Reproducibility of the Measurement of the Right Portal Vein Diameter at the 30–33-Week Scan

Reproducibility of the Measurement of the Right Portal Vein Diameter at the 30–33-Week Scan | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Reproducibility of the Measurement of the Right Portal Vein Diameter at the 30–33-Week Scan Iglika Ivancheva SIMEONOVA BRACHOT, Aurélie Brossard- Violeau, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7235716/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective : This study aimed to evaluate the intra- and inter-operator reproducibility of right portal vein (RPV) assessment during routine third trimester ultrasound in small- and appropriate-for-age fetuses. Materials and methods: This prospective cross-sectional study was conducted at a single center. The study population comprised 67 pregnancies, including 28 (42%) small-for-gestational-age (SGA) fetuses and 39 (58%) appropriate-for-gestational-age (AGA) fetuses. Two blinded sonographers (expert and non-expert) independently evaluated the right portal vein as normal or collapsed via grid evaluation and then repeated two measurements, generating two different appropriate images. Results : Intra-observer agreements of RPV diameter measurement for the two operators were excellent, with interclass correlation coefficients .98 (95% CI, .97–.99) and .98 (95% CI, .95–.99) in the SGA group and .98 (95% CI, .97–.99) and .98 (95% CI, .96–.99) in the AGA group, respectively; P < .0001. Inter-observer agreement was good in the SGA group (.71 < ICC .79; P < .0001) and excellent in the AGA group (.86 < ICC .87; P < .0001). Inter-observer agreement on the criteria for collapsed RPV was substantial to perfect in both the SGA (.62 < K < .92) and AGA group (.61 < K < .94). Conclusions : We demonstrated excellent intra- and inter-observer reproducibility of RPV diameter measurement. Large prospective studies on screening for growth-restricted fetuses could be conducted without concern about the reproducibility of the right portal vein diameter measurement. assessment fetal growth reproducibility right portal vein Figures Figure 1 Figure 2 Figure 3 Full Text Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7235716","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":492126305,"identity":"07350131-f98d-462f-8c73-56212ed167ca","order_by":0,"name":"Iglika Ivancheva SIMEONOVA BRACHOT","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABCElEQVRIiWNgGAWjYBACNgbmhoMNDAw8MAE5KFsOjxZGVC3GULYxHnsYGxgbkLiJDYS08PEvbDw4o6ZORre9+diDj2126RuOnz344AODQT5Oh0k8bDi44dhhHrMzx9INZ7Yl5244k5dsOIPBwLIBp5aDDQcfsB3gMbuRYybNc4Y5d8MBEIPhjwFuW0Ba/tXxmN1/A9JSn25wHsRgMMCthb+x4eDGNmagLTxAlRWHEwzA1uHTIgEM5Jl9IL+kpUnOqDhuOPPGG2PDGQa4tcj3Hz78sedbnb3Z8cPHJD4YVMvznc8xfPChArcWBokENAGFAyAStwYGBv4D6PY24FE9CkbBKBgFIxIAAG2rW2G3EufxAAAAAElFTkSuQmCC","orcid":"https://orcid.org/0000-0001-5972-8272","institution":"1)\tDepartment of Obstetrics and Gynecology, Centre Hospitaler Universitaire de Poitiers, France","correspondingAuthor":true,"prefix":"","firstName":"Iglika","middleName":"Ivancheva SIMEONOVA","lastName":"BRACHOT","suffix":""},{"id":492126306,"identity":"8c0ac5e8-6a06-4336-9faf-c794cb57fe48","order_by":1,"name":"Aurélie Brossard- Violeau","email":"","orcid":"","institution":"Department of Obstetrics and Gynecology, Centre Hospitaler Universitaire de Poitiers, France","correspondingAuthor":false,"prefix":"","firstName":"Aurélie","middleName":"Brossard-","lastName":"Violeau","suffix":""},{"id":492126307,"identity":"05a47ce3-56a8-478a-b108-23d8a11ab88f","order_by":2,"name":"Marion Mercier","email":"","orcid":"","institution":"Department of Obstetrics and Gynecology, Centre Hospitaler Universitaire de Rennes, France","correspondingAuthor":false,"prefix":"","firstName":"Marion","middleName":"","lastName":"Mercier","suffix":""},{"id":492126308,"identity":"14600b83-6826-49a9-a31a-22c6ee4ef679","order_by":3,"name":"Joe De Keizer","email":"","orcid":"","institution":"Department of Statistics, Centre Hospitaler Universitaire de Poitiers, France","correspondingAuthor":false,"prefix":"","firstName":"Joe","middleName":"","lastName":"De Keizer","suffix":""},{"id":492126309,"identity":"0b458023-c351-44c4-b0fa-1ea143f65034","order_by":4,"name":"Fabrice Pierre","email":"","orcid":"","institution":"Department of Obstetrics and Gynecology, Centre Hospitaler Universitaire de Poitiers, France","correspondingAuthor":false,"prefix":"","firstName":"Fabrice","middleName":"","lastName":"Pierre","suffix":""}],"badges":[],"createdAt":"2025-07-28 16:06:55","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":true,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-7235716/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7235716/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":88017033,"identity":"3b5d5a1a-eddf-4cd8-bf4d-4f6b8aa0b3f4","added_by":"auto","created_at":"2025-07-31 13:13:20","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":26613070,"visible":true,"origin":"","legend":"\u003cp\u003eRPV aspects in growth restricted and normal fetuses. (a) Abdominal perimeter plane, showing RPV lumen difficult to follow clearly (open arrow) despite the effort to sweep the beam further up and down. The abdominal perimeter was at the 23th percentile, the EFW was at the 6th percentile and the fetal dopplers were normal at 31 weeks and 3 days. (b) Abdominal perimeter plane in the same fetus, showing an irregular RPV wall at 34 weeks and 6 days (open arrow). The patient underwent plan delivery at 35 weeks in the context of maternal preeclampsia and late-onset fetal growth restriction with cerebral blood-flow redistribution. The birth weight was 1900 g (9th percentile); c) Another fetus with a sharp drop of RPV diameter, note the large ductus venosus caliber (open arrow), the arrow indicates the site of measurement; the EFW was below the 3th percentile at 32 weeks and 3 days, there was also a cerebral blood-flow redistribution. The birth weight was 1825 g at 37 weeks. (d) Abdominal perimeter plane, showing a normal right portal vein aspect, the arrow indicates the site of measurement; the EFW was at the 54th percentile at 31 weeks and the birth weight was 2930 g (10th percentile). The patient delivered normally at 40 weeks and 3 days.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7235716/v1/53f544d337fe3fed8b9d6574.png"},{"id":88017032,"identity":"c0eaf792-463b-4db3-87ef-da85849f3995","added_by":"auto","created_at":"2025-07-31 13:13:20","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":1475869,"visible":true,"origin":"","legend":"\u003cp\u003eBland-Altman plot showing the intra- and inter-observer agreements for the RPV diameter measurement in the small-for-gestational-age group; A) Intra-operator A agreement; B) Intra-operator B agreement; C) Inter-operator agreement OP A/MES 1- OP B/MES 1; D) Inter-operator agreement OP A/MES 2- OP B/MES 2; E) Inter-operator agreement OP A/MES 1- OP B/MES 2; F) Inter-operator agreement OP A/MES 2- OP B/MES 1; OP A, Operator A; OP B, Operator B; MES1: first measurement; MES2: second measurement\u003c/p\u003e","description":"","filename":"Figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-7235716/v1/e2d191abb3c1617cb68e72eb.png"},{"id":88017031,"identity":"d45f28d4-0a26-40eb-97fe-1c51bb65014f","added_by":"auto","created_at":"2025-07-31 13:13:20","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":1562175,"visible":true,"origin":"","legend":"\u003cp\u003eBland-Altman plot showing the intra- and inter-observer agreements for the RPV diameter measurement in the appropriate-for-gestational-age group; A) Intra-operator A agreement; B) Intra-operator B agreement; C) Inter-operator agreement OP A/MES 1- OP B/MES 1; D) Inter-operator agreement OP A/MES 2- OP B/MES 2; E) Inter-operator agreement OP A/MES 1- OP B/MES 2; F) Inter-operator agreement OP A/MES 2- OP B/MES 1; OP A, Operator A; OP B, Operator B; MES1: first measurement; MES2: second measurement\u003c/p\u003e","description":"","filename":"Figure3.png","url":"https://assets-eu.researchsquare.com/files/rs-7235716/v1/2ddd89293db1e5b03277979d.png"},{"id":88017394,"identity":"4afe753d-72cb-40f0-ba68-bf662d3b68ee","added_by":"auto","created_at":"2025-07-31 13:21:40","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2479192,"visible":true,"origin":"","legend":"","description":"","filename":"PORTALGROWTHMaindocument.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7235716/v1_covered_22819ff8-1810-43d7-9ed4-ed06d8cc75af.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003eReproducibility of the Measurement of the Right Portal Vein Diameter at the 30–33-Week Scan\u003c/p\u003e","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"University hospital of Poitiers","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"assessment, fetal, growth, reproducibility, right portal vein","lastPublishedDoi":"10.21203/rs.3.rs-7235716/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7235716/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective\u003c/strong\u003e: This study aimed to evaluate the intra- and inter-operator reproducibility of right portal vein (RPV) assessment during routine third trimester ultrasound in small- and appropriate-for-age fetuses.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMaterials and methods:\u003c/strong\u003e This prospective cross-sectional study was conducted at a single center. The study population comprised 67 pregnancies, including 28 (42%) small-for-gestational-age (SGA) fetuses and 39 (58%) appropriate-for-gestational-age (AGA) fetuses. Two blinded sonographers (expert and non-expert) independently evaluated the right portal vein as normal or collapsed via grid evaluation and then repeated two measurements, generating two different appropriate images. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: Intra-observer agreements of RPV diameter measurement for the two operators were excellent, with interclass correlation coefficients .98 (95% CI, .97–.99) and .98 (95% CI, .95–.99) in the SGA group and .98 (95% CI, .97–.99) and .98 (95% CI, .96–.99) in the AGA group, respectively; P \u0026lt; .0001. Inter-observer agreement was good in the SGA group (.71 \u0026lt; ICC .79; P \u0026lt; .0001) and excellent in the AGA group (.86 \u0026lt; ICC .87; P \u0026lt; .0001). Inter-observer agreement on the criteria for collapsed RPV was substantial to perfect in both the SGA (.62 \u0026lt; K \u0026lt; .92) and AGA group (.61 \u0026lt; K \u0026lt; .94). \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e: We demonstrated excellent intra- and inter-observer reproducibility of RPV diameter measurement. Large prospective studies on screening for growth-restricted fetuses could be conducted without concern about the reproducibility of the right portal vein diameter measurement.\u0026nbsp;\u003c/p\u003e","manuscriptTitle":"Reproducibility of the Measurement of the Right Portal Vein Diameter at the 30–33-Week Scan","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-31 13:13:15","doi":"10.21203/rs.3.rs-7235716/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b1bee740-159a-49c6-aa13-022b1619c761","owner":[],"postedDate":"July 31st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-07-31T13:13:15+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-31 13:13:15","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7235716","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7235716","identity":"rs-7235716","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}