The predictive value of first trimester fetal volume measurements, a prospective cohort study.

Autor: Smeets NA; Department of Gynecology and Obstetrics, Atrium Medical Centre, Heerlen, The Netherlands. n.smeets@atriummc.nl, Winkens B, Prudon M, de Ven Jv, Gondrie VP, van Deursen F, Oei SG
Jazyk: angličtina
Zdroj: Early human development [Early Hum Dev] 2013 May; Vol. 89 (5), pp. 321-6. Date of Electronic Publication: 2012 Dec 14.
DOI: 10.1016/j.earlhumdev.2012.11.001
Abstrakt: Objectives: To determine if fetal volume (FV) measurements with three-dimensional ultrasound in the first trimester of pregnancy can detect the fetus at risk for preterm birth and/or low birth weight.
Methods: In this prospective cohort study, 538 participants were included during the routine first trimester ultrasound examination. Volume measurements were performed with VOCAL (9°). Firstly, the relation between FV and gestational age for a set of participants with normal pregnancies (training set), was assessed using multiple linear regression analysis, which was then used to determine the expected normal values. Secondly, for a new set of participants with normal pregnancies and a set of participants with complicated pregnancies (preterm birth and/or low birth weight), i.e. the validation set, the observed fetal volumes (FVobserved) were compared with their expected normal values (FVexpected) and expressed as a percentage of the expected normal value. The difference in mean percentage was then assessed with independent-samples t-test. Finally, logistic regression analysis was applied to the validation set to analyze the ability to predict the pregnancy outcome with FV calculation.
Results: Linear regression analysis of FV as a predictor of preterm birth and/or low birth weight did not result in significant (p=0.630 and 0.290, respectively) or clinical relevant results (standardized effect sizes of 0.061 and 0.179, respectively). The predicting quality was also very low (AUC=0.508 and 0.545 respectively).
Conclusions: Fetal volume measurements in the first trimester of pregnancy are not useful as a prognostic tool for predicting pregnancies of high risk for preterm birth or a low birth weight.
(Copyright © 2012 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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