scholarly journals VP37.20: A new approach in management of fetal growth‐restricted pregnancy using daily interval fetal weight gain gms/day in third trimester

2020 ◽  
Vol 56 (S1) ◽  
pp. 221-222
Author(s):  
T. Shah ◽  
D. Martingano ◽  
N. Patel ◽  
M. Maas ◽  
F. Rana ◽  
...  
2021 ◽  
Vol 6 (1) ◽  
pp. 17
Author(s):  
Yati Isnaini Safitri ◽  
Nur Masruroh

Kecukupan gizi ibu hamil ditentukan oleh kenaikan berat badan ibu yang juga akan mendukung kenaikan berat badan janin serta kecepatan janin mensintesis jaringan. Pencatatan hasil berat badan pada setiap kunjungan ibu hamil bermanfaat untuk mengetahui kesejahteraan janin yang ada di dalam kandungan ibu. Pengukuran Tinggi Fundus Uteri (TFU) menjadi titik awal evaluasi pertumbuhan janin. Taksiran berat janin berguna untuk memantau pertumbuhan janin dalam rahim, sehingga diharapkan dapat mendeteksi dini kemungkinan terjadinya pertumbuhan janin yang abnormal. Tujuan penelitian Menganalisis hubungan antara kenaikan berat badan ibu hamil dengan taksiran berat janin di RBG Zakat Surabaya. Sampel berjumlah 25 ibu adalah ibu hamil trimester 3 yang datang berkunjung ke klinik RBG Zakat Surabaya selama bulan Mei-Agustus 2019. Tehnik pengambilan sample menggunakan teknik purposive sampling. Analisis data menggunakan chi-square. Hasil penelitian Berdasarkan hasil uji statistic dengan chi-square di dapatkan hasil perhitungan menunjukkan signifikansi (α) = 0,396. Dengan asumsi jika ρ <0,05 Ho Ditolak maka ada hubungan antara kenaikan berat badan ibu dengan taksiran berat badan janin.The nutritional adequacy of pregnant women is determined by the increase in maternal weight, which will also support the increase in fetal weight, and the rate at which the fetus synthesizes tissue. Recording weight results at every visit of pregnant women is useful to know the welfare of the fetus in the mother's womb. Uterine Fundus Height Measurement (TFU) is the starting point for evaluating fetal growth. Estimated fetal weight is useful for monitoring fetal growth in the uterus, so it is expected to detect early the possibility of abnormal fetal growth. Research Objectives To analyze the relationship between weight gain of pregnant women and fetal weight estimates in RBG Zakat Surabaya. The sample of 25 mothers was 3rd trimester pregnant women who came to visit the Zakat Surabaya RBG clinic during May-August 2019. The sampling technique used purposive sampling technique. Data analysis using chi-square. Results of the study Based on the results of the statistical test with chi-square obtained the calculation results showed significance (α) = 0.396. Assuming if ρ <0.05 Ho is rejected then there is a relationship between maternal weight gain and estimated fetal weight. 


Author(s):  
Sara Essam ALdabouly ◽  
Mohamed Mohsen El Namori ◽  
Mona Khaled Omar ◽  
Essmat Hamdy AboZeid

Background: Throughout the fourth week of embryonic development the umbilical cord (UC) is formed, which corresponds to the fifth to the twelfth weeks of gestation. Fetuses with intrauterine growth restriction (IUGR) have leaner UCs than fetuses of appropriate gestational age do, and the caliber of the umbilical vein decreases significantly, resulting in a worsening of the Doppler parameters of the umbilical artery in the mother. The goal of this study was to evaluate the significance of sonographic UC diameter in determining gestational age in third trimester in pregnant women. Methods: We conducted a comparative cross-sectional research on 300 pregnant women aged range between (20-35) years, singleton gestation, gestational age (3rd) trimester estimated from antenatal mothers last menstrual period (LMP), viable fetus, presenting to obstetrics and gynecology department at Tanta university hospital. Results: Highly statistically significant positive correlation between UC diameter and gestational age, BPD, FL, AC, AFI, and estimated fetal weight was found. The increase in UC diameter was positively and significantly correlated with the increase in gestational age and estimated fetal weight, indicating that those who have prolonged gestational age and estimated fetal weight are more likely to have wider UC diameter. Conclusions: The UC diameter (UCD) has the potential to be a valuable indicator of fetal growth, well-being, and perinatal outcome. Sonographic measurement of UC diameter could be an efficient method of measuring fetal growth and predicting gestational age (GA), particularly between 28-40 weeks GA. It is possible that abnormal UC diameter can be a strong indicator to identify antenatal mothers at risk for IUFD and poor fetal outcomes.


2009 ◽  
Vol 40 (4) ◽  
pp. 633-643 ◽  
Author(s):  
J. Henrichs ◽  
J. J. Schenk ◽  
S. J. Roza ◽  
M. P. van den Berg ◽  
H. G. Schmidt ◽  
...  

BackgroundPrevious research suggests, though not consistently, that maternal psychological distress during pregnancy leads to adverse birth outcomes. We investigated whether maternal psychological distress affects fetal growth during the period of mid-pregnancy until birth.MethodPregnant women (n=6313) reported levels of psychological distress using the Brief Symptom Inventory (anxious and depressive symptoms) and the Family Assessment Device (family stress) at 20.6 weeks pregnancy and had fetal ultrasound measurements in mid- and late pregnancy. Estimated fetal weight was calculated using head circumference, abdominal circumference and femur length.ResultsIn mid-pregnancy, maternal distress was not linked to fetal size. In late pregnancy, however, anxious symptoms were related to fetal size after controlling for potential confounders. Anxious symptoms were also associated with a 37.73 g [95% confidence interval (CI) −69.22 to −6.25, p=0.019] lower birth weight. When we related maternal distress to fetal growth curves using multilevel models, more consistent results emerged. Maternal symptoms of anxiety or depression were associated with impaired fetal weight gain and impaired fetal head and abdominal growth. For example, depressive symptoms reduced fetal weight gain by 2.86 g (95% CI −4.48 to −1.23, p<0.001) per week.ConclusionsThe study suggests that, starting in mid-pregnancy, fetal growth can be affected by different aspects of maternal distress. In particular, children of prenatally anxious mothers seem to display impaired fetal growth patterns during pregnancy. Future work should address the biological mechanisms underlying the association of maternal distress with fetal development and focus on the effects of reducing psychological distress in pregnancy.


2019 ◽  
Vol 11 (1) ◽  
pp. 32-38
Author(s):  
Naznin Rashid Shewly ◽  
Menoka Ferdous ◽  
Hasina Begum ◽  
Shahadat Hossain Khan ◽  
Sheema Rani Debee ◽  
...  

Background: In obstetric management fetal weight estimation is an important consideration when planning the mode of delivery in our day to day practice. In Bangladesh low birth weight is a major public health problem & incidence is 38% - 58%. Neonatal mortality and morbidity also yet high. So accurate antenatal estimation of fetal weight is a good way to detect macrosomia or small for date baby. Thus to improve the pregnancy outcome and neonatal outcome decreasing various chance of neonatal mortality and morbidity antenatal fetal weight prediction is an invaluable parameter in some situation where to identify the at risk pregnancy for low birth weight become necessary. Reliable method for prenatal estimation of fetal weight two modalities have got popularity - Clinical estimation and another one is ultrasonic estimation. This study was designed to determine the accuracy of clinical versus ultrasound estimated fetal weight detecting the discrepancy with actual birth weight at third trimester. So that we can verify more reliable and accurate method. Objectives: To find out more accurate and reliable modality of fetal weight estimation in antenatal period during obstetric management planning. To compare clinical versus ultrasound estimated fetal weight & to determine discrepancy of both variable with actual birth weight. Method: This prospective, cross sectional analytical study was carried out in Dhaka Medical College Hospital from January 2006 to December 2006. By purposive sampling 100 pregnant women fulfilling inclusion criteria were included in my study in third trimester (29wks-40wks). In clinical weight estimation procedure SFH (Symphysio Fundal Height) was measured in centimeter. On pervaginal finding whether vertex below or above the ischial spine was determined. By Johnson’s formula fetal weight in grams was estimated. Then by ultrasound scan different biometric measurements were taken and finally by Hadlock’s formula fetal weight was estimated. Eventually actual birth weight was taken after birth by Globe Brand weighing machine. Accuracy of both modalities were compared and which one was more reliable predictor was determined by statistical analysis. Results: After data collection were analyzed by computer based software (SPSS). There was gradual and positive relationship between symphysiofundal height and estimated birth weight. Discrepancy between clinical and actual birth weight at third trimester was statistically significant – Paired Student’s ‘t’ test was done where p value was <0.001. Whereas discrepancy between sonographically estimated fetal weight with actual birth weight was not statistically significant (by paired ‘t’ test where p value was >0.05). That implies discrepancy between ultrasound estimated fetal weight and actual birth weight was significantly less than that of clinically estimated fetal weight. 14% clinically and 46% sonographically estimated fetal weight were observed within £ 5% of actual birth weight. 31% clinical and 42% sonographically estimates observed within 6% to 10% of actual birth weight and 55% clinical and 12% sonographically estimate were >10% of actual birth weight. That is about 88% sonographical versus 45% clinical estimates were within 10% of actual birth weight. Conclusion: There is no doubt about importance of fetal weight in many obstetric situations. Clinical decisions at times depends on fetal weight. Whether to use oxytocin, to use forceps or vacuum for delivery or extend of trial or ended by Caesarian section immediately or no scope of trial to be largely depend on fetal size and weight. So more accurate modality for antenatal fetal weight estimation has paramount importance. In my study sonographically estimated weight have more accuracy than that of clinical estimate in predicting actual birth weight. Sonographically estimated fetal weight is more reliable, accurate and reproducible rather than other modality. J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 32-38


Author(s):  
E.A. Derkach , O.I. Guseva

Objectives: to compare the accuracy of equations F.P. Hadlock and computer programs by V.N. Demidov in determining gestational age and fetal weight in the third trimester of gestation. Materials: 328 patients in terms 36–42 weeks of gestation are examined. Ultrasonography was performed in 0–5 days prior to childbirth. Results: it is established that the average mistake in determination of term of pregnancy when using the equation of F.P. Hadlock made 12,5 days, the computer program of V.N. Demidov – 4,4 days (distinction 2,8 times). The mistake within 4 days, when using the equation of F.P. Hadlock has met on average in 23,1 % of observations, the computer program of V.N. Demidov — 65,9 % (difference in 2,9 times). The mistake more than 10 days, took place respectively in 51,7 and 8,2 % (distinction by 6,3 times). At a comparative assessment of size of a mistake in determination of fetal mass it is established that when using the equation of F.P. Hadlock it has averaged 281,0 g, at application of the computer program of V.N. Demidov — 182,5 g (distinction of 54 %). The small mistake in the mass of a fetus which isn't exceeding 200 g at application of the equation of F.P. Hadlock has met in 48,1 % of cases and the computer program of V.N. Demidov — 64,0 % (distinction of 33,1 %). The mistake exceeding 500 g has been stated in 18 % (F.P. Hadlock) and 4,3 % (V.N. Demidov) respectively (distinction 4,2 times). Conclusions: the computer program of V.N. Demidov has high precision in determination of term of a gestation and mass of a fetus in the III pregnancy.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Linda Lindström ◽  
Mårten Ageheim ◽  
Ove Axelsson ◽  
Laith Hussain-Alkhateeb ◽  
Alkistis Skalkidou ◽  
...  

AbstractFetal growth restriction is a strong risk factor for perinatal morbidity and mortality. Reliable standards are indispensable, both to assess fetal growth and to evaluate birthweight and early postnatal growth in infants born preterm. The aim of this study was to create updated Swedish reference ranges for estimated fetal weight (EFW) from gestational week 12–42. This prospective longitudinal multicentre study included 583 women without known conditions causing aberrant fetal growth. Each woman was assigned a randomly selected protocol of five ultrasound scans from gestational week 12 + 3 to 41 + 6. Hadlock’s 3rd formula was used to estimate fetal weight. A two-level hierarchical regression model was employed to calculate the expected median and variance, expressed in standard deviations and percentiles, for EFW. EFW was higher for males than females. The reference ranges were compared with the presently used Swedish, and international reference ranges. Our reference ranges had higher EFW than the presently used Swedish reference ranges from gestational week 33, and higher median, 2.5th and 97.5th percentiles from gestational week 24 compared with INTERGROWTH-21st. The new reference ranges can be used both for assessment of intrauterine fetal weight and growth, and early postnatal growth in children born preterm.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Chalana M. Sol ◽  
Charissa van Zwol - Janssens ◽  
Elise M. Philips ◽  
Alexandros G. Asimakopoulos ◽  
Maria-Pilar Martinez-Moral ◽  
...  

Abstract Background Exposure to bisphenols may affect fetal growth and development. The trimester-specific effects of bisphenols on repeated measures of fetal growth remain unknown. Our objective was to assess the associations of maternal bisphenol urine concentrations with fetal growth measures and birth outcomes and identify potential critical exposure periods. Methods In a population-based prospective cohort study among 1379 pregnant women, we measured maternal bisphenol A, S and F urine concentrations in the first, second and third trimester. Fetal head circumference, length and weight were measured in the second and third trimester by ultrasound and at birth. Results An interquartile range increase in maternal pregnancy-averaged bisphenol S concentrations was associated with larger fetal head circumference (difference 0.18 (95% confidence interval (CI) 0.01 to 0.34) standard deviation scores (SDS), p-value< 0.05) across pregnancy. When focusing on specific critical exposure periods, any detection of first trimester bisphenol S was associated with larger second and third trimester fetal head circumference (difference 0.15 (95% CI 0.05 to 0.26) and 0.12 (95% CI 0.02 to 0.23) SDS, respectively) and fetal weight (difference 0.12 (95% CI 0.02 to 0.22) and 0.16 (95% CI 0.06 to 0.26) SDS, respectively). The other bisphenols were not consistently associated with fetal growth outcomes. Any detection of bisphenol S and bisphenol F in first trimester was also associated with a lower risk of being born small size for gestational age (Odds Ratio 0.56 (95% CI 0.38 to 0.74) and 0.55 (95% CI 0.36 to 0.85), respectively). Bisphenols were not associated with risk of preterm birth. Conclusions Higher maternal bisphenol S urine concentrations, especially in the first trimester, seem to be related with larger fetal head circumference, higher weight and a lower risk of being small size for gestational age at birth.


Author(s):  
Russalina Stroeder ◽  
Julia Radosa ◽  
Lea Clemens ◽  
Christoph Gerlinger ◽  
Gilda Schmidt ◽  
...  

Abstract Purpose To assess changes in the pelvic floor anatomy that cause pelvic floor disorders (PFDs) in primigravidae during and after pregnancy and to evaluate their impact on women’s quality of life (QoL). Methods POP-Q and translabial ultrasound examination was performed in the third trimester and 3 months after delivery in a cohort of primigravidae with singleton pregnancy delivering in a tertiary center. Results were analyzed regarding mode of delivery and other pre- and peripartal factors. Two individualized detailed questionnaires were distributed at 3 months and at 12 months after childbirth to determinate QoL. Results We recruited 45 women, of whom 17 delivered vaginally (VD), 11 received a vacuum extraction delivery (VE) and 17 a Cesarean section in labor (CS). When comparing third-trimester sonography to 3 months after delivery, bladder neck mobility increased significantly in each delivery group and hiatal area increased significantly in the VD group. A LAM avulsion was found in two women after VE. Connective tissue weakness (p = 0.0483) and fetal weight at birth (p = 0.0384) were identified as significant risk factors for the occurrence of PFDs in a multivariant regression analysis. Urinary incontinence was most common with 15% and 11% of cases at 3, respectively, 12 months after delivery. 42% of women reported discomfort during sexual intercourse, 3 months after delivery and 24% 12 months postpartum. Although 93% of women engage a midwife after delivery, only 56% participated in pelvic floor muscle training. Conclusion Connective tissue weakness and high fetal weight at birth are important risk factors for the occurrence of PFDs. Nevertheless, more parturients should participate in postpartal care services to prevent future PFDs.


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