Accuracy of Ultrasound Estimation of Fetal Weight (EFW) at Term: Insights From a Malaysian Tertiary Hospital for Primary Care Implementation

Background Estimated fetal weight (EFW) is a key determinant of obstetrical decision‐making and an independent risk factor of high perinatal morbidity and mortality. However, routine ultrasound during pregnancy test is not universally available in the Malaysia primary care settings. Objective To compare the accuracy of ultrasonographic EFW to the actual birth weight (ABW). Study DesignThis was a prospective cohort study involving women with singleton pregnancies, at term (37–38 + 6 weeks) and age ≥ 18 years. The accuracy of EFW was evaluated by calculating the percentage error (PE). PE of < 10% was regarded as “accurate.” Results A total of 153 participants were recruited. The majority of the participants were Malay (77.8%), followed by Indian (12.4%), Chinese (4.6%), and others. There was no significant association between ethnicity and ultrasound accuracy. The mean maternal weight at booking was 64.10 kg, while the mean body mass index (BMI) was 26.09 kg/m 2 . The mean EFW was 2992.72 ± 338 g, while the mean ABW was 2960 ± 400 g. For ultrasound accuracy, the mean PE was 8.11%, with 68.63% of accurate EFW. Maternal weight, parity, and gestational diabetes were significantly associated with the accuracy of ultrasound EFW. The mean number of days from ultrasound to birth was 2.64 days. Performing an EFW within 24 h prior to delivery yielded optimal accuracy of EFW. There was a significant association between experiences of examiners with ultrasound accuracy. Conclusion The accuracy of EFW in our study was comparable to similar studies done in other countries. There was a strong positive correlation between ultrasound EFW using the Hadlock‐4 weight estimation model with ABW in our population. The accuracy of EFW within 24 h prior to delivery warranted a calculated decision on the induction of labor. Adequate training of examiners was crucial. Routine ultrasound EFW services should be made available and accessible in all healthcare settings in Malaysia.