| Clinical and ultrasonographic weight estimation in large for gestational age fetus. | |
| | |
MedLine Citation:
|
PMID: 12270559 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To examine prospectively the effect on pregnancy outcome of a management protocol, that adds ultrasonographic weight estimation in fetuses suspected clinically as large. STUDY DESIGN: Prospective follow up study of all singleton deliveries during a 1 year period. All patients underwent routine clinical estimation of fetal weight. When clinical estimation of fetal weight was > or = 3700 g, patients were referred for ultrasonographic estimation of fetal weight. When the latter was > or = 4000 g the patient was informed about the risks of birth trauma. Cesarean section was recommended only when > or = 4500 g. Ultrasonography was repeated every 4 days when possible. Predictive values of clinical and ultrasonographic estimations of fetal weight for diagnosing macrosomia, defined for the purpose of this study as 4000 g or more, and their effect on the rate of cesarean sections. RESULTS: Five hundred fifty-five (14.4%) out of 3844 singletons were estimated as 3700 g or more. Only 315 fetuses had ultrasonographic estimation of weight within 3 days of delivery. The sensitivity of clinical and ultrasonographic prediction of macrosomia was 68 and 58%, respectively. Cesarean section rate in newborns weighing 4000 g or more was 22% when macrosomia was clinically suspected compared to 11% when it was not (P<0.05). In fetuses estimated ultrasonographically as 4000 g or larger the cesarean section rate was doubled (50.7% versus 24.9%, P<0.05) compared to those estimated as smaller than 4000 g, although actual weight of 4500 g or more was recorded in 10.6 and 8.5% of these groups, respectively. There were no cases of shoulder dystocia in macrosomic babies when macrosomia was not detected by ultrasound compared to two cases of shoulder dystocia (2.7%) when macrosomia was detected by ultrasound. CONCLUSION: Antenatal suspicion of macrosomia increased the cesarean section rate while the associated improvement in pregnancy outcome remains questionable. The contribution of ultrasound, added to routine clinical estimation of fetal weight, was clinically insignificant apart from a further increase in cesarean section rate. |
| | |
Authors:
|
Zeev Weiner; Izhar Ben-Shlomo; Ronit Beck-Fruchter; Yael Goldberg; Eliezer Shalev |
Related Documents
:
|
17261119 - Caesarean delivery and risk of stillbirth in subsequent pregnancy: a retrospective coho... 16127519 - Comparison between visual and computerized cardiotocography in low risk pregnancy. 12346599 - In re a.c., 16 june 1987. 9084519 - The role of labetalol and propofol in the management of hellp syndrome--a case report. 9402299 - Remodelling of guinea-pig aorta during pregnancy: selective alteration of endothelial c... 10687829 - Intrapartum fetal distress and magnesium sulfate. 22444549 - Effect of one or three timed artificial inseminations before natural service on reprodu... 8248549 - Effect of igf-1 on placental prostanoid production. 6344229 - Recurrent transient hyperthyroidism and hypothyroidism associated with pregnancy. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: European journal of obstetrics, gynecology, and reproductive biology Volume: 105 ISSN: 0301-2115 ISO Abbreviation: Eur. J. Obstet. Gynecol. Reprod. Biol. Publication Date: 2002 Oct |
Date Detail:
|
Created Date: 2002-09-24 Completed Date: 2003-04-15 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 0375672 Medline TA: Eur J Obstet Gynecol Reprod Biol Country: Ireland |
Other Details:
|
Languages: eng Pagination: 20-4 Citation Subset: IM |
Affiliation:
|
Department of Obstetrics and Gynecology, Afula and the Rappaport Faculty of Medicine, Ha'Emek Medical Center, Technion-Israel Institute of Technology, Haifa, Israel. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Cesarean Section Delivery, Obstetric Dystocia / epidemiology Female Fetal Macrosomia / diagnosis*, ultrasonography Fetal Weight* Gestational Age Humans Pregnancy Pregnancy Outcome Prospective Studies Sensitivity and Specificity Shoulder Ultrasonography, Prenatal* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Tissue factor (TF) and tissue factor pathway inhibitor (TFPI) in the placenta and myometrium.
Next Document: References intervals for fetal biometrical parameters.