Document Detail


Third trimester ultrasound for the prediction of the large for gestational age fetus in low-risk population and evaluation of contingency strategies.
MedLine Citation:
PMID:  22729391     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: Evaluation of the effectiveness of third trimester fetal biometry and Doppler studies in predicting the birth of a large for gestational age neonate (LGA ≥ 95(th) centile). Assessment of the value of integrated models (combining maternal characteristics, first trimester parameters, third trimester fetal biometry) and the usefulness of contingency strategies. METHOD: Observational cross-sectional study on 2308 uncomplicated singleton pregnancies examined at 11 to 14 weeks and at 30 to 34 weeks. RESULTS: Ultrasound estimated fetal weight (EFW, area under the curve (AUC) = 0.83) was the best single predictor of LGA. Maternal weight, delta nuchal translucency and EFW were independent predictors for the integrated model, but the latter was not statistically better (AUC = 0.84) than using EFW alone. The detection rates for LGA were 72.5% and 73.7% for a 25% screen positive rate, by EFW and the third trimester integrated model respectively. A contingency strategy of rescanning 50% of the population in the third trimester according to the risk estimation by a first trimester prediction model results in detection rate of 64.7% for LGA for the same 25% screen positive rate (AUC = 0.78). CONCLUSIONS: Third trimester ultrasound is an effective screening modality for identifying fetal macrosomia. A contingency strategy utilizing first trimester parameters can reduce the need for unnecessary examinations. © 2012 John Wiley & Sons, Ltd.
Authors:
Athanasios Pilalis; Athena P Souka; Ioannis Papastefanou; Vasiliki Michalitsi; Perikles Panagopoulos; Charalambos Chrelias; Dimitrios Kassanos
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-25
Journal Detail:
Title:  Prenatal diagnosis     Volume:  -     ISSN:  1097-0223     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-8     Citation Subset:  -    
Copyright Information:
© 2012 John Wiley & Sons, Ltd.
Affiliation:
Fetal Medicine Unit, 3rd Department of Obstetrics and Gynaecology, University of Athens, 'Attikon' University Hospital, Athens, Greece; Leto Maternity Hospital, Fetal Medicine Unit, Athens, Greece.
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