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Peer-reviewedCC BY-NC-NDGinekologia Polska

Comparison of ultrasound accuracy versus clinical fetal weight estimation – a retrospective cross-sectional study

  • Agnieszka A. Strojny1
  • Stepan Feduniw2
  • Arkadiusz Baran2
  • Dagmara Filipecka-Tyczka2
  • Radoslaw B. Maksym2
  • Michal Rabijewski3
  • Jan Modzelewski4
  • Grazyna Baczek5
  • Grzegorz Szewczyk2
  • Anna Scholz6
6 affiliations
  1. 11st Department of Gynecology & Obstetrics Medical University in Warsaw, Poland, Poland
  2. 21st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland
  3. 3Department of Reproductive Health, Centre of Postgraduate Medical Education, Warsaw, Poland
  4. 4Deparment of Obstetric, Perinatology, Gynecology and Reproduction, Jozef Polikarp Brudzinski Public Pediatric Clinical Hospital, Warsaw Medical University, Warsaw, Poland
  5. 5Department of Gynecology and Obstetrics Didactics Faculty of Health Sciences Warsaw Medical University, Warsaw, Poland
  6. 6Department of Obstetrics, Perinatology and Neonatology, Center for Postgraduate Medical Education, Warsaw, Poland
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Abstract

OBJECTIVES: Estimating fetal weight (EFW) is essential for decisions regarding mode of delivery, labour induction, and identification of at-risk fetuses. Deviations from expected weight may lead to labour complications and maternal or neonatal injury; therefore, abnormalities must be detected before delivery. There are two most used methods of EFW: ultrasound (US) biometry, requiring highly skilled staff and equipment, and widely available clinical examination (O/E) based on measurements of the dimensions of a mother. To compare the accuracy of two EFW methods: US examination performed according to ISUOG guidelines, with Hadlock IV (BPD-HC-AC-FL) formula vs O/E performed by midwives in a real-life clinical setting. MATERIAL AND METHODS: The study was conducted using the dataset from electronic patient records (2742 records) of gestational-age patients between 37 and 42 weeks who gave birth between January 2017 and July 2020 in St. Sophia's Hospital in Warsaw. Both methods' accuracy was judged by comparing the variations between the EFW in both forms and the actual birth weight (ABW) for each patient. RESULTS: Results measured using US, and O/E, compared to ABW varied significantly (p < 0.001). The study revealed that, on average, ultrasound tended to underestimate fetal weight, whereas O/E frequently overestimated it. The discrepancy in EFW using these methods was most pronounced at the extreme ends of fetal weight measurements. Additionally, factors such as fetal age, fetal length, and gestational age significantly influenced the accuracy of these measurements, as evidenced by multivariate regression analysis. CONCLUSIONS: Clinical examination can complement ultrasound in fetal weight estimation, but further studies are needed to improve EFW accuracy and support safer obstetric decision-making.

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Cite

BibTeXRIS
BibTeX
@article{strojny2026comparison,
  title = {{Comparison of ultrasound accuracy versus clinical fetal weight estimation – a retrospective cross-sectional study}},
  author = {Agnieszka A. Strojny and Stepan Feduniw and Arkadiusz Baran and Dagmara Filipecka-Tyczka and Radoslaw B. Maksym and Michal Rabijewski and Jan Modzelewski and Grazyna Baczek and Grzegorz Szewczyk and Anna Scholz},
  journal = {Ginekologia Polska},
  year = {2026},
  month = oct,
  doi = {10.5603/gpl.110276},
  url = {https://doi.org/10.5603/gpl.110276},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Comparison of ultrasound accuracy versus clinical fetal weight estimation – a retrospective cross-sectional study
AU  - Agnieszka A. Strojny
AU  - Stepan Feduniw
AU  - Arkadiusz Baran
AU  - Dagmara Filipecka-Tyczka
AU  - Radoslaw B. Maksym
AU  - Michal Rabijewski
AU  - Jan Modzelewski
AU  - Grazyna Baczek
AU  - Grzegorz Szewczyk
AU  - Anna Scholz
PY  - 2026
DA  - 2026/10/31
JO  - Ginekologia Polska
DO  - 10.5603/gpl.110276
UR  - https://doi.org/10.5603/gpl.110276
AB  - OBJECTIVES: Estimating fetal weight (EFW) is essential for decisions regarding mode of delivery, labour induction, and identification of at-risk fetuses. Deviations from expected weight may lead to labour complications and maternal or neonatal injury; therefore, abnormalities must be detected before delivery. There are two most used methods of EFW: ultrasound (US) biometry, requiring highly skilled staff and equipment, and widely available clinical examination (O/E) based on measurements of the dimensions of a mother. To compare the accuracy of two EFW methods: US examination performed according to ISUOG guidelines, with Hadlock IV (BPD-HC-AC-FL) formula vs O/E performed by midwives in a real-life clinical setting. MATERIAL AND METHODS: The study was conducted using the dataset from electronic patient records (2742 records) of gestational-age patients between 37 and 42 weeks who gave birth between January 2017 and July 2020 in St. Sophia's Hospital in Warsaw. Both methods' accuracy was judged by comparing the variations between the EFW in both forms and the actual birth weight (ABW) for each patient. RESULTS: Results measured using US, and O/E, compared to ABW varied significantly (p < 0.001). The study revealed that, on average, ultrasound tended to underestimate fetal weight, whereas O/E frequently overestimated it. The discrepancy in EFW using these methods was most pronounced at the extreme ends of fetal weight measurements. Additionally, factors such as fetal age, fetal length, and gestational age significantly influenced the accuracy of these measurements, as evidenced by multivariate regression analysis. CONCLUSIONS: Clinical examination can complement ultrasound in fetal weight estimation, but further studies are needed to improve EFW accuracy and support safer obstetric decision-making.
SN  - 0017-0011
SN  - 2543-6767
ER  -