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Re: EFW accuracyFrom: Dave Berck (djberck@yahoo.com)Tue May 20 13:54:24 2008
I do not believe that there are accuracy standards of ultrasound EFW, which is notoriously innacurate. I seem to remember a J Perinatology article -- here's the reference (done on a US navy base of all places -- Chauhan SP, Sullivan CA, Lutton TD, Magann EF, Morrison JC. Parous patients' estimate of birth weight in postterm pregnancy. J Perinatol 1995;15:192–194 (Level II-2) ) in which a comparison was made between U/S EFW, Leopold's , and Maternal estimates of EFW. The maternal estimates were the most accurate. Would you have sectioned a non-diabetic even if you had some way to know the birthweight of 4325? David J. Berck, MD, MPH
----- Original Message ---- From: Darrell Vaughan <dvaughan@nirai.ne.jp> To: Multiple recipients of list ULTRASOUND <ultrasound@mail.obgyn.net> Sent: Monday, May 19, 2008 9:18:43 PM Subject: EFW accuracy Regarding a case of severe shoulder dystocia, finally delivered by the Zavanelli maneuver and C-section, in which the baby was severely injured, I have questions about the accuracy of the EFW. (Background: The mother was a Japanese G2 P1 with a history of vaginal delivery of a 3350gm female. 8 days prior to delivery the EFW was 3750gm (female). 3 days prior to delivery the EFW was 3580gm (almost 200gm less). At delivery at 40 5/7 weeks after spontaneous labor, the actual birth weight was 4325gm.) Is it outside of acceptable norms to measure 200gm less after a 5-day interval in such a case, or can this be attributed to the normal amount of measurement error at this EGA? The AC was especially subject to measurement variation. Is either EFW (3750gm or 3580gm) outside of acceptable norms when the actual BW is 4325gm 8 and 3 days later, respectively? Thanks for any input.
-- Darrell Vaughan
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