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Year : 2015  |  Volume : 2  |  Issue : 1  |  Page : 1-6

Review of limb volume measurement techniques in assessing fetal weight by ultrasound with special reference to ImageJ package

Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Udupi, Karnataka, India

Correspondence Address:
Dr. Shripad Hebbar
Kasturba Medical College, Manipal University, Madhavanagar, Manipal - 576 104, District Udupi, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2394-2010.158121

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Traditionally intrauterine nutritional status of the growing fetus is evaluated using ultrasound estimated weight, which is then compared with standardized prenatal growth chart for that particular gestational age. The fetuses belonging to less than 10 th centile groups are considered to have reduced growth, whereas those who are more than 90 th centile belong to macrosomia group. Both these extreme groups have their own characteristic obstetric problems and may have poorer outcome. The conventional fetal weight formulae incorporated in regular ultrasound machines are largely dependent on head size, abdominal circumference, and femur length and are prone to random errors as high as 15% of actual birth weight. The margin of error further increases with very small and very large fetuses, and also, these measurements are not valid when the fetus has anterior abdominal wall defects. Malnourishment and obesity studies in pediatric subjects have shown us that subcutaneous fat significantly contributes to actual weight, and mid arm circumference can be used as screening tool for nutritional disorders. The errors in fetal weight estimation can be minimized if fetal soft tissues such as arm and thigh volumes are included for nutritional assessment of the fetus. The recent advances in three-dimensional (3D) ultrasonography has made limb volume estimation simple, easy, and birth weight models using limb volume measurements have higher accuracy, least systematic and random errors compared with the usual two-dimensional biometry of head, trunk, and limb length alone. However, these machines incur significant cost and procurement may not be feasible for resource poor organizations. The present review discusses developments in 3D analysis of fetal limb volulmetry, the methodologies, and affordable solutions using alternative image processing tools such as ImageJ in regular sonographic practice. We have also searched various databases (PUBMED, MEDLINE, SCOPUS, GOOGLE SCHOLAR AND SCIENCE DIRECT, J-Gate Plus and ProQuest) for birth weight models using limb volume measurements and have provided 13 different birth weight equations based on arm and/or thigh volumes.

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