Bor-Lin Yao

Three-Dimensional Ultrasound-Assessed Fetal Thigh Volumetry in Predicting Birth Weight

Objective To compare the accuracy of three-dimensional ultrasound-assessed fetal thigh volumetry in predicting birth weight with that of other commonly used formulas composed of biparietal diameter (BPD), abdominal circumference (AC), and femur length (FL) by two-dimensional ultrasound. Methods We assessed the thigh volume of 100 fetuses using three-dimensional ultrasound. Meanwhile, their BPD, AC, and FL were measured by two-dimensional ultrasound. All infants were delivered within 48 hours after the ultrasound examinations. From polynomial regression analysis, we generated a best-fit formula for the thigh volume to predict birth weight. The accuracy of this thigh-volume formula was compared with those of three formulas commonly used in the United States. In addition, another group of 50 fetuses was measured for prospective validation. Results The thigh volume assessed by three-dimensional ultrasound was highly correlated with birth weight (r = 0.89, n = 100, P < .0001). The best-fit formula for thigh volume to predict birth weight was linear, and it was superior to the other commonly used two-dimensional formulas in predicting birth weight. The predicting error (0 g), percent error (0.7%), absolute error (176.1 g), and absolute percent error (5.8%) of the thigh-volume formula were all smaller than those of the other formulas (n = 100, all P < .05). In addition, the thigh-volume formula predicted birth weight more accurately than the other two-dimensional formulas in the prospective-validation group. The three-dimensional formula had smaller mean values of predicting error (38.6 g), percent error (1.5%), absolute error (160.0 g), and absolute percent error (5.1%) than the two-dimensional formulas (n = 50, all P ≤ .001), as well as the smallest variances of the above errors (178.1 g, 5.6%, 84.3 g, and 2.9%, respectively). Conclusion The three-dimensional ultrasound-assessed thigh volume has better accuracy in predicting birth weight than the commonly used formulas by two-dimensional ultrasound, and it may improve fetal weight prediction in clinical practice. However, a large-scale prospective validation study may be needed to confirm our conclusions.

Predicting birth weight by fetal upper-arm volume with use of three-dimensional ultrasonography.

OBJECTIVE Our purpose was to determine the usefulness and accuracy of the three-dimensional ultrasonography assessed fetal upper-arm volume in predicting birth weight. STUDY DESIGN From June 1996 to October 1996, we performed a prospective study of ultrasonography on 105 pregnant women without fetal structural anomaly or aneuploidy. Both the traditional two-dimensional ultrasonographic parameters and three-dimensional ultrasonography for fetal upper arm volume were measured within 48 hours of delivery. RESULTS The upper arm volume correlated well with birth weight (r = 0.92, n = 105, p < 0.0001). With use of linear and polynomial regression, we obtained a best-fit new formula, Birth weight = 1088.60 + 36.024 x Upper-arm volume. The accuracy of this new formula is compared with that of two Chinese equations predicting fetal weight reported before and other formulas commonly used in the world as well. Our formula is more accurate in predicting birth weight than all the other formulas by traditional two-dimensional ultrasonography, either in error, percentage error, or absolute error. Another group by prospective validation further proved this finding. CONCLUSION The upper-arm volume assessed by three-dimensional ultrasonography can accurately predict birth weight, and its accuracy is superior to the previous, formulas. Our study has at least validated the application of upper-arm volume by three-dimensional ultrasonography in estimating fetal weight. Further larger series are needed to confirm our findings.

The perception of menopause among women in Taiwan

OBJECTIVES Hormone replacement therapy (HRT) has become a popular topic and the subject of many newspaper and magazine health articles in the last 5 years in Taiwan, so a great deal of knowledge about the menopause has been introduced to Taiwanese women. With this massive change, we wanted to know the current perception of the menopause among women in Taiwan and also evaluate the prevalence of various acute menopausal symptoms and womens attitudes toward receiving hormone replacement therapy. METHODS We designed a cross-sectional study, using structured questionnaires, targeting women who attended the health information seminar on the menopause and HRT, held in an urban area in Taiwan. The audience was asked to fill out the questionnaire before the seminar began. More than 2000 questionnaires were collected, but only 386 women completed all items of the questionnaire and were included in this study. Among them, 161 women were postmenopausal and their answers to questions regarding acute menopausal symptoms were collected for statistical analysis. The other 225 women were non-menopausal and their perception of menopausal symptoms was also collected for analysis. Qualitative data, in the form of transcripts, were interpreted using text-based content analysis. RESULTS Among these women, 375/386 (97%) had previously heard of the menopause, but only 207/386 (53%) knew the definition of the term. The most commonly indicated source of knowledge on the menopause was reading material, such as newspapers and magazines 283/386 (43%); less common sources of information were friends 141/386 (22%), medical personnel 114/386 (18%) and family members 49/386 (8%). Among these women, 276 (71%) thought they should receive therapy. The most common acute menopausal symptoms in postmenopausal women and perception of menopausal symptoms in non-menopausal women, respectively, were insomnia 68/161 (42%); 111/225 (49%), hot flushes 61/161 (38%); 115/225 (51%), heart palpitation 55/161 (34%); 103/225 (46%), an irritable temper 54/161 (34%); 138/225 (61%), dyspareunia 52/161 (32%); 100/225 (44%), headaches or dizziness 45/161 (28%); 74/225 (33%), a lack of energy 42/161 (26%); 73/225 (32%), depression 32/161 (20%); 114/225 (51%), night sweating 29/161 (18%); 61/225 (27%), and loss of bladder control 26/161 (16%); 37/225 (16%). CONCLUSIONS According to this study, Taiwanese women have a much higher percentage of awareness of the menopause than other Asian women, as reported previously and a greater willingness to receive treatment. We also found that most of their knowledge of the menopause was obtained from reading material (43%) or friends (22%). Furthermore, the percentage of recognition of menopausal symptoms, especially of vasomotor symptoms, is lower than that of Western women and higher than that of women in Hong Kong and Southern China.

THREE-DIMENSIONAL ULTRASOUND ASSESSMENT OF FETAL LIVER VOLUME IN NORMAL PREGNANCY: A COMPARISON OF REPRODUCIBILITY WITH TWO-DIMENSIONAL ULTRASOUND AND A SEARCH FOR A VOLUME CONSTANT

The purposes of this study are to compare the reproducibility of two-dimensional ultrasound (2DUS) and three-dimensional ultrasound (3DUS) in the assessment of fetal liver volume (LV), and to test whether the fetal LV assessed by the traditional method with 2DUS is equal to that with 3DUS in normal pregnancy. If significantly different, we then try to calculate a new constant of fetal LV for the traditional equation from the LV values obtained with 3DUS. In total, 30 normal singleton fetuses with gestational ages ranging from 20 to 30 weeks were included for the reproducibility test and 55 cases ranging from 20 to 31 weeks gestation were enrolled for finding a new volume constant of LV. The results showed that 3DUS is superior to 2DUS in the reproducibility test of fetal LV assessment. Moreover, the LV assessed with the traditional 2DUS method (identified as LV_42) was significantly smaller than that measured with 3DUS (P < 0.001). If the traditional 2DUS equation is to be used, the multiplying factor in the equation for the calculation of LV should be modified to 0.55 (SE = 0.017, N = 55). With the new volume constant, the new derived LV with 2DUS (identified as LV 55) was not different from that with 3DUS (identified as LV_3D). In conclusion, we recommend that 3DUS, instead of 2DUS, should be used for reaching an accurate assessment of fetal LV. Otherwise, applying our new volume constant may be of help in detecting abnormal fetal liver growth when only 2DUS is available.

Prenatal sonographic diagnosis of single umbilical artery

We evaluated the reliability of prenatal sonography and the usefulness of the umbilical vein and artery diameter ratio, transverse umbilical artery diameter, and systolic‐diastolic ratio in detecting single umbilical artery (SUA).