[The estimation of fetal weight by measurement of the adipose tissue of the extremities. Use in the diagnosis of hypotrophy].
OBJECTIVE
To investigate the accuracy of small for age fetuses diagnosis by a new method of fetal weight estimation, in comparison with some others models. A retrospective study.


METHODS
From a 232 fetuses population, whom age is known, ultrasound measurement have been performed (BPD, TBD, FL, AC and thigh circumference). Three physicians collaborated to data collection. All measurement have been done within a 3 days duration between measuring and birth in order to compare actual and calculated weight. There are 39 small fetuses coming from 10th percentile (17.5%), between then 24 from 5th percentile.


RESULTS
Positive predictive value (PPV) of small for age diagnosis (from 10th P) by our model is 74% with a 74% sensibility and a 94% specificity. With Warsof estimation model, the PPV is only 47% with a 71% sensibility and a 83% specificity (p = 0.001).


CONCLUSIONS
Limbs subcutaneous fat ultrasound measurement improve considerably fetal weight estimation quality (mean error = 6% vs 10% for most of the classical models) and, as an extension, small for age fetuses diagnosis. The cutaneous and subcutaneous circumferences, between which is situated fat tissue have a better individual correlation to actual weight than abdominal circumference, usually considered as the best trophicity parameter.


CONCLUSIONS
High positive predictive value show long term predictive detection possibility. It appears that this diagnosis could be done earlier with a better accuracy that the classical ultrasound biometry.
Balouet
P
P
Service de Gynéco-Obstétrique, CHRU, Hôpital Clemenceau, Caen.
Hamel
P
P
Domessent
D
D
Allouche
C
C
Speckel
D
D
Barjot
P
P
Herlicoviez
M
M
D000005:Abdomen / Q000196:embryology; D000273:Adipose Tissue / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D001835:Body Weight; D005121:Extremities / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D005260:Female; D005269:Femur / Q000196:embryology; D005317:Fetal Growth Retardation / Q000175:diagnosis*; D005333:Fetus / Q000033:anatomy & histology*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D011247:Pregnancy; D011446:Prospective Studies; D012886:Skull / Q000196:embryology; D013848:Thigh / Q000196:embryology; D016216:Ultrasonography, Prenatal
Estimation du poids foetal par la mesure de la graisse des membres. Application au diagnostic de l'hypotrophie.