Sonographic prediction of fetal macrosomia: The consequences of false diagnosis

Nir Melamed, Yariv Yogev, Israel Meizner, Reuven Mashiach, Avi Ben-Haroush

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)225-230
Number of pages6
JournalJournal of Ultrasound in Medicine
Volume29
Issue number2
DOIs
StatePublished - 1 Feb 2010

Keywords

  • Diagnosis
  • Estimated fetal weight
  • Macrosomia
  • Sonography

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