TY - JOUR
T1 - Sonographic prediction of fetal macrosomia
T2 - The consequences of false diagnosis
AU - Melamed, Nir
AU - Yogev, Yariv
AU - Meizner, Israel
AU - Mashiach, Reuven
AU - Ben-Haroush, Avi
PY - 2010/2/1
Y1 - 2010/2/1
N2 - Objective. The purpose of this study was to determine the effect of false diagnosis of macrosomia (<4500 g) on maternal/perinatal outcomes. Methods. We conducted a case-control study of women (n = 1938) in whom sonographically estimated fetal weight (EFW) was determined up to 3 days before delivery and actual birth weight (BW) was 3500 to 4499 g. Women with false-positive and -negative findings for macrosomia were compared, respectively, with women with true-negative and -positive findings for outcome variables. Results. The cesarean delivery (CD) rate was 2 to 2.5 times higher when EFW was 4000 to 4499 g, regardless of actual BW. Failure to detect macrosomia was associated with higher rates of perineal trauma, 5-minute Apgar scores less than 7, and neonatal trauma, mostly related to the higher rate of surgical vaginal deliveries. The use of another sonographic model with a lower false-positive rate could theoretically reduce the CD rate by approximately 5%. Conclusions. False diagnosis of macrosomia substantially increases the CD rate and leads to maternal/neonatal complications.
AB - Objective. The purpose of this study was to determine the effect of false diagnosis of macrosomia (<4500 g) on maternal/perinatal outcomes. Methods. We conducted a case-control study of women (n = 1938) in whom sonographically estimated fetal weight (EFW) was determined up to 3 days before delivery and actual birth weight (BW) was 3500 to 4499 g. Women with false-positive and -negative findings for macrosomia were compared, respectively, with women with true-negative and -positive findings for outcome variables. Results. The cesarean delivery (CD) rate was 2 to 2.5 times higher when EFW was 4000 to 4499 g, regardless of actual BW. Failure to detect macrosomia was associated with higher rates of perineal trauma, 5-minute Apgar scores less than 7, and neonatal trauma, mostly related to the higher rate of surgical vaginal deliveries. The use of another sonographic model with a lower false-positive rate could theoretically reduce the CD rate by approximately 5%. Conclusions. False diagnosis of macrosomia substantially increases the CD rate and leads to maternal/neonatal complications.
KW - Diagnosis
KW - Estimated fetal weight
KW - Macrosomia
KW - Sonography
UR - http://www.scopus.com/inward/record.url?scp=75749152086&partnerID=8YFLogxK
U2 - 10.7863/jum.2010.29.2.225
DO - 10.7863/jum.2010.29.2.225
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 20103792
AN - SCOPUS:75749152086
SN - 0278-4297
VL - 29
SP - 225
EP - 230
JO - Journal of Ultrasound in Medicine
JF - Journal of Ultrasound in Medicine
IS - 2
ER -