Ultrasonographic estimation of fetal weight: acquiring accuracy in residency.

OBJECTIVE: Ultrasonographic imaging is considered an objective means for fetal weight estimation. The goals of this study were to determine the accuracy of ultrasonographic estimates of fetal'weight performed by residents in training and to ascertain how rapidly the residents gained proficiency in this regard. METHODS: A total of 300 ultrasonographic estimates of fetal weight and corresponding birth weight were collected and stratified into 4 groups by the level of residents' experience, from level 1 (inexperienced, with <6 months of exposure) to level 4 (advanced experience, with at least 24 months of training). The proportional difference between ultrasonographic estimates of fetal weight and birth weight was calculated for each case and grouped according to the level of training of the examiner. The derived data were compared by analysis of variance, linear regression, and chi2 test. RESULTS: Significant increases in the accuracy of ultrasonographic estimates of fetal weight were observed with advancing levels of resident experience (P< .0001). Overall, 30.6% of ultrasonographic estimates of fetal weight fell within 5% of birth weight, and 60.6% fell within 10%. Among the least experienced residents (<6 months of training), 49.4% of estimates fell within 10% of birth weight; among those with 6 to 11 months of experience, 53.5% of estimates fell within 10%; among those with 12 to 23 months of experience, 64.1 % of estimates fell within 10%; and among the most experienced (>24 months), 73.6% of estimates fell within 10%. CONCLUSIONS: There is a learning curve for ultrasonographic estimates of fetal weight, with a significant decrease in the percent error seen with advancing training among residents, reaching acceptable levels of more than 70% of estimates within 10% of birth weight after 24 months of ultrasonographic experience.