title: Accuracy in estimating fetal urinary bladder volume using a modified ultrasound technique.
abstract: OBJECTIVE
  Fetal urine production at different gestational ages has been evaluated using ultrasound in several previous studies. In a recent study, we investigated the accuracy when estimating the bladder volume using the conventional ultrasound technique and found a total variability of 17.3-10.9% for bladder volumes of 5-40 mL. The variability is mainly caused by: (i) inappropriate image selection (the 'freezing error') and (ii) limitations when measuring on the frozen image (the 'frozen error'). The aim of this study was to reduce the total error by reducing the 'freezing' and the 'frozen error'. To this end, we used a modified manual ultrasound technique (adding a 'rocking' motion to the conventional method) and digitized the selected image.
  
  
  METHODS
  Two patients for each gestational week from 24 to 40 weeks were selected. The fetal urinary bladder was examined with ultrasound three times within 1 min and documented on videotape. The volume, as assessed by the longitudinal section of the recorded bladder images, stored in digitized form, was evaluated on three occasions with > 24 h in between. The mean and variability (standard deviation, SD) were estimated.
  
  
  RESULTS
  For fetal bladder volumes between 5 and 40 mL, the 'freezing error' (SD), the 'frozen error' and the 'total error' were 11.7-5.1%, 8.0-3.0% and 14.2-5.9%, respectively. Comparing the present with a previous study, when selecting images and assessing bladder volumes repeatedly within 1 min, SD was 12.9-5.5% vs. 17.3-10.9%.
  
  
  CONCLUSIONS
  Using a modified ultrasound technique, the variability in fetal bladder volume estimation can be reduced.
authors.affiliation: Department of Obstetrics and Gynaecology, North Elfsborg County Hospital, Trollhättan, Sweden. mats.fagerquist@vgregion.se
authors.forename: M
authors.initials: M
authors.lastname: Fägerquist
authors.forename: U
authors.initials: U
authors.lastname: Fägerquist
authors.forename: H
authors.initials: H
authors.lastname: Steyskal
authors.forename: A
authors.initials: A
authors.lastname: Odén
authors.forename: S G
authors.initials: SG
authors.lastname: Blomberg
mesh_terms: D000328:Adult; D003198:Computer Simulation; D005314:Embryonic and Fetal Development; D005260:Female; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D013548:Sweden; D016216:Ultrasonography, Prenatal / Q000379:methods*; D001743:Urinary Bladder / Q000000981:diagnostic imaging* / Q000196:embryology*