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Master Thesis

Performance de l'échographie dans l'estimation de poids foetal chez les foetus RCIU naissant avant 28 SA : une étude observationnelle unicentrique de 120 cas

Abstract : Background: antenatal diagnosis of IUGR is mostly based on sonographic fetal weight estimation (FWE). FWE is associated with a mean error of 10% in the general population. Few studies are evaluating the sonographic performance of IUGR fetuses born in very preterm conditions. Objectives: main objective was to assess the error rate of sonographic fetal weight estimation (beyond ± 10%) compared with birth weight in a population of fetus IUGR born before 28 weeks of gestation. The secondary objectives were (1) to determine the absolute mean error of FWE and the rate error beyond 20%; (2) to evaluate the rate error (beyond ± 10%) of fetal weight estimation in a group of fetuses with FWE at the limit of viability (that is FWE between 450g and 550g) and their neonatal outcomes; (3) to identify risk factors of obtaining a FWE beyond ± 10% in IUGR born before 28 weeks of gestation. Methods: retrospective monocentric study conducted in a university hospital. Single pregnancies with antenatal IUGR diagnosis (FWE < third percentile) with an ultrasound realized less than 14 days before birth and born living or not before 28 weeks of gestation were included. Multiple pregnancies, late dating, and fetal abnormalities which could bias the fetal weight estimation were excluded from the study. Results: one hundred and twenty women from 1st January 2010 to 31st December 2020 were included. Ultrasound had an absolute error >10% in 42,5% of cases. The mean error was 10,7% (± 8,2) in our cohort. In the group of fetuses with FWE between 450g and 550g, the sonographic error was beyond 10% in 48,6% of cases. Neonatal mortality in this group was high (88,2%). In multivariate analysis, the only factor that seems to affect the reliability of FWE is oligoanamnios (OR = 3,5; CI 95 [1,1 – 10,6]; p = 0,03). Conclusion: severe and early IUGR could be a complex obstetrical situation and FWE is involved in prognostic evaluation. Although the FWE remains an interesting tool, its margin of error seems important and must be taken into account in the information given to couples.
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Submitted on : Wednesday, October 20, 2021 - 4:14:09 PM
Last modification on : Tuesday, November 30, 2021 - 3:46:25 AM
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Élisa da Costa Oliveira. Performance de l'échographie dans l'estimation de poids foetal chez les foetus RCIU naissant avant 28 SA : une étude observationnelle unicentrique de 120 cas. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03388805⟩



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