Document Detail

Sonographic diagnosis of the large for gestational age fetus at term: does it make a difference?
MedLine Citation:
PMID:  1727587     Owner:  NLM     Status:  MEDLINE    
We evaluated 406 women with late third-trimester ultrasound examinations to determine whether the sonographic diagnosis of a large for gestational age (LGA) fetus, defined as an estimated fetal weight at or above the 90th percentile, altered the management of labor and delivery. The sonographic prediction of LGA fetuses had a sensitivity, specificity, and positive predictive value of 50, 90, and 52%, respectively. Women without the sonographic diagnosis of an LGA fetus (N = 338) differed from those with the diagnosis (N = 68) in the frequency of diagnosed labor abnormalities (19 versus 30%, P = .03), use of epidural anesthesia (57 versus 74%, P = .01), and the incidence of cesarean deliveries (32 versus 53%, P = .004). To determine whether it was the sonographic prediction of an LGA fetus or the actual fetal weight that altered clinical management and perinatal outcomes, we stratified the study population into four groups and compared the true negatives with the false positives and the false negatives with the true positives. The incorrect sonographic diagnosis of an LGA fetus had a statistically significant effect on both the diagnosis of labor abnormalities (P = .04) and the incidence of elective cesareans (P = .04) in pregnancies with appropriate for gestational age birth weights.
A B Levine; C J Lockwood; B Brown; R Lapinski; R L Berkowitz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  79     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  1992 Jan 
Date Detail:
Created Date:  1992-01-23     Completed Date:  1992-01-23     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  55-8     Citation Subset:  AIM; IM    
Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai School of Medicine, New York, New York.
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MeSH Terms
Cesarean Section
Fetal Macrosomia / ultrasonography*
Multivariate Analysis
Obstetric Labor Complications
Predictive Value of Tests
Pregnancy Trimester, Third
Pregnancy in Diabetics
Retrospective Studies
Sensitivity and Specificity
Ultrasonography, Prenatal*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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