الفهرس | Only 14 pages are availabe for public view |
Abstract The accurate antenatal diagnosis of fetal weight and amniotic fluid index remain very important tools to get best result for mother and fetus. The aim of our study is to evaluate the effect of amniotic fluid volume on the accuracy of the expected fetal weight (EFW) at term in pregnant women. It was carried on 129 apparently healthy pregnant women with a gestation age range of 38:40 weeks. Inclusion criteria: Pregnant women with gestation age range of 38:40 weeks with singleton healthy fetus. Body mass index <30, Medical free pregnant women. Exclusion criteria: Twin pregnancy, Fetal congenital anomalies, Body mass index ≥30, Any medical disorder as DM, HTN and Endocrine diseases as thyroid diseases. The following was done for all the patients: 1. History. 2. Examination: Summary 58 - General examination was performed for detection of any systemic disease and measuring vital signs and body mass index of the patient. - Abdominal (obstetric) examination: Fundal level, Fundal grip, lateral grip and pelvic grips for detection of gestational age, lie, presentation and position. 3. Vaginal examination to confirm presentation and position of the fetus and assess dilatation, position and effacement of the cervix. 4. Routine investigations: - Blood group and Rh factor. - Complete blood count. - Random blood sugar. 5. Sonographic examination: The sonographic examination was done in Menoufia University Hospital by the machine IBE2500D with curvilinear probe and (3.5-5.5 MHZ) frequency, all fetal biometry and AFI measurements were made by the same person. Estimated fetal weight will be calculated using the Hadlock IV formula: The Hadlock IV formula had a greater accuracy for EFW in the study population, as validated by previous studies. The amniotic fluid index (AFI) will be used to evaluate amniotic fluid levels. The standard 4-quadrant measurement of the vertical pocket will be used to calculate AFI. The results of this work: - Socio-demographic characteristics of all participants were described regarding age and occupation using ANOVA: analysis of variance and X2: pearson chi-square test, There is no significant Summary 59 difference between studied groups regarding age and occupation (p value>0.05). - Clinical (Obstetric) characteristics of all participants were described regarding: BMI, Gravidity, Parity, CS and NVD, There is no significant difference between studied groups regarding BMI, Gravidity, Parity, CS and NVD (p value>0.05). - Sonographic characteristics include: Gestational weeks, EFW and AFI in addition to Birth weight of all participants were described, There is non-significant difference between studied groups regarding Gestational weeks (p value>0.05) but there is a highly significant difference between studied groups regarding EFW, Birth weight and AFI (p value<0.001). - Correlation between AFI and both EFW and birth weight in studied groups was described, There is highly significant positive good correlation between AFI and EFW (r=0.733 - p value<0.001) and there is highly significant positive good correlation between AFI and birth weight (r=0.640 -p value<0.001). - Correlation between EFW and birth weight in studied groups was described, There is highly significant correlation between EFW and birth weight in studied groups (p value<0.001). - Comparison between studied groups regarding Absolute error, Absolute percentage error, Substantial error as Absolute error(AE)= EFW-BW, Absolute percentage error(APE)= = EFW−BWBW𝑥100%, Substantial error(SE) defined as APE >10% and Estimation of EFW &BW was done to compare the incidence of underestimated and overestimated EFW results that is showed that there is tendency for over estimation in the three studied groups also, There is a highly significant difference between the studied Summary 60 groups regarding: absolute error, absolute percentage error and substantial error( p-value<0.001) - Comparison between studied groups regarding inacurate EFW was done as inacurate EFW was defined if there was more than absolute 15% difference between EFW and BW ,calculated as follow;(BW-EFW)/EFW 𝑥100, There is non-significant difference between studied groups regarding inacurate EFW (p value>0.05). |