Three-Dimensional Ultrasonic Volumetric Assessment of Fetal Liver for Determination of Gestational Age: Correlation with Conventional Parameters

Abstract

Background: Fetal liver volume can be a precise measure of somatic growth. It represents a sizable part of the fetal abdomen and reflects metabolic and hematological activities at different stages during gestation. Objective: To analyze the pattern of growth for fetal liver volume (FLV) in pregnancies and its relationship with traditional biometric parameters and gestational age (GA) as a reliable indicator of fetal growth. Methods: A cross-sectional observational study involving 100 pregnant women with a potential singleton fetus between 16 and 40 weeks was carried out at Al-Yarmouk Teaching Hospital, Baghdad, Iraq. The FLV was evaluated using the ellipsoid formulation, which is predicated on 3D linear measurements obtained via ultrasound. Standard biometric parameters, including biparietal diameter (BPD), femur length (FL), and abdominal circumference (AC), were established. Results: FLV exhibited a robust positive correlation with estimated fetal weight (r = 0.706, p = 0.0001) and gestational age evaluated through BPD, FL, and AC (r > 0.72, p = 0.0001). During late gestation, FLV values remained stable within a narrow range of 356–360 cm³. There were no significant differences noted between male and female fetuses regarding FLV, linear liver dimensions, or birth weight (p > 0.05), thereby confirming sex neutrality. Conclusions: Fetal liver volume is a reliable, gender-neutral measure of fetal growth with high correlation with both abdominal circumference and weight. It can be considered for prenatal assessments to facilitate early identification of intrauterine growth restriction and fetal growth tracking.