The birth weight of macrosomia influence the accuracy of ultrasound estimation of fetal weight at term

Abstract

Objective: To evaluate and analyze the accuracy of ultrasound estimation of the fetal weight of Macrosomia at term. Method: The instruments used were α6(Aloka; Japan) color Doppler ultrasound imagers, and vinno 80 (feieno; China) with a frequency of 3.5 MHz. The formula used to calculate the estimated fetal birth weight (EFW) was that proposed by Hadlock et al. (Hadlock 2). The biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) measurements were performed strictly following the practice guidelines. Detailed measurement standards are shown in the figure and the table in the text. Macrosomia is typically defined as a birth weight above the 90th percentile for gestational age or >4000 g.Two indexes were used to calculate the error between EFW and birth weight (BW): Simple error (SE = BW À EFW); Absolute percentage error (APE, which reflects this percentage in absolute value, percentage error [PE = SE/BW] Â 100).In order to better evaluate the measurement results, we made the following definitions: 1. When APE > 15%, the measurement deviation is significant. 2. The ratio of those cases with APE > 15% to the total number of cases measured by a sonographer was greater than 20%, indicating that the sonographer was prone to significant measurement deviation.Result: A total of 374 cases were analyzed. The mean maternal age was 31.48 (±15.93) years. Each pregnant woman carries only one fetus. The mean gestational age at delivery was 39.93 (±0.84) weeks. There were 245 male infants (65.5%), 129 female infants (34.5%), 214 cesarean section (57.2%), and 160 vaginal delivery (42.7%). 339 cases (90.64%) were estimated to be lower than the actual BW. The estimated weight was higher than the actual weight in 35 cases, accounting for 9.36%.The APE>15% in 56 cases, accounting for 14.97%. The accuracy of estimated fetal weight was closely related to the BW of the fetus and had no significant correlation with the seniority of the physician, the gender of the fetus, and the fetal position. Conclusion:Studies on macrosomia have shown that the BW of macrosomia tends to be underestimated, which is also reflected in the results of this study. The accuracy of estimated fetal weight still needs to be improved. Our study found that the accuracy of estimated fetal weight was closely related to the BW of the fetus and had no significant correlation with the seniority of the physician, the gender of the

Risk of adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus by age: a multicentric cohort study in Hebei, China

“…Pregnant women with AMA and GDM was lower for metabolize glucose, and excessive placental transport of glucose and other nutrients from pregnant woman to fetus caused abnormal fetal growth, including macrosomia and LGA 30 . The length of the biparietal diameter of macrosomia increased, and the fetal position appeared abnormally 31 , and pregnant women with AMA were at increased risk of breech presentation 32 . These findings were consistent to the result of this study, that was, AMA with GDM had the higher risk of abnormal fetal position.…”

The Effect of Timing and Methods for the Diagnosis of Gestational Diabetes Mellitus on Obstetric Complications

“…These complications increase the risk of trauma during labor, the need for CS, and prolonged the hospital stays in the Neonatal Intensive Care Unit [ 26 , 28 ]. It is therefore important to estimate fetal weight accurately during antenatal ultrasound, and a suitable birth plan should be made [ 38 ].…”

Can we improve the diagnosis of fetal macrosomia?

“…Despite the importance of an accurate identification before birth, the current models used mainly based on fetal biometry and the subsequent estimated fetal weight (EFW). In this issue of the Journal of Clincal Ultrasound 4 retrospectively analyzed 380 cases of macrosomia delivered in 1‐year interval at their unit. In more than 50% of the cases, there was underestimation >300 g in the antenatal evaluation of EFW.…”