OP05.07: The clinical utility of a routine 36‐week growth ultrasound in a selected low‐risk population
Bibliographic record
Abstract
Determine the sensitivity of a third trimester fetal assessment ultrasound in detecting small for gestational age (SGA) neonates (EFW < 10th centile) and to determine the clinical utility of implementing a routine 36-week fetal assessment in patients who screened low-risk for preterm pre-eclampsia (PE) (FMF UK) in the first trimester. A prospective cohort interventional study involving a subset of pregnant patients enrolled in a larger first trimester screening and PE risk assessment study (IMPRESS study, REB19-0359). Consenting, eligible patients (18- 40 years of age, singleton pregnancy, no maternal comorbidities) who screened low-risk for first trimester preterm PE screening (< 1:100 risk) on the basis of a multifactorial algorithm (FMF UK) were offered a routine 36-week ultrasound (group 1). This was compared to an earlier control group who were offered no additional routine ultrasound follow up after their detailed ultrasound if they had a low risk PE screen except at their care providers discretion (group 2). A local growth chart was used to classify SGA and compared to Hadlock and WHO growth charts. Between Nov 1, 2021, and Oct 31, 2022, 2022 patients met the inclusion criteria and received a routine pregnancy scan at 36 weeks (group 1 = 954, group 2 = 1068). The rate of SGA at birth was comparable to both groups (11.6 vs 12% p = 0.8) The 36-week scan demonstrated 22% sensitivity in detecting SGA at birth in group 1. Sensitivity only modestly improved to 25% if using the WHO or Hadlock growth curves rather than local growth curves. The group 1 though did have a statistically reduced incidence of babies born at < 3rd centile compared to group 2 (4.1 vs 6.9% p = 0.037). Detection rate for breech and oligohydramnios in group 1 at 36 weeks were 6.5 and 0.35%. Routine 36 week growth scan for a selected low risk population demonstrated a poor sensitivity in detection of SGA at birth. However, we did demonstrate a reduced incidence of neonates born < 3rd centile, the SGA group with the highest perinatal morbidity and mortality.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".