Comparison of 3 Fetal Weight Estimation Formula Using

Comparison of 3 Fetal Weight Estimation Formula Using Symphisiofundal Height in Predicting Birth Weight at Makasar Primary Health Care Facility, 2014 Manusita VN, Lopolisa AT, Tendi W, Tryanni V, Alim DP, Utami TW** Faculty of Medicine Universitas Indonesia **Obstetry and Gyencology Departement –Faculty of Medicine Universitas Indonesia INTERNATIONAL STUDENT CONGRESS OF BIOMEDICAL SCIENCES 9/17/2021 Presented at ISCOMS, Groningen (ISCOMS) 1

INTRODUCTION RESEARCH QUESTIONS AND HYPOTHESIS METHODS RESULTS DISCUSSION CONCLUSION • High maternal mortality in Indonesia (359/100. 000 birth)1 • Dystocia as the 4 th leading cause 2 • Fetal weight estimation as way to predict to dystocia and appropriate management • US as tool to predict fetal weight is not widely available in primary health care in Indonesia FUTURE PROSPECTIVE 9/17/2021 1. Badan Koordinasi Keluarga Berencana Nasional (BKKBN). Survey Demografi dan Kesehatan Indonesia (SKDI) 2012. Jakarta: BKKBN; 2013. 2. Jevitt CM. Shoulder dystocia: etiology, common risk factors, and management. 2005. J Midwifery Womens Presented at ISCOMS, Groningen 2 Health. 50(6): 485 -97.

INTRODUCTION RESEARCH QUESTIONS AND HYPOTHESIS METHODS RESULTS DISCUSSION • Fetal weight estimation formulas are developed 3 • Johnson Toschack formula (the most frequently used in Indonesia), South Africa formula (Buchmann et al 4), and Niswander formula • There hasn’t been study comparing the accuracy between 3 formulas. CONCLUSION FUTURE PROSPECTIVE 9/17/2021 3. Malik N, Shahzad S, Malik SM, Anwar S. Comparison of two different methods for estimatation. 2012. RMJ. 37(1): 38 -41. 4. Buchmann E, Tlate K. A Simple clinical formula for predicting fetal weight in labour at term-derivation and Presented at ISCOMS, Groningen 3 validation. 2009. SAMJ. 99(6): 457 -60

INTRODUCTION RESEARCH QUESTIONS AND HYPOTHESIS METHODS RESULTS DISCUSSION Research Question What formula have better result in predicting actual birth weight between 3 formula developed (Johson Tohscack, Niswander, South Africa)? CONCLUSION FUTURE PROSPECTIVE 9/17/2021 Presented at ISCOMS, Groningen 4

INTRODUCTION RESEARCH QUESTIONS AND HYPOTHESIS METHODS RESULTS DISCUSSION CONCLUSION Hypothesis Johnson Tohsachs formula may have better result in predicting birth weight – being most frequently used formula in PHC – Includes head descendent factor in formula FUTURE PROSPECTIVE 9/17/2021 Presented at ISCOMS, Groningen 5

INTRODUCTION RESEARCH QUESTIONS AND HYPOTHESIS METHODS RESULTS DISCUSSION CONCLUSION FUTURE PROSPECTIVE 9/17/2021 • Cross sectional, secondary data • Makasar primary health care (PHC), Jakarta • September 2014 • Total population sampling of medical records (MR) Inclusion • MR of woman giving birth at Makasar PHC with the fetal characteristics: -singleton -head presentation -alive • Giving birth within January-September 2014 Exclusion Incomplete MR data of symphisiofundal height and birth weight Presented at ISCOMS, Groningen 6

INTRODUCTION RESEARCH QUESTIONS AND HYPOTHESIS METHODS RESULTS DISCUSSION CONCLUSION FUTURE PROSPECTIVE 9/17/2021 Data on MR • Demographical data • Symphisiofundal height data (cm) -measured with measure tape when the patient was in phase I of labor • Birth weight data (gram) -measured with birth weight scale after the baby was born Presented at ISCOMS, Groningen • SPSS for Windows • Bland Altman Plot • One ssample TTest to check mean difference between formula estimation and actual birth weight significan t? 7

INTRODUCTION RESEARCH QUESTIONS AND HYPOTHESIS Mother’s Age: 28 (17 -40) years old Mother’s Education METHODS RESULTS DISCUSSION CONCLUSION FUTURE PROSPECTIVE 9/17/2021 Presented at ISCOMS, Groningen 8

INTRODUCTION RESEARCH QUESTIONS AND HYPOTHESIS Table 1. Variables data of symphisiofundal height, birth weight, and birth length Symphisiofundal height Mean ± Standard Deviation Median (Min-Max) 31 (27 -38) cm DISCUSSION Birth Weight 3139, 02 ± 436, 06 CONCLUSION Birth Length 49 (35 -54) METHODS RESULTS Variables FUTURE PROSPECTIVE 9/17/2021 Presented at ISCOMS, Groningen 9

INTRODUCTION RESEARCH QUESTIONS AND HYPOTHESIS METHODS RESULTS DISCUSSION CONCLUSION FUTURE PROSPECTIVE 9/17/2021 Fig 3. Bland Altman plot for Johnson Toschack formula Presented at ISCOMS, Groningen Fig 4. Bland Altman plot Niswander Formula 10

INTRODUCTION RESEARCH QUESTIONS AND HYPOTHESIS METHODS RESULTS DISCUSSION CONCLUSION FUTURE PROSPECTIVE 9/17/2021 Fig 5. Bland Altman plot for South Africa formula Presented at ISCOMS, Groningen 11

INTRODUCTION RESEARCH QUESTIONS AND HYPOTHESIS METHODS RESULTS DISCUSSION Table 2. One sample T-test analysis between formula and actual birth weight Mean Difference (gram) Johnson Tohsach -44, 1463 Niswander South Africa 469, 3268 378, 1707 Standard Deviation (gram) 420, 10669 392, 58382 388, 14235 p value 0, 246 <0, 001 CONCLUSION FUTURE PROSPECTIVE 9/17/2021 Presented at ISCOMS, Groningen 12

INTRODUCTION RESEARCH QUESTIONS AND HYPOTHESIS METHODS RESULTS DISCUSSION CONCLUSION FUTURE PROSPECTIVE 9/17/2021 • Fetal weight estimation formulas Johnson Tohscack, South Africa, and Niswander in sequence • Difference between formula and actual weight within 95% limit of agreement Johnson Tohsack (96%), Niswander (32%), South Africa (55, 3%) • Formula weight within ± 10% actual birth weight -Jonshon Tohsack (56, 9%) -Niswander (27, 6%) -South Africa (42, 3%) Presented at ISCOMS, Groningen 13

INTRODUCTION RESEARCH QUESTIONS AND HYPOTHESIS Numprasert et al 5 METHODS Kumari et al 6 and Torloni et al 7 RESULTS • Johnson Tohsack formula has better result than other formula DISCUSSION CONCLUSION • 72% fetal weight estimation by Johnson Tohscack formula are within ± 10% actual birth weight Better result in Johnson Tohscak formula • Head descendent factor is included in formula FUTURE PROSPECTIVE 9/17/2021 5. Numprasert W. A study in Johnson’s formula: fundal height measurement for estimation of birth weight. 2004. AU J. T. 8 (1): 15 -20 6. Kumari A, Goswami S, Mukherjee P. Comparative study of various methods of fetal weight estimation in term pregancy. 2013. Journal of South Asian Federation of Obstetric and Gynecology. 5(1): 22 -25 Presented ISCOMS, M, Groningen 7. Torloni MR, Sass N, Sato JS, Renzi ACP, at Fukuyama de Lucca PR. Clinical formulas, mother’s opinion, and ultrasound in 14 predicting birth weight. 2008. Sau Paulo Med J. 126 (3): 145 -9.

INTRODUCTION RESEARCH QUESTIONS AND HYPOTHESIS METHODS RESULTS DISCUSSION CONCLUSION FUTURE PROSPECTIVE 9/17/2021 Wide range difference between formula weight and actual weight • symphisiofundal height measurement wasn’t done in optimal condition • measurement variability factor between different health worker Presented at ISCOMS, Groningen 15

INTRODUCTION RESEARCH QUESTIONS AND HYPOTHESIS METHODS RESULTS DISCUSSION Conclusion Johnson Tohsach fetal weight estimation formula has better result in predicting birth weight than South Africa and Niswander formula CONCLUSION FUTURE PROSPECTIVE 9/17/2021 Presented at ISCOMS, Groningen 16

INTRODUCTION RESEARCH QUESTIONS AND HYPOTHESIS METHODS RESULTS DISCUSSION • Future research in the same field using primary data (optimum measurement condition) and bigger population • Fetal weight estimation formula may become alternative tool in predicting birth weight, but not as the only one tool CONCLUSION FUTURE PROSPECTIVE 9/17/2021 Presented at ISCOMS, Groningen 17

Thank You 9/17/2021 Presented at ISCOMS, Groningen 18

References • • 9/17/2021 Badan Koordinasi Keluarga Berencana Nasional (BKKBN). Survey Demografi dan Kesehatan Indonesia (SKDI) 2012. Jakarta: BKKBN; 2013. Jevitt CM. Shoulder dystocia: etiology, common risk factors, and management. 2005. J Midwifery Womens Health. 50(6): 485 -97. Malik N, Shahzad S, Malik SM, Anwar S. Comparison of two different methods for estimatation. 2012. RMJ. 37(1): 38 -41. Torloni MR, Sass N, Sato JS, Renzi ACP, Fukuyama M, de Lucca PR. Clinical formulas, mother’s opinion, and ultrasound in predicting birth weight. 2008. Sau Paulo Med J. 126 (3): 145 -9. Numprasert W. A study in Johnson’s formula: fundal height measurement for estimation of birth weight. 2004. AU J. T. 8 (1): 15 -20. Kumari A, Goswami S, Mukherjee P. Comparative study of various methods of fetal weight estimation in term pregancy. 2013. Journal of South Asian Federation of Obstetric and Gynecology. 5(1): 22 -25 Buchmann E, Tlate K. A Simple clinical formula for predicting fetal weight in labour at term-derivation and validation. 2009. SAMJ. 99(6): 457 -60. Levin I, Gamzu R, Buchman V, Rapaport A, Pauzner D, Lessing JB, et al. Clinical estimation of fetal weight: is accuracy acquired with professional experience? 2011. Fetal Diagn Ther. 29: 321 -4. Presented at ISCOMS, Groningen 19