Suspected macrosomia? Better not tell

Objective To evaluate the management policy of delivery in a suspected macrosomic fetus and to describe the outcome of this policy. Study design For this prospective observational study we followed the management by reviewing the medical records of 145 women and their infants. The study population i...

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Bibliographic Details
Published in:Archives of gynecology and obstetrics 2008-09, Vol.278 (3), p.225-230
Main Authors: Sadeh-Mestechkin, D., Walfisch, A., Shachar, R., Shoham-Vardi, I., Vardi, H., Hallak, M.
Format: Article
Language:English
Subjects:
Adult
Birth weight
Case-Control Studies
Delivery, Obstetric - methods
Endocrinology
Female
Fetal Macrosomia - diagnosis
Fetal Macrosomia - diagnostic imaging
Fetal Macrosomia - therapy
Gynecology
Health risk assessment
Human Genetics
Humans
Induced labor
Infant, Newborn
Medicine
Medicine & Public Health
Obstetrics/Perinatology/Midwifery
Original Article
Pregnancy
Prospective Studies
Ultrasonography
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Summary:Objective To evaluate the management policy of delivery in a suspected macrosomic fetus and to describe the outcome of this policy. Study design For this prospective observational study we followed the management by reviewing the medical records of 145 women and their infants. The study population included women at term admitted to the obstetrics department with suspected macrosomic infants, as was diagnosed by an obstetrician and/or by fetal sonographic weight estimation of ≥4,000 g. The comparison group ( n  = 5,943) consisted of all women who gave birth during the data collection period. Results Induction of labor and cesarean delivery rates in the macrosomic pregnancies (actual birth weight >4,000 g) of the study group were significantly higher when compared with the macrosomic pregnancies of the comparison group. When comparing the non-macrosomic to the macrosomic pregnancies (actual birth weight 4,000 g) of the study group no significant difference was demonstrated regarding maternal or infant complications. The sensitivity, specificity and positive predictive value of the methods used for detecting macrosomia were 21.6, 98.6 and 43.5%, respectively. Conclusion Our ability to predict macrosomia is poor. Our management policy of suspected macrosomic pregnancies raises induction of labor and cesarean delivery rates without improving maternal or fetal outcome.
ISSN:0932-0067
1432-0711
DOI:10.1007/s00404-008-0566-y