Antepartum detection of macrosomic fetus: the effect of misdiagnosis

ABSTRACT

To determine the effect of misdiagnosis of macrosomia on maternal and perinatal outcomes. We conducted a retrospective study, between January 2007 and December 2008 of women [n = 464] who delivered singleton neonates with actual birth weight over 4000g and in whom fetal weight was estimated, by both methods:sonographic and clinical, up to 3 days before delivery. Statistical comparisons were made between patients in whom fetal macrosomia was predicted "prediction " group [n=336]and those in whom it was not " non prediction "group [n=128] for outcome variables. The cesarean delivery was performed in 35.9% in " non predicted " group, and in 35.7% in the " predicted " group. The difference was not statistically significant. Failure to detect macrosomia was associated with higher rates of maternal and fetal complications in the group " non predicted " compared with the group " predicted "perineal trauma, post partum hemorrhage, 5- minute Apgar scores less than 7, and shoulder dystocia, mostly related to the higher rate of surgical vaginal deliveries. The misdiagnosis of fetal macrosomia substantially did not modify the cesarean section rate but leads to increase the maternal and neonatal complications