ABSTRACT
Objective: Large number of fetal weight formulae derived using different populations suggest that there is no fetal weight formula which is acceptable worldwide. Ethnicity and gender of the fetus are the well reported and recognized causes of inaccuracies in these fetal weight formulae. The aim of this study was to compare the accuracies of Schild's gender specific formula with Hadlock's, Shepard's and Aoki's formulae in Pakistani population
Study Design: Cross sectional study
Place and Duration of Study: This study was conducted at Ziauddin University Hospital, from May 2014 to May 2015
Material and Methods: This cross sectional study recruited 150 primary gravida with singleton pregnancy. Patients with hypertension, diabetes and smoking were excluded. Sonographic evaluation for fetal parameters was done during 36.39 +/- 0.684 weeks of gestation. Mean fetal weight was estimated from these formulae. Mean error, mean percentage error and the limit of agreement by Bland -Altman plot was determined. Anova was applied to compare the means of estimated fetal weight, error and percentage error. Gender and weight was noted after birth
Results: No significant difference was found between the means of estimated fetal weightobtained by these formulae. Statistically significant difference was found between mean error of these formulae [p -value = 0.012] ranging between -217.24 gram to - 310.93 gram. Insignificant difference in mean percentage errors was noted which was between - 6.74% to - 9.37%. The narrowest and widest limit of agreement was found with Schild's formula and Hadlock's formula respectively
Conclusion:In our population,for pregnancies with in normal range of fetal weight, Hadlock's, Shepard's, Aoki's and Schild's fetal weight formulae, all showed low values of mean errors and mean percentage errors which were within acceptable range
ABSTRACT
Accurate fetal weight estimation is important in preventing and managing fetal and maternal complications. Many fetal weight formulae have been derived, but none seems to be accurate enough to be applied globally for all ranges of fetal weight. Major factors causing errors in fetal weight estimation include inappropriately derived equations not considering ethnic differences among populations, fetal gender difference and different ranges of fetal weight. Use of fetal thigh volume and arm volume for fetal weight estimation by 3D ultrasound may increase the precision of fetal weight formulae. However, the superiority of 3D ultrasound in fetal weight estimation over 2D ultrasound is debatable as greater expertise is required, time consumed is more and there is no substantial increase in accuracy. It is suggested that fetal gender specific, fetal weight range specific and community based formula should be derived and used for better accuracy. Further studies are recommended. Articles published between October 1993 to October 2015 were selected from PubMed and Google Scholar, for this review article
ABSTRACT
Nephropathy due to damage of filtration barrier is a primary origin of end stage renal disease in Diabetics. It is associated with considerable morbidity and mortality. Mostly clinicians rely on urine analysis of Albumin. In the recent years extensive research has been conducted to find out a novel biomarker which can help in the early diagnosis of nephropathy. A search was conducted regarding publications of new diagnostic biomarkers for nephropathy. Among many renal biomarker researched lately, Nephrin was identified as the one that can become an early predictor of nephropathy and the levels of which can also ascertain the severity of the disease