Three-dimensional US assessment of hepatic volume, head circumference, and abdominal circumference in healthy and growth-restricted fetuses.
OBJECTIVE
To establish reproducibility and normal values for fetal hepatic volume and its significance in identification of fetal growth restriction relative to head and upper abdominal circumferences according to a cross-sectional study design.


METHODS
Pregnant women (n = 135) underwent ultrasonography. The coefficient of variation (CV) for hepatic volume scans obtained at 0 and 20 minutes and hepatic area tracings, performed twice for each scan, was determined (n = 20; range, 23-36 weeks). Normal data for hepatic volume and head and upper abdominal circumferences were obtained (n = 85; range, 20-36 weeks) and related to data from growth-restricted fetuses (birth weight < P5 centile; n = 24; range, 22-36 weeks).


RESULTS
CV was 2.9% for volume scans and 1.6% for area tracings. In 85 uncomplicated cases, mean fetal hepatic volume (P50 centile) was 9.7 mL +/- 4.4 (SD) at 20 weeks and 96.4 mL +/- 8.2 at 36 weeks of gestation. In 24 growth-restricted fetuses, hepatic volume, head circumference, and upper abdominal circumference expressed as percentages of the normal P50 centile were 45%, 90%, and 82%, respectively. Mean difference in hepatic volume between fetal growth restriction and normal fetal development, as expressed with the z score, -4.32 +/- 1.4, was significantly different (P <.05) from that for head circumference, -3.04 +/- 1.3, but not from that for upper abdominal circumference, -4.7 +/- 1.2. Fetal hepatic measurement was obtained in 109 pregnancies.


CONCLUSIONS
Acceptable reproducibility exists for hepatic volume determinations. In fetal growth restriction, reduction is more pronounced for hepatic volume than for head or upper abdominal circumference; hepatic volume is a better discriminator than head circumference but not upper abdominal circumference.
Boito
Simona M E
SM
Department of Obstetrics and Gynaecology, Erasmus University Medical Centre, University Hospital Rotterdam-Dijkzigt, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
Laudy
Jacqueline A M
JA
Struijk
Piet C
PC
Stijnen
Theo
T
Wladimiroff
Juriy W
JW
D000005:Abdomen / Q000000981:diagnostic imaging / Q000196:embryology*; D003430:Cross-Sectional Studies; D005314:Embryonic and Fetal Development; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging*; D005865:Gestational Age; D006257:Head / Q000000981:diagnostic imaging / Q000196:embryology*; D006801:Humans; D021621:Imaging, Three-Dimensional; D016014:Linear Models; D008099:Liver / Q000000981:diagnostic imaging / Q000196:embryology*; D011247:Pregnancy; D012016:Reference Values; D015203:Reproducibility of Results; D016216:Ultrasonography, Prenatal