Customized fetal growth modeling and monitoring-A statistical process control approach Academic Article uri icon

abstract

  • An SPC-based methodology is developed to detect early deviations of fetal biometry from expected normal growth. Using Response Modeling Methodology (RMM), an initial fetal growth model is estimated in Phase I, based on four ultra-sound (US) measurements. Regression-adjusted SPC control scheme, based on a new median control chart and a control chart for residuals variation, monitor absolute deviations from the expected growth trajectory (as predicted by the growth model). Hadlock's boundary reference centiles, currently used by obstetricians as "specification limits", are also integrated in the monitoring scheme. As pregnancy progresses, newly collected data dynamically update the parameters of the median prediction model and of the associated control limits. Real longitudinal data from both normal pregnancies and those that resulted in adverse medical outcomes have been analyzed, using four fetal US biometric measures. Results show that non-smooth growth trajectory, expressed in exceptionally large absolute deviations from predicted median values, is a good precursor to possible prenatal adverse outcomes. Directions for future research are outlined. Limited # of free downloads at: http://www.tandfonline.com/eprint/PkKgafwnZGSRkhcKeY5C/full

publication date

  • January 1, 2014