Točnost ultrazvučne procjene tjelesne težine ploda

master's thesis

• Title (english): Accuracy of fetal weight ultrasound assessment
• Author: Katja Erjavec
• Mentor: Ratko Matijević (mentor)
• Committee member: Berivoj Mišković (predsjednik povjerenstva)
• Committee member: Dinka Pavičić-Baldani (član povjerenstva)
• Committee member: Ratko Matijević (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2014-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Procjena tjelesne težine ploda jedan je od temeljnih postupaka kvalitetne
antenatalne i intrapartalne skrbi. Ultrazvučna metoda procjene najtočnija je i najčešće
korištena metoda, no ostaje nejasno koja je od brojnih formula koje se koriste u
kliničkoj praksi najtočnija i najpouzdanija. Cilj ovog istraživanja bio je utvrditi
postoji li statistički značajna razlika između stvarne tjelesne težine ploda određene
nakon poroda i tjelesne težine ploda procjenjene ultrazvukom koristeći dvije različite
formule (Hadlock II i Campbell Wilkin formula). Također, istraživanjem se nastojalo
prepoznati protektivne i rizične čimbenike za dobru procjenu tjelesne težine ploda.
Ova prospektivna studija provedena je u KB «Sveti duh» u Zagrebu u razdoblju od
10. prosinca 2013. do 10. ožujka 2014. godine. Obuhvaćene su 342 trudnice koje su
rodile u rađaonici te koje su u medicinskoj dokumentaciji imale podatak o
ultrazvučnoj procjeni tjelesne težine ploda unatrag 3 dana od poroda. Razlika između
procijenjene i stvarne tjelesne težine ploda testirana je Wilcoxon Matched Pairs
Testom.
Ustanovljeno je kako se stvarna tjelesna težina ploda ne razlikuje značajno od tjelesne
težine ploda procijenjene Hadlock II formulom, dok je u slučaju procjene temeljem
Campbell Wilkin formule razlika statistički značajna. Također, utvrđeno je kako su
procjene manje precizne za ekstremne vrijednosti tjelesne težine, dok indeks tjelesne
mase, tjelesna težina majke i trajanje trudnoće nemaju značajan utjecaj na točnost
ultrazvučne procjene tjelesne težine ploda.
Zaključno, ultrazvučna procjena tjelesne težine ploda Hadlock II forumulom točna je
i pouzdana metoda procjene te se njena primjena preporuča u svakodnevnoj kliničkoj
praksi. Campbell Wilkin formula treba se koristiti sa oprezom i u iznimnim
situacijama kada nije moguće koristiti Hadlock II formulu. Također, važno je obratiti
posebnu pažnju kada se tjelesna težina ploda nalazi izvan uobičajenih vrijednosti jer
ultrazvučna procjena tada ima ograničenu vrijednost.

Abstract (english)

Fetal weight assessment is one of the basic principals of appropriate
antenatal and intrapartal care. Ultrasound assessment is the most accurate and most
often used method, but it is still unclear which of the many formulas used for the
assessment is most accurate and most reliable. The aim of this study was to determine
whether there is a difference between actual birth weight assessed after delivery and
estimated fetal weight assessed using the ultrasound and two different formulas;
Hadlock II and Campbell Wilkin formula. Furthermore, the purpose of this study was
to recognize the protective and risk factors that influence the accuracy of fetal weight
ultrasound assessment.
This prospective study was done between December 10th 2013 and March 10th 2014
at KB «Sveti duh» in Zagreb. The study included 342 pregnant women who gave
birth at the delivery ward and who had a fetal weight ultrasound assessment done
within three days prior to delivery and documented in their medical history. The
difference between actual and estimated birth weight was tested using the Wilcoxon
Matched Pairs Test.
The study found that there is no significant difference between acutal birth weight
and estimated birth weight assessed using the Hadlock II formula, while a significant
difference exists when the Campbell Wilkin formula is used. Also, the accuracy of
fetal weight assessment is less accurate when used for extreme values of fetal weight,
while body mass index, weight of the pregnant woman and gestational age do not
influence the accuracy of fetal weight assessment.
In conclusion, fetal weight ultrasound assessment using Hadlock II formula is an
accurate and reliable method of assessment and should be used routinely in every day
clincial practice. The Campbell Wilkin formula should be used with caution and
exclusively when it is not possible to use the Hadlock II formula. Additionally, it is
important to be more attentive when fetal weight is outside normal range because the
assessment is less accurate in those cases and has limited value.

• Keywords: ultrazvuk; procjena tjelesne težine ploda; Hadlock II; Campbell Wilkin
• Keywords (english): ultrasound; fetal weight assessment; Hadlock II; Campbell Wilkin
• Language: croatian
• URN:NBN: urn:nbn:hr:105:010063
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2015-10-12 14:49:38