Document Detail

The fetal arm: individualized growth assessment in normal pregnancies.
MedLine Citation:
PMID:  15914686     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The goals were to introduce fractional arm volume (AVol) as a new soft tissue parameter of fetal growth assessment and to develop individualized growth standards, based on Rossavik models, for AVol, midarm circumference (ArmC), and humeral diaphysis length (HDL). METHODS: A prospective longitudinal study of 22 fetuses was conducted using 2- and 3-dimensional sonography. Three new growth parameters (HDL, ArmC, and AVol) were used to establish individualized standards for arm growth with the use of Rossavik functions [P=c(t)k (+) s(t), where P is the anatomic parameter; c, k, and s are model coefficients; and t is the time variable]. Second-trimester models were specified from the linear slopes of growth curves before approximately 28.0 menstrual weeks. For a given fetus, normal third-trimester trajectories were predicted for each parameter. Observed and predicted measurements were compared by percent deviations. RESULTS: Rossavik functions fit all parameter trajectories extremely well (R(2)=95.7%-99.4%). By fixing coefficients k at their mean values, their respective fits did not change, and the variabilities of both coefficients c and s were reduced. Coefficient c was also significantly related to second-trimester slope, as was s to c, for all 3 parameters (R(2)=97.7%-98.7%; P<.0001). Mean percent deviations between observed and predicted third-trimester HDL, ArmC, and AVol measurements were -0.1% +/- 2.9%, 0.5% +/- 4.6%, and 0.4% +/- 8.5%, respectively. CONCLUSIONS: Individualized growth assessment, using HDL and ArmC, can accurately predict normal arm growth during the third trimester of pregnancy. AVol may also allow earlier detection and improved monitoring of soft tissue abnormalities that can occur in fetuses with growth disturbances.
Wesley Lee; Russell L Deter; Beverley McNie; Luis F Gonçalves; Jimmy Espinoza; Tinnakorn Chaiworapongsa; Mamtha Balasubramaniam; Roberto Romero
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine     Volume:  24     ISSN:  0278-4297     ISO Abbreviation:  J Ultrasound Med     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-05-25     Completed Date:  2005-09-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8211547     Medline TA:  J Ultrasound Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  817-28     Citation Subset:  IM    
Division of Fetal Imaging, Department of Obstetrics and Gynecology, William Beaumont Hospital, Royal Oak, MI 48073-6769, USA.
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MeSH Terms
Arm / embryology*,  ultrasonography
Fetal Growth Retardation / diagnosis
Fetus / anatomy & histology*
Models, Theoretical
Pregnancy Trimester, Third
Prospective Studies
Ultrasonography, Prenatal

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