Avaliação do volume de membros fetais aferidos pela ultrassonografia tridimensional e correlação com o índice de massa corpórea dos recém-nascidos

Abstract

Objective: To assess the usefulness of fetal limb volumes as predictors to low postnatal body mass index (BMI) using three-dimensional ultrasonography (3DUS) with the extended imaging virtual organ computer-aided analysis (XI VOCAL) method. Methods: This was prospective cross-sectional study which assessed 300 singleton pregnancies between 33 and 41 weeks of gestation. The Hadlock 4 formula was used to estimate fetal weight (EFW). The XI VOCAL 10 planes method was used to assess the fetal upper-arm and thigh volumes. Postnatal anthropometry was assessed using the BMI and it was considered low (?10th percentile) or normal (>10th percentile). We determined receiver operating characteristic (ROC) curves and their respective areas under the curves for the percentiles of EFW, fetal thigh and upper-arm volumes. Results: Of the 300 newborns, BMI was ?10th percentile for 21 and >10th percentile for 279. The area under the ROC curve for EFW, fetal upper-arm and thigh volume, were 0.801, 0.924, and 0.930, respectively. We determined the sensitivity and specificity of these three parameters for predicting postnatal low BMI and we found the values of 85.70% and 65.60%, for EFW; 90.48% and 88.17%, for fetal thigh volume; and 76.19% and 92.47%, for fetal upper-arm volume; respectively. Conclusion: Fetal limb volumes estimated by 3DUS using the XI VOCAL method were effective predictors of low postnatal BMI.