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Scientific basis for standardization of fetal head measurements by ultrasound: a reproducibility study.

Napolitano, R; Donadono, V; Ohuma, EO; Knight, CL; Wanyonyi, SZ; Kemp, B; Norris, T; Papageorghiou, AT (2016) Scientific basis for standardization of fetal head measurements by ultrasound: a reproducibility study. Ultrasound in Obstetrics & Gynecology, 48 (1). pp. 80-85. ISSN 1469-0705 https://doi.org/10.1002/uog.15956
SGUL Authors: Papageorghiou, Aris

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Abstract

OBJECTIVE: To compare the standard methods for ultrasound measurement of fetal head circumference (HC) and biparietal diameter (BPD) (outer-to-outer (BPDoo) vs outer-to-inner (BPDoi) caliper placement), and compare acquisition of these measurements in transthalamic (TT) vs transventricular (TV) planes. METHODS: This study utilized ultrasound images acquired from women participating in the Oxford arm of the INTERGROWTH-21(st) Project. In the first phase of the study, BPDoo and BPDoi were measured on stored images. In the second phase, real-time measurements of BPD, occipitofrontal diameter (OFD) and HC in TT and TV planes were obtained by pairs of sonographers. Reproducibility of measurements made by the same (intraobserver) and by different (interobserver) sonographers, as well as the reproducibility of caliper placement and measurements obtained in different planes, was assessed using Bland-Altman plots. RESULTS: In Phase I, we analyzed ultrasound images of 108 singleton fetuses. The mean intraobserver and interobserver differences were < 2% (1.34 mm) and the 95% limits of agreement were < 5% (3 mm) for both BPDoo and BPDoi. Neither method for measuring BPD showed consistently better reproducibility. In Phase II, we analyzed ultrasound images of 100 different singleton fetuses. The mean intraobserver and interobserver differences were < 1% (2.26 mm) and the 95% limits of agreement were < 8% (14.45 mm) for all fetal head measurements obtained in TV and TT planes. Neither plane for measuring fetal head showed consistently better reproducibility. Measurement of HC using the ellipse facility was as reproducible as HC calculated from BPD and OFD. OFD by itself was the least reproducible of all fetal head measurements. CONCLUSIONS: Measurements of BPDoi and BPDoo are equally reproducible; however, we believe BPDoo should be used in clinical practice as it allows fetal HC to be measured and compared with neonatal HC. For all head measurements, TV and TT planes provide equally reproducible values at any gestational age, and HC values are similar in both planes. Fetal head measurement in the TT plane is preferable as international standards in this plane are available; however, measurements in the TV plane can be plotted on the same standards. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

Item Type: Article
Additional Information: © 2016 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Keywords: biparietal diameter, fetal head biometry, head circumference, occipitofrontal diameter, reproducibility, transthalamic and transventricular plane, ultrasound, variability, Obstetrics & Reproductive Medicine, 1114 Paediatrics And Reproductive Medicine
SGUL Research Institute / Research Centre: Academic Structure > Institute of Medical & Biomedical Education (IMBE)
Academic Structure > Institute of Medical & Biomedical Education (IMBE) > Centre for Clinical Education (INMECE )
Journal or Publication Title: Ultrasound in Obstetrics & Gynecology
ISSN: 1469-0705
Language: eng
Dates:
DateEvent
1 July 2016Published
29 April 2016Accepted
9 May 2016Published Online
Publisher License: Creative Commons: Attribution 3.0
Projects:
Project IDFunderFunder ID
UNSPECIFIEDBill and Melinda Gates Foundationhttp://dx.doi.org/10.13039/100000865
PubMed ID: 27158767
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/108121
Publisher's version: https://doi.org/10.1002/uog.15956

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