الفهرس 
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Abstract
The quest for precise prediction of fetal birth weight holds
paramount importance in obstetrics, primarily for identifying potential
complications and planning appropriate interventions. Traditional methods,
including various biometric measurements, have been the cornerstone of
fetal weight estimation. However, recent advancements have introduced
more refined approaches, such as measuring fetal thigh circumference (TC)
and fractional thigh volume (TVol), to enhance the accuracy of these
predictions.
These methods are increasingly being studied for their efficacy and
reliability in predicting fetal birth weight. However, the accuracy of TC and
TVol can vary based on factors such as gestational age, fetal development,
and the presence of anomalies. Studies, including those by Gembicki et al.
(2022), have shown that these methods tend to be more accurate at later
gestational ages, presumably when the fetus is more developed and its
physical parameters are more distinct and measurable.
Moreover, fetal anomalies or abnormal growth patterns can
significantly affect the accuracy of TC and TVol as predictors. In such
cases, these methods may not yield accurate estimates of fetal birth weight,
as the typical development trajectory is altered. Despite these challenges,
TC and TVol are considered valuable in predicting fetal birth weight in
low-risk pregnancies. It is crucial, however, to be aware of their limitations
and to use them alongside other methods like fetal biometry for a more
comprehensive assessment.
Summary
74
This study aimed to further explore and validate the use of TC and
TVol in a clinical setting, examining their accuracy in a diverse population
and considering factors that might influence their efficacy.
This cross-sectional study was conducted over a nine-month period
in 2023 at Menoufia University Hospital and Shebeen El-Kom Teaching
Hospital. The study’s cohort comprised 60 pregnant women attending
routine obstetrics and gynecology clinics at these institutions.
The study employed 2-D transabdominal ultrasound scans to
measure fetal parameters. These scans, conducted between the 37th and
40th weeks of gestation, included measurements of biparietal diameter
(BPD), head circumference (HC), abdominal circumference (AC), femur
length (FL), and thigh circumference (TC). The data gathered from these
measurements were then utilized to estimate fetal weight, applying three
different formulas: Hadlock’s, Vintzileos’, and Lee 1’s.
The study’s findings were multifaceted:
The participants’ average weight was 66.02 kg, and their height was
1.59 m, resulting in a mean Body Mass Index (BMI) of 26.32 Kg/m².
Ultrasound measurements revealed mean biparietal diameter (BPD)
of 10.77 mm, head circumference of 33.03 mm, abdominal circumference
(AC) of 34.10 mm, estimated thigh circumference of 16.17 mm, and femur
length of 7.20 mm. The actual thigh circumference averaged at 16.27 mm.
The actual mean birth weight was 3552.60 grams. Estimations by
Hadlock‘s, Vintzileos‘, and Lee 1‘s formulas, along with a Lee 2 method,
varied, with Lee 1‘s formula tending to overestimate and the others
generally underestimating fetal weight.
Summary
75
Statistically significant differences were found between actual birth
weight and estimates from Hadlock‘s method (186.22 grams difference),
Vintzileos‘ method (253 grams difference), Lee 1 formula (140.47 grams
difference), and Lee 2 method (43.92 grams difference).
A high correlation existed between actual birth weight and the
estimated weights by the various methods, with particularly strong
correlations for estimates from Hadlock‘s, Vintzileos‘, Lee 1‘s methods,
and the Lee 2 method.
Multiple regression analysis showed that the estimates from the Lee
2 method and the Lee 1 formula were significant predictors of actual birth
weight.
Receiver Operating characteristic (ROC) analysis was used to
evaluate the diagnostic performance of these estimates. Thigh volume and
estimates from the Lee 1 formula showed high specificity, while the
sensitivity of estimates varied with the method used. The area under the
curve (AUC) values indicated good to excellent predictive power of these
methods.
In conclusion, this study underscores the variability in the accuracy
of fetal weight estimation methods. It highlights the Lee 2 method and Lee
1‘s formula as notable predictors of actual birth weight, demonstrating the
potential for improved fetal weight estimation through the selection of
appropriate models.