In utero estimates of fetal weight were evaluated prospectively in 109 fetuses with the use of sonographic models developed in a previous study. This report confirms that the best in utero weight estimates result from the use of models based on measurements of head size, abdominal size, and femur length. Since the accuracy of these models (1 SD = 7.5%) is significantly better than those based on measurements of head and body (e.g., biparietal diameter, abdominal circumference), we recommend routine use of such models in obstetric sonography.
"The fetal parameters recorded (in mm) were femur length (FL), head circumference (HC), abdominal circumference (AC), and biparietal diameter (BPD). Estimated fetal weight (EFW) was calculated using the Hadlock algorithm (Hadlock et al. 1985). We had access to the records of any other ultrasound performed to women in the same hospital unit "
[Show abstract][Hide abstract] ABSTRACT: Prenatal exposure to bisphenol A (BPA) and phthalates may affect fetal growth; however, previous findings are inconsistent and based on few studies.
We assessed whether prenatal exposure to BPA and phthalates were associated with fetal growth in a Spanish birth cohort of 488 mother-child pairs.
We measured BPA and eight phthalates [four di-2-ethylhexyl phthalate metabolites (DEHPm), mono-benzyl phthalate (MBzP), and three low molecular weight phthalate metabolites (LMWPm)] in two spot-urine samples collected during the first and third trimester of pregnancy. We estimated growth curves for femur length (FL), head circumference (HC), abdominal circumference (AC), biparietal diameter (BPD), and estimated fetal weight (EFW) during pregnancy (weeks 12-20 and 20-34), and for birth weight, birth length, head circumference at birth, and placental weight.
Overall, results did not support associations between exposure to BPA or DEHPm during pregnancy and fetal growth parameters. Prenatal MBzP exposure was positively associated with FL at 20-34 weeks resulting in an increase of 3.70% of the average FL (95% CI: 0.75, 6.63%) per doubling of MBzP concentration. MBzP was positively associated with birth weight among boys (48 g; 95% CI: 6, 90) but not in girls (-27 g; 95% CI: -79, 25) (interaction p-value = 0.04). The LMWPm mono-n-butyl phthalate (MnBP) was negatively associated with HC at 12-20 pregnancy weeks (-4.88% of HC average [95% CI: -8.36, -1.36%]).
This study, one of the first to combine repeat exposure biomarker measurements and multiple growth measures during pregnancy, finds little evidence of associations of BPA or phthalate exposures with fetal growth. Phthalate metabolites MBzP and MnBP were associated with some fetal growth parameters, but these findings require replication.
Environmental Health Perspectives 07/2015; DOI:10.1289/ehp.1409190 · 7.98 Impact Factor
"The FL was obtained in a horizontal view, measuring the full femur excluding the epiphysis from one end of the diaphysis to the other. Estimated fetal weight (EFW), was calculated from measurements of AC and FL, using the Hadlock formula (Log 10 EFW = 1.304 + (0.05281 × AC) + (0.1938 × FL) − (0.004 × AC × FL) . "
[Show abstract][Hide abstract] ABSTRACT: Telemedicine (TM) challenge is to create an intelligent tool that delivers personalized training to professionals with different backgrounds. We present an adaptive retrieval system that used vocabulary and ontologies founded on the telemedicine body of knowledge (TM-BoK) hierarchy and Medical Sub-headings (MeSH). The XML-manifest that contains a Navigable Knowledge Map and a separate Rule-extension executed by Agents during the process of navigation. The result is an adaptive and adaptable TM knowledge delivery tool.
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