[Fetal weight estimation during labour: comparison of the clinical and ultrasonographic approaches].
OBJECTIVE
The estimation of the fetal weight is of major interest in many situations when the route of delivery has to be determined: breech presentations, diabetes and suspected macrosomia. The objective was to evaluate the accuracy of different methods for estimating fetal weight (EFW) during labour. A quality audit of the ultrasound images was also performed.


METHODS
This was a prospective study performed in thirty patients at 37 weeks gestation or more, during the second stage of labour. The accuracy of clinical versus ultrasonographic (US) approach for EFW was tested (by two formulas according to Hadlock, with one that does not account head circumference [HC]). The ultrasound images' quality was also evaluated.


RESULTS
The clinical assessment was significantly more accurate (-1 ± 8.5%) than the US approach using the formula with HC (-8 ± 9.8 %) (P<0.01). This difference was not found when choosing the formula without HC. Analysis of ultrasound images for abdomen and femur showed 74% and 89% of satisfactory measurements respectively, but only 43% for HC.


CONCLUSIONS
These results did not demonstrate a superiority of the US over the clinical approach for EFW during labour. Taking into account the cephalic measurements appeared as a limitation of the accuracy of US formulas.
Maternité régionale universitaire de Nancy, 10, rue du Docteur-Heydenreich, 54000 Nancy, France; UHP-Inserm (U947) CIC-IT 801, imagerie adaptative diagnostique et interventionnelle, CHU de Nancy Brabois, 54511 Vandœuvre-lès-Nancy, France. Electronic address: e.perdriolle@gmail.com.
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Perdriolle-Galet
Pôle femme mère couple, hôpital Paule-de-Viguier, 330, avenue de Grande-Bretagne, 31000 Toulouse, France.
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Thiebaugeorges
Maternité régionale universitaire de Nancy, 10, rue du Docteur-Heydenreich, 54000 Nancy, France.
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Lamy
Maternité régionale universitaire de Nancy, 10, rue du Docteur-Heydenreich, 54000 Nancy, France.
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Makke
Maternité régionale universitaire de Nancy, 10, rue du Docteur-Heydenreich, 54000 Nancy, France.
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Barbier
Maternité régionale universitaire de Nancy, 10, rue du Docteur-Heydenreich, 54000 Nancy, France.
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Monceau
Maternité régionale universitaire de Nancy, 10, rue du Docteur-Heydenreich, 54000 Nancy, France; UHP-Inserm (U947) CIC-IT 801, imagerie adaptative diagnostique et interventionnelle, CHU de Nancy Brabois, 54511 Vandœuvre-lès-Nancy, France; Fondation PremUP, 4, avenue de l'Observatoire, 75006 Paris, France.
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Morel
D000293:Adolescent; D000328:Adult; D005260:Female; D020567:Fetal Weight / Q000502:physiology*; D005865:Gestational Age; D006801:Humans; D007743:Labor, Obstetric; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000592:standards*; D016216:Ultrasonography, Prenatal / Q000592:standards*; D055815:Young Adult
Fetal weight; Macrosomia; Macrosomie; Poids fœtal; Ultrasound; Échographie