normal pregnancy: Fasting plasma active GLP-1 level is a negative predictor of fetal abdomen circumference and maternal weight change. Full Text available with Trip Pro

The role of maternal gut hormones in normal pregnancy: Fasting plasma active GLP-1 level is a negative predictor of fetal abdomen circumference and maternal weight change. Maternal weight in pregnancy contributes to a glycemic environment that affects fetal growth. Gut peptides (glucagon-like peptide 1 (GLP1), glucose-dependent insulinotropic peptide (GIP), ghrelin, and peptide YY (PYY)) have been related to insulin sensitivity and secretion, weight control, and adipose tissue metabolism (...) index (ISI), and indices of insulin secretion were calculated. Fetal growth was estimated by ultrasound.Fasting GLP1 increased significantly from the second to the third trimester (P<0.05). Fasting GLP1 correlated positively with high-density lipoprotein cholesterol (r=0.52, P=0.04). At the second trimester, fasting GLP1 levels correlated negatively with fetal abdomen circumference (r=-0.55, P=0.034), birth weight (r=-0.50, P=0.040), HOMA-R (r=-0.65, P=0.001), insulin secretion, and triglycerides

2010 European Journal of Endocrinology

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

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

2011 Ultrasound in Obstetrics and Gynecology

226. Ultrasound prediction of birthweight and growth restriction in fetal gastroschisis (Abstract)

Ultrasound prediction of birthweight and growth restriction in fetal gastroschisis Most ultrasound estimated fetal weight (EFW) formulas incorporate abdominal circumference, which may overstimate growth restriction in fetal gastroschisis. The aim of this study was to determine the optimal ultrasound formula for prediction of birthweight and fetal growth restriction (FGR) in gastroschisis.We conducted a retrospective cohort analysis of singleton fetuses with gastroschisis. Percentage of error

2010 EvidenceUpdates

227. Clinical care of severe acute respiratory infections – Tool kit

on one side, distended neck veins Tension pneumothorax Distended neck veins, mu ed heart sounds, tachycardia, hypotension Pericardial tamponade Sweet smelling breath, deep or rapid breathing DKA History of trauma or no known cause Hidden sources of signi cant blood loss (stomach, intestines, intra-abdominal, chest, long-bone trauma) or spinal injury Key Findings from the SAMPLE History and Secondary Exam IF YOU FIND... REMEMBER... Vomiting and diarrhoea Ask about contacts and report cases per (...) pneumothorax (hypotension with absent breath sounds/hyperresonance on one side, distended neck veins) Perform needle decompression. Give oxygen, IV uids. ? Will need chest tube Open (sucking) chest wound Give oxygen, place 3-sided dressing, monitor for tension pneumothorax. ? Will need chest tube Breathing not adequate Give oxygen, assist ventilation with BVM. Large burns of chest or abdomen (or circumferential burn to limb) Give IV uids per burn size, give oxygen, remove constricting clothing/jewelry

2020 WHO Coronavirus disease (COVID-19) Pandemic

228. Assisted Vaginal Birth

estimated fetal weight of greater than 4 kg or a clinically big baby head circumference above the 95th percentile occipito–posterior position midpelvic birth or when one‐fifth of the head is palpable per abdomen. High maternal BMI greater than 30, short maternal stature, neonatal birth weight greater than 4 kg and occipito–posterior positions are all indicators of increased failure and require special consideration. , , - At midpelvic stations, particularly station 0 or where rotation is required (...) to assisted vaginal birth is recommended where uncertainty exists following clinical examination. [New 2020] Grade of recommendation: A There is insufficient evidence to recommend the routine use of abdominal or perineal ultrasound for assessment of the station, flexion and descent of the fetal head in the second stage of labour. [New 2020] Grade of recommendation: C What type of consent is required prior to attempting assisted vaginal birth? Women should be informed about assisted vaginal birth

2020 Royal College of Obstetricians and Gynaecologists

229. Variants near CCNL1/LEKR1 and in ADCY5 and Fetal Growth Characteristics in Different Trimesters. Full Text available with Trip Pro

life onward in The Netherlands and Australia. Repeated fetal ultrasound examinations were performed to measure head circumference (HC), abdominal circumference (AC), femur length (FL), and estimated fetal weight (EFW). Analyses were based on a total group of 3909 subjects.The C-allele of rs900400 was associated in second trimester with smaller fetal HC and FL, and in third trimester with smaller HC, AC, FL, and EFW. For each C-allele, the combined effect estimate for EFW in third trimester (...) Variants near CCNL1/LEKR1 and in ADCY5 and Fetal Growth Characteristics in Different Trimesters. A recent genome-wide association study identified variants near CCNL1/LEKR1 (rs900400) and in ADCY5 (rs9883204) to be associated with birth weight. We examined the associations of these variants with fetal growth characteristics in different trimesters, with a main interest in the timing of the associations and the affected body proportions.We used data from two prospective cohort studies from fetal

2011 Journal of Clinical Endocrinology and Metabolism

230. Prenatal evaluation of the position of the fetal conus medullaris. (Abstract)

skin-covered spinal dysraphism.In 84.7% of the 300 cases, both operators were able to visualize the conus medullaris and the last vertebral body. Ninety-five percent limits of agreement for the intraobserver variability in measurement of conus distance were ± 1.9 mm. For the interobserver variability, they were - 3.7 and 2.5 mm. We found a linear relationship between conus distance and gestational age, biparietal diameter and abdominal circumference. The strongest relationship was observed (...) Prenatal evaluation of the position of the fetal conus medullaris. To determine the position of the fetal conus medullaris during pregnancy in relation to the last vertebral body and to examine its use in detecting skin-covered spinal dysraphism.This was a retrospective study involving 300 consecutive ultrasound examinations between 15 weeks of gestation and term. Two operators independently assessed images of the spine to determine whether the conus medullaris and the last vertebral body could

2011 Ultrasound in Obstetrics and Gynecology

231. Standardization of fetal ultrasound biometry measurements: improving the quality and consistency of measurements. Full Text available with Trip Pro

signed ranks test, and variance was assessed using Pitman's test. Interobserver agreement was also assessed using the intraclass correlation coefficient (ICC), and all images were scored for quality in a blinded fashion.At baseline the level of agreement and image scoring were high. A significant reduction in the differences between sonographers and the lead sonographer were seen for fetal biometry overall (head circumference, abdominal circumference and femur length) between the first and third (...) Standardization of fetal ultrasound biometry measurements: improving the quality and consistency of measurements. To assess whether a standardization exercise prior to commencing a fetal growth study involving multiple sonographers can reduce interobserver variation.In preparation for an international study assessing fetal growth, nine experienced sonographers from eight countries participated in a standardization exercise consisting of theoretical and practical sessions. Each performed a set

2011 Ultrasound in Obstetrics and Gynecology

232. Biometry and estimated fetal weight by two-dimensional and three-dimensional ultrasonography: an intra- and inter-observer reliability and agreement study. Full Text available with Trip Pro

Biometry and estimated fetal weight by two-dimensional and three-dimensional ultrasonography: an intra- and inter-observer reliability and agreement study. To evaluate and compare the intraobserver and interobserver reliability and agreement for the biparietal diameter (BPD), abdominal circumference (AC), femur length (FL) and estimated fetal weight (EFW) obtained by two-dimensional ultrasound (2D-US) and three-dimensional ultrasound (3D-US).Singleton pregnant women between 24 and 40 weeks were (...) invited to participate in this study. They were examined using 2D-US in a blinded manner, twice by one observer, intercalated by a scan by a second observer, to determine BPD, AC and FL. In each of the three examinations, three 3D-US datasets (head, abdomen and thigh) were acquired for measurements of the same parameters. We determined EFW using Hadlock's formula. Systematic errors between 3D-US and 2D-US were examined using the paired t-test. Reliability and agreement were assessed by intraclass

2011 Ultrasound in Obstetrics and Gynecology

233. Fetal omphalocele ratios predict outcomes in prenatally diagnosed omphalocele. (Abstract)

repair. Omphalocele diameter upon antenatal ultrasound was compared with abdominal circumference, femur length, and head circumference, yielding the respective omphalocele (O)/abdominal circumference (AC), O/femur length (FL), and O/head circumference (HC) ratios. The absolute measurements were used to classify giant lesions. Omphalocele ratios and giant omphalocele designations were evaluated as predictors of inability to achieve primary repair.Among 25 included cases, staged or delayed closure (...) Fetal omphalocele ratios predict outcomes in prenatally diagnosed omphalocele. The objective of the study was to evaluate whether ratios considering omphalocele diameter relative to fetal biometric measurements perform better than giant omphalocele designation at predicting inability to achieve neonatal primary surgical closure.Cases of fetal omphalocele that underwent evaluation between May 2003 and July 2010 were identified. Inclusion was restricted to live births with plan for postnatal

2011 American Journal of Obstetrics and Gynecology

234. Prediction of intrauterine fetal death (IUFD) associated with small for gestational age: impact of including ultrasound biometry in the customized models. (Abstract)

multiple regression (Cust-chart). The same process was repeated including second-trimester biometric parameters: biparietal diameter, head circumference, femur length and abdominal circumference in the regression models (Cust-plus-USS-chart). The association between small-for-gestational age < 10(th) centile (SGA) pregnancies, defined using the two customized charts or our population-based growth chart (Pop-chart) and IUFD, were compared. Statistical analyses including OR, 95% CI and screening accuracy (...) Prediction of intrauterine fetal death (IUFD) associated with small for gestational age: impact of including ultrasound biometry in the customized models. Customized growth charts derived from maternal demographic characteristics alone have been shown to improve the prediction of pregnancy complications compared to population growth curves. We sought to estimate the impact of adding ultrasound biometric parameters to the customized chart for the prediction of intrauterine fetal death (IUFD

2011 Ultrasound in Obstetrics and Gynecology

235. Influence of fetal and parental factors on intra-uterine growth measurements: results of the EDEN mother-child cohort. (Abstract)

cohort included 2002 pregnant women with singleton pregnancies attending one of two university hospitals. Data from two routine ultrasound examinations for fetal biometry were recorded, at 20-25 and 30-35 weeks of gestation. Biparietal diameter (BPD), head circumference (HC), femur length (FL), abdominal circumference (AC) and estimated fetal weight (EFW) were studied as a function of prepregnancy maternal body mass index (BMI), maternal height, paternal height, fetal sex and gestational age.Data (...) Influence of fetal and parental factors on intra-uterine growth measurements: results of the EDEN mother-child cohort. In small-for-gestational-age neonates, parental and fetal characteristics can be used to distinguish between constitutionally small size and growth restriction, which is associated with a higher risk of morbidity and mortality. The aim of this study was to quantify relationships of parental and fetal characteristics with fetal ultrasound measurements.The EDEN mother-child

2011 Ultrasound in Obstetrics and Gynecology

236. The duration of persistent abnormal ductus venosus flow and its impact on perinatal outcome in fetal growth restriction. Full Text available with Trip Pro

The duration of persistent abnormal ductus venosus flow and its impact on perinatal outcome in fetal growth restriction. To study if the duration of individual Doppler abnormalities is an independent predictor of adverse outcome in fetal growth restriction (FGR) caused by placental dysfunction.This was a secondary analysis of patients with FGR (abdominal circumference < 5(th) percentile and umbilical artery (UA) pulsatility index (PI) elevation) who had at least three examinations before

2011 Ultrasound in Obstetrics and Gynecology

237. The accuracy of sonographic weight estimation as a function of fetal sex. (Abstract)

circumference (AC), femur diaphysis length (FL), biparietal diameter (BPD) and head circumference (HC).In seven out of the eight models tested, the presence of a male fetus was associated with a significantly lower systematic error compared with a female fetus (-0.2 to 2.1% vs. 1.3 to 6%, P<0.001). On multivariate analysis, fetal sex was independently associated with sonographic accuracy so that the likelihood of a weight estimation within 10% of birth weight was 30% higher for male fetuses compared (...) The accuracy of sonographic weight estimation as a function of fetal sex. To determine whether the accuracy of sonographic fetal weight estimation is related to fetal sex.The accuracy of sonographic fetal weight estimation was compared between male and female fetuses using 3672 sonographic weight estimations performed within 3 days prior to delivery. Fetal weight was estimated using eight regression models that are based on different combinations of the following biometric parameters: abdominal

2011 Ultrasound in Obstetrics and Gynecology

238. The use of three-dimensional ultrasound does not improve training in fetal biometric measurements. (Abstract)

circumference (HC), abdominal circumference (AC), and femur length (FL)) by a trainer. Subsequently, each midwife measured the parameters on another 10 fetuses. The same set of measurements was repeated by the trainer. The percentage deviation between the midwives' and the trainer's measurements was determined and compared between training groups. Time required for completion was recorded. Frozen images were reviewed by another sonographer to assess the image quality using a standardized scoring system.The (...) The use of three-dimensional ultrasound does not improve training in fetal biometric measurements. To investigate whether three-dimensional (3D) technology offers any advantage over two-dimensional (2D) ultrasound in fetal biometric measurement training.Ten midwives with no hands-on experience in ultrasound were randomized to receive training on 2D or 3D ultrasound fetal biometry assessment. Midwives were taught how to obtain fetal biometric measurements (biparietal diameter (BPD), head

2011 The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians Controlled trial quality: uncertain

239. Effect of L-arginine on the expression of Bcl-2 and Bax in the placenta of fetal growth restriction. (Abstract)

intervals. The newborn birth weight and perinatal outcomes were also documented. Placental tissue was sampled within 10 min after delivery for analysis. The expression of Bcl-2 and Bax in placental tissue was determined by immunohistochemical technique.The fetal growth parameters of biparietal diameter, femur length, and abdominal circumference increased more significantly in L-arginine group than those in control group (p < 0.01). The cure rate and birth weight in L-arginine group were higher than (...) Effect of L-arginine on the expression of Bcl-2 and Bax in the placenta of fetal growth restriction. To investigate the effect of l-arginine on fetal growth restriction (FGR) in terms of the expression of Bcl-2 and Bax in placenta.Sixty pregnant women with FGR were randomized to receive conventional treatment alone (control group, n = 30) or in combination with L-arginine (L-arginine group, n = 30). The parameters of fetal growth and development were monitored by B-ultrasound at regular

2011 The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians Controlled trial quality: uncertain

240. What are the limits of accuracy in fetal weight estimation with conventional biometry in 2D ultrasound? A novel postpartum study. (Abstract)

biometric parameters.This was a prospective multicenter study including 628 singleton pregnancies at term. Inclusion criteria were healthy newborns with no physical or chromosomal malformations. Postpartum measurement of head circumference, abdominal circumference and thigh length was performed. Six 'best-fit' formulae were derived using forward regression analysis in a formula-finding group (n = 419), and their accuracy was compared with birth weight in an evaluation group (n = 209) using percentage (...) What are the limits of accuracy in fetal weight estimation with conventional biometry in 2D ultrasound? A novel postpartum study. Commonly used formulae for fetal weight estimation, including combinations of several biometric parameters, lack accuracy despite efforts to improve them. This study aimed to investigate the limits of fetal weight estimation based on conventional biometric parameters on two-dimensional (2D) ultrasound by developing and evaluating new weight equations using postpartum

2011 Ultrasound in Obstetrics and Gynecology

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