Influence of Sonographic Fetal Weight Estimation Inaccuracies in Macrosomia on Perinatal Outcome.
Ultraschall Med
; 43(5): e56-e64, 2022 Oct.
Article
em En
| MEDLINE
| ID: mdl-32767300
ABSTRACT
OBJECTIVE:
To evaluate the influence of inaccurate sonographic fetal weight estimation in macrosomia on the mode of delivery and neonatal outcome (NO).METHODS:
In 14â633 pregnancies between 2002 and 2016, this retrospective study evaluated the association between sonographic fetal weight estimation, true birth weight (BW), mode of delivery (primary cesarean section [pCS], secondary cesarean section, vaginal delivery, and operative vaginal delivery rates) and NO parameters (5-min Apgar <â7, pH <â7.1, neonatal intensive care unit [NICU] admission, shoulder dystocia). Singleton pregnancies >â37â+â0 weeks with ultrasound-estimated fetal weight (EFW) within 7 days before delivery were included. The study population was divided into four groups Group 1 (false-negative) EFW <â4000âg/BW ≥â4000âg; Group 2 (true-positive) EFW ≥â4000âg/BW ≥â4000âg; Group 3 (false-positive) EFW ≥â4000âg/BW <â4000âg; and Group 4 (true-negative) EFW <â4000âg/BW <â4000âg.RESULTS:
As expected, the highest secondary cesarean section (sCS) rate was found in Group 2 (true-positive) (30.62â%), compared with only 17.68â% in Group 4 (true-negative). The sCS rate in the false-positive Group 3 was significantly higher (28.48â%) in comparison with the false-negative Group 1 (21.22â%; OR 1.48; 95â% CI, 1.16 to 1.89; Pâ=â0.002). In comparison with the true-negative Group 4, univariate analyses showed significantly higher rates for sCS in all other groups odds ratio (OR) 2.06 for Group 2 (95â% CI, 1.74 to 2.42; Pâ<â0.001), 1.85 for Group 3 (95â% CI, 1.54 to 2.22, P <â0.001), and 1.25 for Group 1 (95â% CI, 1.05 to 1.49; P <â0.01). No significant differences were found for NO between Groups 1 and 3 for the parameters 5-min Apgar <â7 (Pâ=â0.75), pH <â7.1 (Pâ=â0.28), or NICU admission (Pâ=â0.54). However, there was a significantly higher chance for shoulder dystocia in Group 1 compared with Group 3 (OR 4.58; 95â% CI, 1.34 to 24.30; Pâ=â0.008).CONCLUSION:
Sonographic EFW inaccuracies in fetal macrosomia appear to have a greater impact on the mode of delivery than birth weight itself. Underestimation of fetal weight may be associated with a higher probability of shoulder dystocia.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Peso Fetal
/
Distocia do Ombro
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Newborn
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Pregnancy
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article