UMBILICAL CORD THICKNESS, THE PROMISING DARK HORSE FOR FETAL WEIGHT
ESTIMATION: A COMPARATIVE STUDY
Abstract
Introduction: Fetal weight estimation remains a critical aspect of
modern day obstetrics for monitoring the growth of fetus in-utero,
specially in a high risk setting. The dilemma in clinical
decision-making stems from the lack of accurate methods for fetal weight
estimation, particularly in Low and Middle Income Countries. Objectives:
To compare the diagnostic accuracy of newer method (Umbilical Cord
Thickness) of fetal weight estimation with the conventional methods
within limited resources. Design: Prospective cohort study Methods: A
total of 190 consenting women in early/latent phase of labour were roped
in for the study, and fetal weight was estimated for each, using three
different available techniques, viz. clinical, conventional ultrasound
and newer method, with the help of Johnson’s formula, Dare’s formula,
Hadlock’s formula, and Cord circumference regression equation. Mean
Percentage Error(MPE) was calculated for each method and a comparative
analysis was done. Results: The analysis revealed MPE in decreasing
order as: Dare> Johnson> Cord Circumference
> Hadlock’s. The sensitivity of cord circumference method
and Hadlock’s method was 91.2% and 91.7% respectively. However, both
the sensitivity and specificity of Hadlock’s method increased
drastically when combined with Umbilical Cord method. Conclusion: Thus,
this study advocates the use of Umbilical Cord Circumference for
estimation of fetal weight in conjunction with the conventional methods,
specially in high risk areas, to reduce perinatal morbidities related
to, or resulting from inaccurate fetal weight estimation. Keywords: cord
circumference, Hadlock’s method, Fetal weight, Ultrasound