[Use of language in relationship with pregnant women in general--and with ultrasound scanning in particular].
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Communication↗
Biomedical subjects
B M Weldner
Publications and source records attributed to B M Weldner.
Reliability of ultrasound fetometry in estimating gestational age in the second trimester.
The reliability of ultrasound fetometry for estimating gestational age (GA) in the second trimester was evaluated, using the fetal variables: biparietal diameter (BPD), occipitofrontal diameter (OFD), mean abdominal diameter (AD), and femur length (FL), each value being taken as the mean of five measurements. Of the individual variables, BPD gave the best precision, with a standard deviation (SD) from true GA of 3.2 days. Using a combination of all four variables, GA could be estimated with a SD of 2.2 days, which was not significantly better than the formula, GA = BPD X 1.2 + FL X 1.0 + 49, which gave results with a SD of 2.4 days. Equations obtained from regression analysis of the variables against true GA were tested in 44 cases where the precise date of conception was known, GA being estimated by BPD with a SD of 3.2 days, and by the combination of BPD and FL with a SD of 2.7 days; the maximum difference between GA estimated by BPD and by FL was 7 days. Using a combination of BPD and FL to estimate GA in the total population, the number of post-term deliveries was only marginally less than when using BPD alone.
Anthropometry↗
Growth in breech presentation. Ultrasound and post-partal assessment of growth in 225 fetuses presenting by the breech in the 33rd gestational week.
225 fetuses with ultrasonically determined gestational age were shown by ultrasound to be in breech presentation in the 33rd gestational week. The biparietal diameter (BPD) and the mean of two perpendicular abdominal diameters (AD) were measured ultrasonically in gestational weeks 33, 35, and 38. Based on these measurements, fetal weight was estimated and compared with weight, length, and head circumference at birth and at 18 months of age. 42% of the fetuses were born in breech presentation (breech group) and 58% in vertex presentation (vertex group). The mean birth weight corrected for gestational age was 4.9% lower in the breech group than in the vertex group, which corresponds to the lower intra-uterine values of BPD and AD found in the breech group. The weight differences at birth still persisted at 18 months of age. There were no differences between the groups regarding head circumference or length, either at birth or at 18 months of age.
Birth Weight↗
Intra-uterine weight curves obtained by ultrasound.
Using multiple regression analysis, a formula was evolved for estimating fetal weight in utero, based on fetal biparietal diameter (BPD), abdominal diameter (AD) (mean of two orthogonal readings), and femur length (FL), measured by ultrasound within 48 hours before delivery or legal abortion in a stratified sample of 89 pregnancies, approx. 10 in each 500-g weight class up to 5 000 g. Tested on 135 neonates of varying birth weights, the formula evolved, wt = BPD0.972 X AD1.743 X FL0.367 X 10(-2.647), neither under- nor over-estimated weight in any weight class, the error in estimates having a standard deviation of 7.1%, and maximum error being 18% of true weight. To establish an intrauterine growth curve, the formula was applied to 177 longitudinal measurements in 19 normal pregnancies; the estimated weight against gestational age (GA) curve so obtained best fitted a third-degree equation, wt = 1443.4 - 32.32 X GA + 0.203 X GA2 - 0.000215 X GA3 (r2 = 0.978), tallying closely with the birth weight curve obtained in the same population from 4743 pregnancies where gestational age had been assessed by ultrasound in early pregnancy. The present two growth curves, based on fetometry and on birth weight, differ from previous curves used almost universally by pediatricians.
Abdomen↗
Normal range growth curves for fetal biparietal diameter, occipito frontal diameter, mean abdominal diameters and femur length.
Normal range curves for the growth of fetal biparietal diameter (BPD), occipitofrontal diameter (OFD), mean abdominal diameter (AD), and femur length (FL) were obtained in a longitudinal series of ultrasound measurements in 19 normal pregnancies. Regression analysis was used to fit the data to equations. The best equations for BPD and AD on gestational are close to similar longitudinally obtained regression curves from other Scandinavian countries.
Adult↗
Prenatal diagnosis of dwarfism by ultrasound screening.
In a general, ultrasound screening programme, 12 453 women were examined at 16 and 32 weeks of pregnancy. The screening detected all limb deformities in the population during the study period. The seeming prevalence of dwarfism in the population was 750 per million.
Dwarfism↗
Maternal and fetal factors in breech presentation.
The authors used ultrasound examination in an attempt to identify fetal and environmental differences between breech and vertex presentations. During a period of 13 months, 228 pregnancies with the fetus in breech position were found by routine ultrasound screening in the 33rd gestational week. Before delivery, 132 fetuses (58%) turned to vertex presentation and 96 (42%) remained in breech presentation. Fetal growth, posture, position, placental site, and amniotic fluid volume in the 33rd, 35th, and 38th gestational weeks were studied. In contrast to earlier proposed theories, no difference between the two groups (breech and vertex) was found regarding the frequency of extended fetal legs and cornual-fundal placental implantation. However, the neonates born in breech presentation had a shorter gestational age by ten days at delivery, and preterm delivery was more common. At birth, the breech neonates weighed 4.9% less than their vertex controls in relation to gestational age. In the breech group, there was an increased frequency of oligohydramnios, contracted pelvis, and uterine and fetal malformations. These conditions occurred only in 15% of the breech pregnancies; in the remaining 85%, no single cause of the breech presentation could be identified.
Adult↗
[Scholarship report: from the 5th World Congress on Ultrasound in medicine and Biology].
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Female↗
Accuracy of fetal sex determination by ultrasound.
The accuracy of fetal sex determination was tested in 101 consecutive pregnancies routinely examined by ultrasound in the 32nd gestational week. Sex determination was done when penis/scrotum or vulva could be discerned between the thighs of the fetus. Fetal sex could be determined in 75 per cent of the male infants and in 73 per cent of the females. The wrong sex was determined in 3 per cent of all examinations. In 25 and 21 per cent of female and male fetuses respectively sex determination could not be accomplished. The results were better in the 32nd than in the 38th week. The significance of fetal sex determinations is discussed.
Diagnostic Errors↗