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A total of 63 formulas using various combinations of abdominal circumference (AC), femur length (FL), biparietal diameter (BPD) and head circumference (HC) for the estimation of fetal weight (EFW), were compared to BW for accuracy in 226 twin pregnancies\/452 fetuses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Using median percentage error (MPE), the most accurate formulas were the Hadlock formulas (1984, 1985 with MPE\u2009&lt;\u20091%) incorporating AC, HC, and FL. The INTERGROWTH\u201021st formula, which incorporates AC and HC, marginally underestimated BW (MPE \u22123.7%). The Hadlock formulas were more likely to overestimate BW than underestimate it. Using small\u2010for\u2010gestational (SGA, EFW\u2009&lt;\u20095th centile), the sensitivity for detection of low BW (BW\u2009&lt;\u20095th centile) was 92%, 81% and 89% for the Hadlock 1984, Hadlock 1985 and INTERGROWTH\u201021st formulas, respectively. SGA prevalence was noted to be higher for the INTERGROWTH\u201021st formula for fetal factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Among 63 proposed formulas for EFW, the Hadlock formulas incorporating HC, AC and FL were the most accurate in twins. However, the INTERGROWTH\u201021st standard, which incorporates AC and HC, did not show lower detection rates for LBW. The frequency and intensity of twin ultrasound surveillance is such that restriction of ultrasound examination to two parameters in ultrasound could be recommended without diminution of accuracy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.16186","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T03:34:18Z","timestamp":1740540858000},"page":"463-470","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Accuracy of ultrasound estimation of fetal weight in twin pregnancy"],"prefix":"10.1002","volume":"170","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7942-9314","authenticated-orcid":false,"given":"Patrick","family":"Dicker","sequence":"first","affiliation":[{"name":"Royal College of Surgeons in Ireland, Obstetrics and Gynecology  Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5983-8682","authenticated-orcid":false,"given":"Ronan","family":"Conroy","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health Royal College of Surgeons in Ireland  Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3477-6494","authenticated-orcid":false,"given":"Fionnuala","family":"McAuliffe","sequence":"additional","affiliation":[{"name":"UCD Perinatal Research Center University College Dublin  Dublin Ireland"},{"name":"National Maternity Hospital  Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7387-3385","authenticated-orcid":false,"given":"Michael","family":"Geary","sequence":"additional","affiliation":[{"name":"Rotunda Hospital  Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean","family":"Daly","sequence":"additional","affiliation":[{"name":"Rotunda Hospital  Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John J.","family":"Morrison","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Galway  Galway Ireland"},{"name":"University Hospital Galway  Galway Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Carroll","sequence":"additional","affiliation":[{"name":"National Maternity Hospital  Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4313-4594","authenticated-orcid":false,"given":"Fergal D.","family":"Malone","sequence":"additional","affiliation":[{"name":"Royal College of Surgeons in Ireland, Obstetrics and Gynecology  Dublin Ireland"},{"name":"Rotunda Hospital  Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2966-6987","authenticated-orcid":false,"given":"Fionnuala M.","family":"Breathnach","sequence":"additional","affiliation":[{"name":"Royal College of Surgeons in Ireland, Obstetrics and Gynecology  Dublin Ireland"},{"name":"Rotunda Hospital  Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,2,24]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1375\/twin.11.2.224"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.04.044"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10040643"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-021-03907-1"},{"key":"e_1_2_10_6_1","unstructured":"National Institute for Health and Care Excellence.Twin and triplet pregnancy.2019.https:\/\/www.nice.org.uk\/guidance\/ng137. 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