Sonograhpic evaluation of fetal macrosomia

ABSTRACT

This study included 86 high risk pregnant patients who were classified as follows 14 with diabetes mellitus [DM], 13 with iron deficiency anaemia, 13 with rheumatic heart disease, 13 with preeclamosia [PET], 10 with chronic hypertension, 15 with history of large birth weight babies and 7 with chronic nephritis, in addition a control group to 41 normal pregnant women. Macrosomia was found in 7.3% of the control group compared to 20.9% of the high risk group as a whole. The incidence of macrosomia among diabetic patients was very high reaching to 64.3% in the high risk group as a whole, the following parameters EFW, FML, AC, HC/AC were of diagnostic value because of their reasonable sensitivities, i.e. 48.9%, 40.5%, 38.4% and 33.7% respectively. BPD and HC were not of diagnostic value because of their low sensitivities i.e. 11.1% and 20.5% respectively. All the mentioned parameters carried a high specificity. In diabetic macrosomia the sensitivity and the specificity of the different ultrasonic parameters were almost comparable to those of the high risk group as a whole. The false negative rate in the high risk group as a whole was relatively low, 12.5% compared to 57.2% in diabetic macrosomia. In conclusion, no single parameter can be used for detection of macrosomia in the different high risk groups. The ultrasonic parameters have their own limitations in detection of macrosomia because of their high false negative rates. Better ultrasonic parameters have to be developed and evaluated such as thigh thickness and subcutaneous fat assessment