تخطى إلى المحتوى / Skip to content

Try TabeebPlus fully for 7 days free!

Evidence Grade Ascore

Estimated Fetal Weight (EFW) Calculator

The estimated fetal weight (EFW) calculator uses Hadlock and Shepard formulas based on fetal biometric measurements including biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL). EFW is essential for detecting fetal growth abnormalities such as SGA, IUGR, and LGA.

Patient Parameters

Enter the values below to calculate the score.

mm
mm
mm
mm
weeks

About

Estimated fetal weight (EFW) is calculated from fetal biometric parameters using validated regression formulas. The Hadlock formula using HC+AC+FL is the most accurate. Results are compared against population-based growth curves to determine percentile for gestational age. EFW <10th percentile suggests SGA/IUGR, while EFW >90th percentile suggests LGA/macrosomia.

Formula

Hadlock (HC+AC+FL): Log10(EFW) = 1.326 + 0.01007(HC) + 0.0438(AC) + 0.158(FL) − 0.00326(AC×FL); Hadlock (AC+FL): Log10(EFW) = 1.304 + 0.05281(AC) + 0.1938(FL) − 0.004(AC×FL); Shepard (BPD+AC): Log10(EFW) = 0.625 − 0.0016(BPD×AC) + 0.059(AC) + 0.1(BPD)

The calculator prioritizes the Hadlock formula with HC+AC+FL (most accurate). If HC is unavailable, it uses Hadlock AC+FL. Other combinations are used as fallbacks. The result is compared against gestational age-specific percentiles.

Score Interpretation

Accurate EFW estimation is critical for detecting fetal growth abnormalities and guiding delivery planning. Fetal growth restriction (FGR/IUGR) affects 5-10% of pregnancies and is associated with increased perinatal morbidity and mortality. Macrosomia (LGA/EFW >4000g) complicates 8-10% of pregnancies and increases risk of shoulder dystocia, birth trauma, and cesarean delivery.

EFW Result0+

Estimated fetal weight in grams with percentile for gestational age.

Management: Interpret based on percentile. <10th = SGA/IUGR evaluation. >90th = LGA/macrosomia evaluation.

Reference Ranges

PopulationNormal RangeNotes
SGA/IUGR<10th percentileEvaluate for growth restriction
AGA (appropriate for GA)10th-90th percentileNormal fetal growth
LGA/Macrosomia>90th percentileIncreased risk of birth complications
Dr. Khaled Hassan

Dr. Khaled Hassan

MD, FACCCardiology

Dr. Khaled is a cardiology consultant with experience in acute cardiac care.

View medical review board & editorial policy →

Example Calculation

GA 32w: BPD 80mm, HC 290mm, AC 280mm, FL 62mm. Hadlock EFW = 1850g (45th percentile). Interpretation: Appropriate for gestational age.

Common Mistakes

Mistake

Using BPD alone for EFW estimation

Correction

BPD alone has low accuracy for EFW. Always include HC, AC, and FL for the most accurate Hadlock estimation.

Frequently Asked Questions

Which EFW formula is most accurate?
The Hadlock formula using HC+AC+FL is the most accurate, with a 95% prediction interval of approximately ±15-18% of actual birth weight. The Shepard formula (BPD+AC) is slightly less accurate but useful when only BPD and AC are available. All formulas become less accurate at extremes of fetal weight and in the third trimester.
What is the clinical significance of EFW <10th percentile?
EFW <10th percentile suggests SGA or possible IUGR. Once detected, detailed assessment includes: amniotic fluid volume, Doppler velocimetry (umbilical artery, middle cerebral artery), fetal anatomy survey, and serial growth scans. Management depends on the underlying cause, gestational age, and severity. IUGR increases risks of stillbirth, neonatal acidosis, and neurodevelopmental delay.

References

  • Hadlock FP et al. Estimation of fetal weight with the use of head, body, and femur measurements. Am J Obstet Gynecol. 1985;151(3):333-337. PubMed
  • Shepard MJ et al. An evaluation of two equations for predicting fetal weight by ultrasound. Am J Obstet Gynecol. 1982;142(1):47-54. PubMed
Medical Disclaimer: This calculator is intended for use by healthcare professionals for educational and clinical decision support purposes only. It is not a substitute for professional clinical judgment.
Call Us
WhatsApp