Accuracy of ultrasonic age determination and weight prediction in the fetus with preterm premature rupture of membranes

Ultrasonic gestational age determination and fetal weight prediction were performed in 20 patients with preterm premature rupture of the membranes [PPROM], and 10 normal gravides with intact membranes, between the 28th and less than 37 weeks of gestation, to assess of the effect of PPROM on the accuracy of ultrasonic age estimation and fetal weight prediction.All gravides had known menstrual age, and delivered within 24 hours of ultrasonic examination, and the actual birth weight was determined. Using single parameter for gestational age assessment [bipartietal diameters, abdominal circumference or femur length], the bipartietal diameters was the least reliable, as there was significant difference in the mean error between the control and studied groups [p<0.05]. Multiple parameters formulas for gestational age estimation [HC, FL;HC, FL, AC; and HC, FL, BPD, AC], did not appear to add further accuracy to single parameters methods. Using three questions for prediction of fetal weight [BPD, AC, MAD, BPD, FL; and HC, AC, FL], we have found no significant difference in the mean error percent between the control and studied groups. Neither amniotic fluid volume, duration of membrane presence or absence of labor pains affected the accuracy of ultrasonic estimation of gestational age or prediction of fetal weight. It is concluded that PPROM appears to have no deleterious effect on the accuracy of ultrasonic estimation of gestational age and prediction of fetal weight, except when the BPD is used as a single parameter for age estimation

Combined bioelectric and ultrasonographic evaluation of the fetus in pregnancy induced hypertension and diabetic pregnancies

To determine the individual and combined abilities of scored non- stress test [NST] and amniotic fluid volume [AFV] assessment in predicting fetal risk in- utero, and to provide an effective screening protocol for intra-uterine fetal compromise, one hundred near term patients [50 patients with severe pregnancy - induced hypertension, and 50 gravidas with known controlled diabetes mellitus] with a singleton pregnancy, formed the subject of the study. Scored NST, and qualitative AFV assessement were weekly performed for each patient till delivery. The obstetric outcome for each pregnancy was determined [perinatal mortality, intrapartum fetal distress, 5- minutes Apgar score <7, or small for gestational age infant], and the predictive abilities of the results of the last performed tests before delivery were estimated, individually and in combination. The predictive ability of scored NST was : sensitivity 75%, specificity 93.2%, PPV 60% and NPV 96.5%; the predictive ability of AFV assessment was sensitivity 58.3% specificity 92% PPV 50%, and NPV 94.2% while the predictive ability of combined NST+ AFV was: sensitivity 80%, specificity 96% PPV 73%, and NPV 97%. The predictive ability of combined NST and AFV assessment was higher than that of either of the testes alone, in both studied groups. The NST was superior to AFV assessment, specially in diabetic gravidas