Development of a semi-automated tool to measure fetal abdominal wall thickness during ultrasound at 20 weeks' gestation

Suresh Seshadri; Sindhu Pudhukudi; Jayanti Vajiravelu; Ponnusamy Saravanan; Jon Hyett; Uma Ram

doi:10.1002/ijgo.15524

Development of a semi-automated tool to measure fetal abdominal wall thickness during ultrasound at 20 weeks' gestation

Int J Gynaecol Obstet. 2024 Apr 12. doi: 10.1002/ijgo.15524. Online ahead of print.

Authors

Suresh Seshadri¹, Sindhu Pudhukudi^{1

2}, Jayanti Vajiravelu¹, Ponnusamy Saravanan^{3

4}, Jon Hyett⁵, Uma Ram⁶

Affiliations

¹ Mediscan Systems, Chennai, India.
² Aster Fetal Medicine, Aster Medcity, Cochin, India.
³ Populations, Evidence and Technologies, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK.
⁴ Department of Diabetes, Endocrinology and Metabolism, George Eliot Hospital, Nuneaton, UK.
⁵ Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia.
⁶ Seethapathy Clinic and Hospital, Chennai, India.

PMID: 38607348
DOI: 10.1002/ijgo.15524

Abstract

Objectives: To develop a semi-automated tool for measuring fetal abdominal wall thickness (AWT). To validate the software using images captured by other centers and create a nomogram for fetal AWT between 18 and 20 weeks.

Methods: A semiautomated tool that measured AWT was developed using images captured at the routine 20-week morphology scan. The software was developed using digital images captured routinely during scans of low-risk women. Inter- and intraobserver reliability was assessed between manual and semi-automated measures. The tool was validated using images acquired from other centers. Linear regression and quadratic polynomials were used to create a nomogram for AWT.

Results: The semi-automated tool was able to measure AWT in all images. Interoperator reliability was 0.90 and 0.97 (P < 0.05) for manual and semi-automated methods, respectively. Measurement agreement varied between three operators from moderate to excellent (0.77, 0.87, 0.92), with overall agreement being good (0.85). The tool could be successfully applied to 89% of images from other centers. A nomogram was generated for AWT measurements of fetuses at 18-20 weeks in normal, low risk mothers.

Conclusion: Semi-automated measurement of AWT was feasible using images captured during the routine 20-week scan. This approach had lower inter- and intraobserver variability compared to manual measurement.

Keywords: abdominal wall thickness; automated measurement; fetal adiposity; fetal growth; gestational diabetes.