Sonographic Prediction of Fetal Weight of the Macrosomia and Its Outcome / 대한주산의학회잡지

ABSTRACT

OBJECTIVE: Our purpose was to assess the efficacy of routine ultrasonographic prediction of macrosomic fetal weight, to determine its influences on subsequent delivery type and to assess perinatal outcome by delivery type. METHODS: The hospital records of 177 patients delivered infants weighing > or =4000gm between January 1997 and December 1998 were reviewed. Statistical comparisons were made between patients in whom fetal macrosomia was predicted before delivery(n=71) and those in whom it was not(n=106) and between the perinatal outcomes for macrosomic fetuses delivered vaginally and by cesarean section. The statistical analysis was performed by student-t test, and Chi-square test and Fisher's exact test. RESULTS: The fetuses were consecutive singleton fetuses in vertex presentation delivered at a single institute. The sensitivity for identifying macrosomic fetus(birth weight >4000gm) with an estimated weight of > or =4000gm was 40%, Overall 60% of the infants had birth weights within 10% of the ultrasonographic estimates and 29% had birth weights within 5% of the ultrasonographic estimates. Cesarean sections were performed in 69% of the 'predicted' group and in 35% of the 'not predicted' group(69% vs 35%, p or =4cm cervical dilatation was similar in the predicted and not predicted groups(19% vs 12%, NS). There was no significant difference in the incidences of the occurrence of birth trauma. CONCLUSION: There appears to be a limitation to obtain estimation of fetal weight by ultrasonography. The antenatal prediction of fetal macrosomia is associated with a marked increase in cesarean deliveries without a significant reduction in the incidence of fetal injury