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Intraexaminer and Interexaminer Variability in 3D Fetal Volume Measurements During the Second and Third Trimesters of Pregnancy
Author(s) -
Simcox Louise E.,
Higgins Lucy E.,
Myers Jenny E.,
Johnstone Edward D.
Publication year - 2017
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/ultra.16.03045
Subject(s) - medicine , intraclass correlation , thigh , fetal head , fetus , limits of agreement , third trimester , pregnancy , obstetrics , surgery , nuclear medicine , clinical psychology , biology , genetics , psychometrics
Objectives To assess intraexaminer and interexaminer reliability of 3‐dimensional fetal sonographic measurements. Methods Three‐dimensional fetal organ volumes (head, kidney, total thigh volume, and fractional thigh volume) were acquired during the second and third trimesters, with the addition of placental volume in the second trimester, by 2 different experienced, blinded sonographers. Fifty‐eight fetuses were examined from 21 to 39 weeks' gestation. Intraexaminer and Interexaminer reliability was assessed with Bland‐Altman plots, and their 95% limits of agreement and intraclass correlation coefficients. Results The most significant interexaminer error was observed in the second‐trimester kidney volume (95% limits of agreement, ± 110%), and the best agreement was for the third‐trimester fractional thigh volume (95% limits of agreement, ± 25%) and second‐trimester head volume (95% limits of agreement, −7%–25%). Second‐ and third‐trimester intraclass correlation coefficient results were all greater than 0.75, apart from second‐trimester kidney volume intraexaminer (0.374) and interexaminer (0.061) measurements, second‐trimester placenta interexaminer measurements (0.390), and third‐trimester kidney interexaminer measurements (0.647). Conclusions Three‐dimensional fetal sonographic volumes of the head, kidney, total thigh, and placenta have limited reproducibility, and improvements in measurement techniques are needed before they can be used routinely to assess fetal growth. The 3‐dimensional fractional thigh volume can be reliably obtained in the late third trimester.