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 Table of Contents  
REVIEW ARTICLE
Year : 2015  |  Volume : 12  |  Issue : 2  |  Page : 67-73

Advances in clinical estimation of foetal weight before delivery


Department of Obstetrics and Gynaecology, Federal Medical Centre, Birnin Kudu, Jigawa, Nigeria

Date of Web Publication10-Nov-2015

Correspondence Address:
Emmanuel Ajuluchukwu Ugwa
Department of Obstetrics and Gynaecology, Federal Medical Centre, Birnin Kudu, Jigawa State
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0331-8540.158888

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  Abstract 

Accurate estimation of foetal weight is of paramount importance before delivery. Clinical estimation of foetal weight is an important and necessary skill in management of obstetrics patients because of its simplicity; and if it is found to be as accurate as sonographic measurement as some studies suggest, it may be considered for screening of foetal weight especially in low-resource settings where ultrasound is unavailable. The aim of this review is to search for various literatures where clinical methods of foetal weight estimation were used and to examine these methods critically for possible recommendation for their use among obstetrics residents and healthcare practitioners. Electronic search of Medline, Pub Med, Health Internetwork Access to Research Initiative (HINARI) and Google Scholar databases from 1953 to 10th December 2014 was conducted for studies which compared clinical and sonographic foetal weight estimation. Various formulae have been suggested by researchers over the years. The methods however depend on the clinical dexterity of clinicians' and not on specific measurements. No simple and easily applied formula has yet been suggested to transform an external maternal measurement into an estimated foetal weight. Researchers on estimation of foetal weight should work towards a consensus and reproducible formula for clinical foetal weight estimation. Symphysio fundal height (SFH) measurement with a tape-measure seems a simple clinical method because it is cheap, readily available, non-invasive and acceptable to patients. These skills should be practiced by senior obstetricians and taught to midwifes, house officers, medical officers and obstetrics residents. It is however subjected to various degrees of intra-observer and inter-observer errors and studies comparing the different formulae are lacking. Therefore, further researches are needed to improve reliability and reproducibility of these clinical methods. The reliability of other clinical methods other than Dare' method should also be explored.

Keywords: Advances, clinical estimation, foetal weight


How to cite this article:
Ugwa EA. Advances in clinical estimation of foetal weight before delivery. Niger J Basic Clin Sci 2015;12:67-73

How to cite this URL:
Ugwa EA. Advances in clinical estimation of foetal weight before delivery. Niger J Basic Clin Sci [serial online] 2015 [cited 2019 May 23];12:67-73. Available from: http://www.njbcs.net/text.asp?2015/12/2/67/158888


  Introduction Top


Accurate estimation of foetal weight is of paramount importance before delivery. During the last decade, estimated foetal weight has been incorporated into the standard routine ante-partum evaluation of high-risk pregnancies and deliveries. The most common method currently used to estimate foetal weight before delivery is clinical palpation. Fox et al. published a study confirming that foetal weight estimations by clinicians are quick, inexpensive, but inaccurate.[1]

Decisions during the management of labour regarding mode of delivery rely partly on estimation of the foetal weight. Both low birth weight and excessive foetal weight at delivery are associated with an increased risk of perinatal complications during labour and the puerperium.[2],[3] The perinatal complications associated with low birth weight are most often due to foetal prematurity, but may also arise from intra-uterine growth restriction.[3] Macrosomic foetuses also have potential complications associated with delivery which include shoulder dystocia, brachial plexus injuries, bony injuries and intra-partum asphyxia, as well as maternal risks that include birth canal injuries, pelvic floor injuries and postpartum haemorrhage.[4] The occurrence of cephalopelvic disproportion is more common with increasing foetal weight and contributes to an increased rate of both operative vaginal and caesarean deliveries for macrosomic foetuses compared with foetuses of normal weight.[5]

With proliferation in ultrasound diagnosis, clinicians especially obstetrics residents are likely to lose the skills of clinical estimation of foetal weight clinical. They may be faced with circumstances when ultrasound is not available or may not be appropriate. As such they may be left aloof. Clinical estimation of foetal weight is therefore an important and necessary skill in management of obstetrics patients because of its simplicity and if it is found to be as accurate as sonographic measurement as some studies suggest, it may be considered for screening of estimation of foetal weight especially in low-resource settings where ultrasound is unavailable.[6],[7],[8] Various degrees of accuracy of clinical and sonographic estimates have been reported by researchers both locally and globally.[8],[9],[10],[11]

Several studies have been done to establish methods for clinical foetal weight estimation. These methods adopt external measurements of the mother and offer an attractive means for determining foetal size. All of these methods however depend on the clinical dexterity of clinicians' and not on specific measurements. No simple and easily applied formula has yet been suggested to transform an external maternal measurement into an estimated foetal weight. Researchers on estimation of foetal weight should work towards a consensus and reproducible formula for clinical foetal weight estimation.

The aim of this review article is to search for various literatures where clinical methods of foetal weight estimation were used and to examine these methods critically for possible recommendation for their use among obstetrics residents and healthcare practitioners.


  Materials and Methods Top


Electronic search of Medline, Pub Med, Health Internetwork Access to Research Initiative (HINARI) and Google Scholar databases from 1953 to 10th December 2014 was conducted for studies which compared clinical and sonographic foetal weight estimation. The search was done in keywords like pregnancy, foetal weight estimation, clinical, ultrasound and delivery [Table 1].
Table 1: Results from previous research comparing clinical and sonographic foetal weight estimates

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(Most studies done in Nigeria used the Dare's method and all except Ugwu et al. found no significant difference between clinical and sonographic methods).

Methods of foetal weight estimation before delivery

Clinical methods

One of the earliest clinical methods of foetal weight estimation was clinical palpation. Several investigations have shown that the accuracy of clinical palpation for estimating foetal weight is ± 278–599 g (±7.5–19.8%) depending on foetal weight and gestational age.[15],[16],[17] The technique is best for estimating foetal weight in the reference range of 2500–4000 g. Several studies demonstrate that the accuracy of clinical palpation for estimating foetal weight <2500 g deteriorates markedly, with a mean absolute percentage error of ± 13.7–19.8%.[15],[16],[17] Only 40–49% of birth weights below the 2500 g threshold are properly estimated by means of clinical palpation to within ± 10% of the actual birth weight. When foetuses weigh <1800 g, the accuracy of such clinical estimates is reduced even further, with more than half of these predictions in error by >450 g (±25%). At the upper limit of term foetal weights, researchers have shown that the positive predictive value of clinical palpation for predicting birth weight >4000 g was 60–63%, with an associated sensitivity of 34–54%.[15],[16],[17] Furthermore, findings have suggested that the accuracy of clinical palpation for predicting foetal weight.[12] Noumi et al.[18] reported that clinical estimates were correct to within ± 10% in 72% of cases in a study of 192 parturient.

Radiological methods

The radiological methods of foetal weight estimation are the use of magnetic resonance imaging (MRI) and sonography. The use of MRI is limited because it is expensive, not readily available and concerns regarding radiation. The sonographic or ultrasonographic technique represents the newest and most technologically sophisticated method of estimating foetal weight. Modern algorithms that incorporate standard defined foetal measurements (e.g., some combination of foetal abdominal circumference [AC], femur length [FL], biparietal diameter [BPD] and head circumference [HC]) are generally comparable in their overall accuracy in predicting foetal weight. Over the past three decades, there have been many published formulae for ultrasonographic estimated foetal weight (EFW). The commonly used formulas in USA are those from Hadlock and colleagues,[19] in Great Britain formulas from Campbell and Wilkin [20] and from Shepard [21] and in Nigeria the formula from Nzeh et al.[22] With a different priority, all of them are used in most of the ultrasound diagnostic centres. The accuracy of predicting birth weight by variety of different formulas incorporating different ultrasonic measurements has been widely studied. Despite the fact that in most studies the ultrasound examinations were obtained by a single or several experienced examiners, the mean absolute percent error ranges between 6 and 15%. The formulae can be arranged into 8 groups according to the type of foetal biometric information that they rely on to make their foetal weight predictions, as follows: AC, FL, AC + FL, AC + BPD, AC + HC, AC + BPD + FL, AC + HC + FL, AC + HC + BPD + FL. The predictive value of the standard ultrasonographic foetal biometric measurements for estimating foetal weight did not increase with increasing order for any of the 4 parameters. The accuracy of EFW is compromised by large intra- and inter-observer variability. Efforts must be made to minimize this variability if EFW is to be clinically useful. This may be achieved through improvement in image quality and uniform calibration of equipment and refinement of measurement methods by averaging multiple foetal measurements and regular audit of measurement quality.

The sonographic EFW is highly correlated with birth weight. However, clinicians should be aware of the risk of overestimation in pregnancies with suspected low-for-gestational-age and underestimation in pregnancies with preterm premature rupture of membrane. There are several technical limitations of the sonographic technique for estimating foetal weight. These are maternal obesity, oligohydramnios and anterior placentation. Other disadvantages of ultrasonography are that it is both complicated and labour intensive, potentially being limited by poor visualization of foetal structure. It also requires costly sonographic equipment and specially trained personnel. Although such expensive imaging equipment is widely available in developed countries, this is generally not the case in developing nations like ours where medical resources are scarce.

Other methods

The simplest approach to birth weight prediction is to apply the mean gestational age-specific birth weight as the prediction criterion for any particular population of women in each case. This involves merely identifying the mean birth weight associated with each gestational age for the given population. This method results in fairly accurate estimations of mean foetal weight for new and demographically well-matched populations of patients, but it is a much poorer tool for estimating the actual birth weight for any particular foetus. However, the accuracy of this method can be used as a benchmark against which other techniques can be assessed for their intrinsic value beyond merely knowing the average birth weight for a particular class of patients. Any other method of accurate prediction of birth weight in individual cases must be able to improve upon the application of such "mean value" estimates in order to have added advantage. If growth curves can be found that are specific to a particular population of pregnant women (for example, specific for the maternal race, parity, foetal gender, altitude of residence and so on, of a particular class of patients), then the accuracy of this "mean-birth-weight" prediction method can be improved significantly. In order to assess the accuracy of this method, the population-specific mean birth weight for a group of Caucasian women with uncomplicated singleton term pregnancies was calculated and applied back to the same group. The mean absolute prediction error for estimating birth weight by simply the population-specific mean value in each case was reported to be ± 449 g and the mean absolute percentage prediction error was ± 13.6%.[23] Clinical risk factor assessment and maternal self-estimation are also recognized methods of foetal weight estimation.[11]

Advances made in clinical estimation of foetal weight before delivery

Many other clinical methods of foetal weight estimation have also been reviewed. These involve the use of formulae to estimate the foetal weight. Various calculations and formulae based on measuring uterine fundal height above symphysis pubis have been developed.

The first method for estimating foetal weight was that of Poulos and Langstadt.[24] They achieved an accuracy within around 250 g in 69% of estimations, with a correlation coefficient r of 0.62 to 0.70. This was the first report of external measurements to predict birth weight using external and trans-rectal measurement of the different axes of the uterus. Poulos and Langstadt based their estimations on two theories. The first was the fundamental physical law stating that for a given homogeneous mass, the weight of the mass (W) is directly proportional to its volume (V), where the density (D) is constant (W = DV). In applying this to the birth weight of an infant and the volume of a uterus, it is obvious that the volume of the uterus is not accurately known, and certain assumptions must be made. This brought about the second theory on the theoretical volume of the uterus. The volume of the uterus was assumed to be either a sphere, or an ellipsoid (an ellipse rotated around its long axis). Based on these considerations, Poulos and Langstadt suggested a foetal weight formula of: Birth weight (g) =1870 + 0.11D 3 ± 250, with D being the mean of the transverse and longitudinal uterine diameters in cm. This provided the estimates described above. All subsequent measurement formulas depend to a greater or lesser extent on Poulos and Langstadt's mathematical assumptions.

The second method was the use of symphysis fundal height (SFH) measurement as first described by Johnson and Toshach,[25] who reported accuracy within 240g in 50.5% of 200 women examined. They found that foetal weight estimation was affected also by head descent and maternal obesity, and suggested the birth weight formula, using the imperial system. Their formula was: Birth weight = 7 pounds, 8 ounces + [(M + S – O – 34) × (5.52 ounces)] where: M = height of fundus in cm S = station, subtracting 1 cm for minus stations, adding 1 cm for plus stations. O = obesity, subtracting 1 cm for women weighing over 200 pounds (91 kg). In a subsequent study, Johnson presented a simplified formula that took into account the more modern metric system. For a foetus with a non-engaged head, it was suggested that: Birth weight in g = (SFH measurement in cm – 13) × (155). Despite claims of reasonable accuracy, these authors did not validate their findings in repeat studies. This has been improved by the Johnson's formula.[26]

Third, Johnson's formula [26] for estimation of foetal weight in vertex presentation is as follows; Foetal weight (g) = FH (cm) n × 155. Where FH = fundal height and n = 12 if vertex is above ischial spine or 11 if vertex is below ischial spine. If a patient weighs more than 91 kg, 1 cm is subtracted from the fundal height. Thirdly, estimated foetal weight in grammes can also be determined by multiplying the longitudinal diameter of the uterus by the square of its transverse diameter and a factor of 1.44, then dividing the product by 2.

Fourth was Dawn's method with formula as: Estimated foetal weight = longitudinal diameter of the uterus × (transverse diameter) 2 × 1.44/2. Measurement was made with pelvimeter and if double abdominal thickness was more than 3 cm, the excess was subtracted from the transverse diameter and half of the excess from longitudinal diameter.[27] Dawn's method reportedly underestimated foetal weight.

Fifth, Ojwang et al. used the product of symphysio-fundal height (SFH) and abdominal girth (AG) measurement at various levels in centimetres above the symphysis pubis in obtaining a fairly acceptable predictive value but with considerable variation from the mean.[28]

Sixth, to further simplify Ojwang's method, Dare et al. at Ile-Ife, Nigeria, in 1990, used the product of SFH and abdominal girth at the level of the umbilicus measured in centimeters, that is, (SFH × AG) grammes. The result was expressed in grammes to estimate foetal weight at term in utero, and the estimate correlated well with birth weight.[29]

Seventh, the formula; birth weight (g) = gestational age (d) × [9.36 + 0.262 × foetal sex + 0.000237 × maternal height (cm) × maternal weight at 26 weeks (kg) + (4.81 × maternal weight gain rate (kg/d) × (parity + 1)], where foetal sex is equal to + 1 for male, -1 for female and 0 for unknown sex, and gestational age is equal to days since onset of last normal menses which equals the conception age (d)+14.[30] These methods have been recommended as a good way of foetal weight estimation in low resource communities where ultrasonography [11] or the skills for it may not be available.

Eighth was that by Bothner et al.,[31] who showed good correlation between intra-partum SFH measurement and birth weight (r = 0.56). Their equation was: Birth weight = (SFH – fifths – 20) × (300). The findings of their work done in established labour, at gestational age ranges of 27–44 weeks by dates and 25–42 weeks by ultrasound, suggested that the level of the foetal head and status of membranes, either intact or ruptured, might affect SFH measurement. However, they concluded that SFH measurement for foetal weight estimation was not clinically useful using their formula. Jeffery et al.[32] did a similar work where they reported even better correlation (r = 0.74) but could not still suggest a simple formula.[33]

Ninth is maternal-characteristics equation stated as; Birth weight (in grams) = −3044 + gestational (in days) × {[23.6+ (0.243 × foetal sex)+ (0.000281 × material height in centimeters × maternal weight at 26 wk in kilograms)+ (3.11 × maternal weight-gain rate in kilograms per day × [parity + 1]) − (0.318 × maternal hemoglobin concentration in grams per deciliter)}, where foetal sex = +1 for male, −1 for female, or 0 for unknown and gestational age = days since the onset of the last normal menses, which equals the conception age (in days) +14.[34] Prospective use of this maternal-characteristics equation yields a correlation of 0.59 between predicted and actual birth weights, with a mean absolute prediction error of 275 ± 229 g (8.0% ±7.1 of actual birth weight). In 86% of cases, the birth weight predictions were accurate to within ± 15%, and in 70% of cases, they were accurate to within ± 10% of actual birth weight.[35] The accuracy of this new method was recently tested by an independent group of investigators from the Czech Republic, who confirmed that its accuracy is comparable to that of the widely used ultrasonographic prediction equation of Shepard.[35]

The tenth method is Kongnyuy – Mbu's method. This method uses only FH to estimate foetal weight (FW) in grams [Estimated FW = 3(FH) 2]. The two authors working in the biggest maternity in Cameroon discovered that the AC of a pregnant Cameroonian woman at term is thrice the fundal height and they derived the formula from the FH × AC used routinely to estimate foetal weights in the service. The authors explained that AC is influenced by the body mass index (BMI) while fundal height is not. The inexpensive and easy availability of the non-elastic tape makes it attractive for use in foetal weight estimation in developing countries.[36]

Other methods are based on SFH alone with different correlations.[37],[38],[39] However, a lot of researchers have felt that SFH measurement alone is not sensitive or specific enough for practical use.[40],[41] Maternal obesity, level of foetal head and membrane status, a full bladder may all increase the SFH. A clear descriptions of SFH measurement have been suggested by Westin,[42] Theron [43] and Bothner.[31] Measurement should be in a supine position with an empty bladder, between uterine contractions. Two measurements should ideally be made and the average of these taken as the SFH.

The correlation between clinical EFW and actual BW is overall weak, particularly in patients with macrosomic foetuses; however, BMI, admission diagnosis and foetal station do not have a significant impact.[44]

A prudent advice is perhaps that of workers who also found a significant error estimating foetal weight by ultrasound. Therefore, they concluded that depending only on the foetal ultrasound for the estimation of foetal weight can lead to unnecessary obstetrical intervention. It is thus necessary to correlate the ultrasound findings with clinical examination.[13]

Usefulness and limitations of the advances made

SFH measurement with a tape-measure seems a simple clinical method because it is cheap, readily available, non-invasive and acceptable to patients. A simple formula for birth weight calculation based on SFH estimation of foetal weight may be required in situ ations where ultrasound facilities are not available. Even if available, such measurements may be inaccurate during labour and at term, especially if the membranes are ruptured and the presenting part is engaged in the pelvis. Clinical palpation of the abdomen in estimating foetal weight requires considerable experience and training. These skills should be practiced by senior obstetricians and taught to midwifes, house officers, medical officers and obstetrics residents. It is however subjected to various degrees of intra-observer and inter-observer errors and studies comparing the different formulae are lacking. Therefore, further researches are needed to improve reliability and reproducibility of these clinical methods. Most recent studies [14],[45] done in Nigeria are still based on Dare's formula and there is a need to explore the reliability of other formula and compare them with Dare's formula. Some studies have compared sonographic estimates and Johnson's formula and agreed that it has a high level of accuracy especially in foetuses above 3 kg.[46],[47],[48] There is need to validate these claims in recent researches.

The clinical methods of estimation of foetal weight adopt external measurements of the mother. They offer an attractive, simple, safe, cheap, non-invasive, acceptable and readily available means for determining foetal weight in utero. They however depend on the clinical dexterity of clinicians' and not on specific measurements and subjected to various degrees of intra-observer and inter-observer errors. Therefore, no simple and easily applied formula has yet been suggested to transform an external maternal measurement into an estimated foetal weight.


  Conclusion and Recommendations Top


Clinical estimation is used extensively because it is both convenient and virtually costless; however, it is a subjective method associated with notable predictive errors. Most recent studies done in Nigeria are still based on Dare's formula and there is a need to explore the reliability of other formulae such as Johnson's and compare them with Dare's formula. Researchers on estimation of foetal weight should work towards a consensus and improve reproducibility and reliable formula for clinical foetal weight estimation. These skills should be practiced by senior obstetricians and taught to midwifes, house officers, medical officers and obstetrics residents.

 
  References Top

1.
Fox NS, Bhavsar V, Saltzman DH, Rebarber A, Chasen ST. Influence of maternal body mass index on the clinical estimation of fetal weight in term pregnancies. Obstet Gynecol 2009;113:641-5.  Back to cited text no. 1
    
2.
Jolly MC, Sebire NJ, Harris JP, Regan L, Robinson S. Risk factors for macrosomia and its clinical consequences: A study of 350,311 pregnancies. Eur J Obstet Gynecol Reprod Biol 2003;111:9-14.  Back to cited text no. 2
    
3.
Patterson RM, Prihoda TJ, Gibbs CE, Wood RC. Analysis of birth weight percentile as a predictor of perinatal outcome. Obstet Gynecol 1986;68:459-63.  Back to cited text no. 3
[PUBMED]    
4.
Nocon JJ, McKenzie DK, Thomas LJ, Hansell RS. Shoulder dystocia: An analysis of risks and obstetric maneuvers. Am J Obstet Gynecol 1993;168:1732-7.  Back to cited text no. 4
    
5.
Horger EO 3rd, Miller MC 3rd, Conner ED. Relation of large birthweight to maternal diabetes mellitus. Obstet Gynecol 1975;45:150-4.  Back to cited text no. 5
    
6.
Hendrix NW, Grady CS, Chauhan SP. Clinical vs. sonographic estimate of birth weight in term parturients. A randomized clinical trial. J Reprod Med 2000;45:317-22.  Back to cited text no. 6
    
7.
Sherman DJ, Arieli S, Tovbin J, Siegel G, Caspi E, Bukovsky I. A comparison of clinical and ultrasonic estimation of fetal weight. Obstet Gynecol 1998;91:212-7.  Back to cited text no. 7
    
8.
Ugwa EA, Sule G, Ashimi A. Estimation of fetal weight before delivery in low-resource setting of North-west Nigeria: Can we rely on our clinical skills? J Matern Fetal Neonatal Med 2014:1-5.  Back to cited text no. 8
    
9.
Shittu AS, Oluwafemi K, Orji EO, Mkinde NO, Ogunniyi SO, Ayoola OO, et al. Clinical versus sonographic estimation of fetal weight in Southwest Nigeria. J Health Popul Nutr 2007;25:14-23.  Back to cited text no. 9
    
10.
Lam ET, Black JM, Little KD, Ausherman J, Rafiroiu C. The effects of exercise on birth weight: A meta-analysis. Am J Health Stud 2002;18:38-45.  Back to cited text no. 10
    
11.
Chauhan SP, Lutton TC, Bailey KJ, Morrison JC. Intrapartum prediction of birthweight: Clinical versus sonographic estimation based on femur length alone. Obstet Gynecol 1993;81:695-7.  Back to cited text no. 11
    
12.
Prechapanich J, Thitadilok W. Comparison of the accuracy of fetal weight estimation using clinical and sonographic methods. J Med Assoc Thai 2004;87 Suppl 3:S1-7.  Back to cited text no. 12
    
13.
Bajracharya J, Shrestha NS, Karki C. Accuracy of prediction of birth weight by fetal ultrasound. Kathmandu Univ Med J 2012;38:74-6.  Back to cited text no. 13
    
14.
Ugwu EO, Udealor PC, Dim CC, Obi SN, Ozumba BC, Okeke DO, et al. Accuracy of clinical and ultrasound estimation of fetal weight in predicting actual birth weight in Enugu, Southeastern Nigeria. Niger J Clin Pract 2014;17:270-5.  Back to cited text no. 14
[PUBMED]  Medknow Journal  
15.
Chauhan SP, Hendrix NW, Magann EF, Morrison JC, Kenney SP, Devoe LD. Limitation of clinical and sonographic estimates of birthweight: Experience with 1034 parturient. Obstet Gynecol 1998;91:72-7.  Back to cited text no. 15
    
16.
Chauhan SP, Cowan BD, Magann EF, Bradford TH, Roberts WE, Morrison JC. Intrapartum detection of macrosomic fetus: Clinical versus 8 sonographic models. Aust NZ J Obstet Gynaecol 1995;35:266-70.  Back to cited text no. 16
    
17.
Sarmandal P, Bailey SM, Grant JM. A comparison of three methods of assessing inter-observer variation applied to ultrasonic fetal measurement in the third trimester. Br J Obstet Gynaecol 1989;96:1261-5.  Back to cited text no. 17
    
18.
Noumi G, Collado-Khoury F, Bombard A, Julliard K, Weiner Z. Clinical and sonographic estimation of fetal weight performed during labor by residents. Am J Obstet Gynecol 2005;192:1407-9.  Back to cited text no. 18
    
19.
Hadlock FP, Harrist RB, Carpenter RJ, Deter RL, Park SK. Sonographic estimation of fetal weight: The value of femur length in addition to head and abdominal measurements. Radiology 1984;150:535-40.  Back to cited text no. 19
[PUBMED]    
20.
Campbell S, Wilkin D. Ultrasonic measurement of the fetal abdominal circumference in estimation of fetal weight. Br J Obstet Gynecol 1975;82:689-97.  Back to cited text no. 20
    
21.
Shepard MJ, Richards VA, Berkowitz RI, Warsof SL, Hobbins JC. An evaluation of two equations for predicting fetal weight by ultrasound. Am J Obstet Gynecol 1982;142:47-54.  Back to cited text no. 21
    
22.
Nzeh DA, Rimmer S, Moore WM, Hunt L. Prediction of birth weight by ultrasound biometry. Br J Radiol 1992;66:987-9.  Back to cited text no. 22
    
23.
Combs CA, Jaekle RK, Rosenn B, Pope M, Miodovnik M, Siddiqi TA. Sonographic estimation of fetal weight based on a model of fetal volume. Obstet Gynecol 1993;82:365-70.  Back to cited text no. 23
    
24.
Poulos P, Langstadt JR. The volume of the uterus during labor and its correlation with birth weight. I. A method for the prediction of birth weight. Am J Obstet Gynecol 1953;65:233-44.  Back to cited text no. 24
    
25.
Johnson RW, Toshach CE. Estimation of fetal weight using longitudinal mensuration. Am J Obstet Gynecol 1954;68:891-6.  Back to cited text no. 25
[PUBMED]    
26.
Johnson RW. Calculations in estimating fetal weight. Am J Obstet Gynecol 1957;74:929.  Back to cited text no. 26
[PUBMED]    
27.
Dawn CS, Modak GS, Ghosh A. A simple procedure for determination of antenatal fetal weight. J Obstet Gynecol Ind 1983;33:133-7.  Back to cited text no. 27
    
28.
Ojwang S, Ouko BC. Prediction of fetal weight in utero by fundal height/girth measurements. J Obstet Gynecol East Central Afr 1984;3:111.  Back to cited text no. 28
    
29.
Dare FO, Ademowore AS, Ifaturoti OO, Nganwuchu A. The value of symphysiofundal height/abdominal girth measurement in predicting fetal weight. Int J Gynaecol Obstet 1990;31:243-8.  Back to cited text no. 29
    
30.
Nahum GG. Estimation of fetal weight — An editorial. Available from: http://www.emedicine.com [Last assessed on 2014 Dec 10].  Back to cited text no. 30
    
31.
Bothner BK, Gulmezoglu AM, Hofmeyr GJ. Symphysis fundus height measurements during labour: A prospective, descriptive study. Afr J Reprod Health 2000;4:48-55.  Back to cited text no. 31
    
32.
Jeffery BS, Pattinson RC, Makin J. Symphysis-fundal measurement as a predictor of low birthweight. Early Hum Dev 2001;63:97-102.  Back to cited text no. 32
    
33.
Bhandary AA, Pinto PJ, Shetty AP. Comparative study of various methods of fetal weight estimation at term pregnancy. J Obstet Gynecol Ind 2004;53:336-9.  Back to cited text no. 33
    
34.
Nahum GG, Stanislaw H. Validation of a birth weight prediction equation based on maternal characteristics. J Reprod Med 2002;47:752-60.  Back to cited text no. 34
    
35.
Halaska MG, Vlk R, Feldmar P, Hrehorcak M, Krcmar M, Mlcochova H, et al. Predicting term birth weight using ultrasound and maternal characteristics. Eur J Obstet Gynecol Reprod Biol 2006;128:231-5.  Back to cited text no. 35
    
36.
Kongnyuy EJ, Mbu ER. Estimation of foetal weight at term using maternal characteristics: The Kongnyuy-Mbu's formula. Eur J Obstet Gynaecol Reprod Biol 2006;231-5.  Back to cited text no. 36
    
37.
Bergström S, Liljestrand J. Parturient fundal height and its relation to fetal weight. J Trop Paediatr 1989;35:27-30.  Back to cited text no. 37
    
38.
Walraven GE, Mkanje RJ, van Roosmalen J, van Dongen P, van Astern HA, Dolmans WM. Single pre-delivery symphysis-fundal height measurement as a predictor of birthweight and multiple pregnancy. Br J Obstet Gynaecol 1995;102:525-9.  Back to cited text no. 38
    
39.
Labrecque M, Boulianne N. Estimation of birth weight by measuring the height of the uterus in the parturient women in the Islamic Federal Republic of the Comoro Islands. Rev Epidemiol Sante Publique 1987;35:378-85.  Back to cited text no. 39
    
40.
Woo JS, Ngan HY, Au KK, Fung KP, Wong VC. Estimation of fetal weight in utero from symphysis-fundal height and abdominal girth measurements. Aust N Z J Obstet Gynaecol 1985;25:268-71.  Back to cited text no. 40
[PUBMED]    
41.
Pschera H, Söderberg G. Estimation of fetal weight by external abdominal measurements. Acta Obstet Gynecol Scand 1984;63:175-9.  Back to cited text no. 41
    
42.
Westin B. Gravidogram and fetal growth. Comparison with biochemical supervision. Acta Obstet Gynecol Scand 1977;56:273-82.  Back to cited text no. 42
[PUBMED]    
43.
Woods DL, Theron GB, Greenfield DH. Perinatal education programme. Manual I: Maternal care. Cape Town: Perinatal Education Programme; 1993. p. 2-3.  Back to cited text no. 43
    
44.
Goetzinger KR, Odibo AO, Shanks AL, Roehl KA, Cahill AG. Clinical accuracy of estimated fetal weight in term pregnancies in a teaching hospital. J Matern Fetal Neonatal Med 2014;27:89-93.  Back to cited text no. 44
    
45.
Njoku C, Emechebe C, Odusolu P, Abeshi S, Chukwu C, Ekabua J. Determination of accuracy of fetal weight using ultrasound and clinical fetal weight estimations in calabar south, South Nigeria. Int Sch Res Not 2014. DOI: [10.1155/2014/970973].  Back to cited text no. 45
    
46.
Alnakash AH, Mandan DR. Fetal body weight: How far the clinical and sonographic estimations can coincide. Iraq J Community Med 2013;180-3.  Back to cited text no. 46
    
47.
Sauceda Gonzalez LF, Ramirez Sordo J, Rivera Flores S, Falcón Martínez JC, Zarain Llaguno F. Multicenter study of fetal weight estimation in term pregnancies. Ginecol Obstet Mex 2003;71:174-80.  Back to cited text no. 47
    
48.
Cury AF, Garcia SA. Estimation of fetal weight: Comparison between a clinical method and ultrasonography. Rev Bras Ginecol Obstet 1998;20:551-5.  Back to cited text no. 48
    



 
 
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