PubMed · 12455394
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J Madeleine Nash. 2002-11-11. Inside the womb.. https://pubmed.ncbi.nlm.nih.gov/12455394/
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OBJECTIVE: Female fetuses, on average, weigh less than male fetuses at all gestational ages. The purpose of this study was to compare female and male fetuses in terms of intrauterine ultrasound growth measurements and to develop gestational-age-related charts based on a computerized perinatal database. METHODS: This was a retrospective study of unselected women in the second and third trimesters of pregnancy, who had a normal scan at 10-14 weeks. Data analysis was performed using measurements obtained from a mixed-race population of 4234 women, who underwent 5198 ultrasound examinations. The scans were performed by four trained sonographers, according to a standardized protocol. Routine measurements included biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL). The main end-points were sex- and race-specific differences in fetal biometry, which were also used to estimate fetal weight. RESULTS: The base-line demographic characteristics and risk factors were comparable in female and male fetuses. Significant differences in fetal BPD, HC, AC and estimated fetal weight, but not FL, were seen between male and female fetuses. Centile charts for each of these variables were constructed for both male and female fetuses. CONCLUSIONS: This study suggests that small but consistent sex-related differences in prenatal BPD, HC and AC measurements are established by as early as 15 weeks of gestation. The use of sex-specific nomograms may improve the prenatal assessment of fetal growth as well as the diagnosis of structural abnormalities.
Control of fetal lung growth and development is exquisitely orchestrated and regulated. Branching morphogenesis is carefully choreographed with cell growth, proliferation, differentiation, and apoptosis in a spatially and temporally dependent manner. Some of the signals and pathways mediating these events have recently been uncovered, but much remains unknown. The precise etiologic derangements that give rise to pulmonary hypoplasia in congenital diaphragmatic hernia remain elusive. Some clues have been discovered in developmental and signaling pathways that include receptor tyrosine kinase growth factors, homeobox genes, transcription factors, airway distension, retinoid signaling, and oxidation-reduction.
AIM: To develop and validate a graphical method for ultrasonic foetal weight estimation with predictive qualities comparable to state-of-the-art computational methods. METHOD: Study data were obtained from 3839 consecutive singleton pregnancies with ultrasound examination within 7 days of delivery. We translated the well established Hadlock 2-parameter formula based on abdomen circumference and femur length into a nomogram [corrected]. We compared the measured foetal weight with estimations obtained from this new nomogram and three other methods. RESULTS: Measured by the foetal weight percentage error the new nomogram underestimates the foetal weight on average by 2.5 % (9.86) (mean [SD]) with uniform results over the complete birth weight spectrum. By the same measurement the Hadlock 4-parameter formula underestimates the foetal weight by 1.2 % (9.3) whereas the Hansmann nomogram overestimates the foetal weight by 14.5 % (16.1) The difference between the estimated foetal weight percentage error obtained from the new nomogram and from the Hadlock 2-parameter formula is 0.06 % (0.27) and hence clinically irrelevant. CONCLUSION: The new nomogram has predictive qualities comparable to state-of-the-art computational methods and is thus not only as reliable but also easy to use in situations when computers are not available. It can be recommended for foetal weight estimation over the whole spectrum of birth weight.