ABSTRACT
>Objective: To determine the relative accuracy of clinical and sonographic estimates of fetal weight (EFW) among parturients with diabetes requiring insulin (White's classifications A2 and higher).Methods: In early labor, clinical EFW was followed by sonographic mensuration of fetal parts. At the completion of the study, sonographic EFW was calculated using abdominal circumference and femur length. Student's t test, Wilcoxan test, and chi square test were used to assess the relative accuracy of the two methods of assessing birth weight.Results: Among 94 parturients with various classifications of diabetes, the clinical estimate of birth weight has a significantly higher simple error (-180.3 + 419.5 g) but not a significantly higher mean standardized absolute error (130.7 +/- 130.1 g/kg) than sonographic prediction (-139.3 +/- 447.1 g, 115.6 +/- 90.8 g/kg, respectively). Analysis of the data, according to gestational age, indicates that clinical EFW is more accurate than sonographic EFW among term (n = 67) parturients with diabetes, but both methods are comparable in preterm (n = 27) parturients. However, when the data are analyzed according to birth weight, EFW by Leopold maneuvers is significantly more accurate than those obtained sonographically in infants weighing 2500-3999 g (n = 66) and >4000 g (n = 12).Conclusion: In term gestations of diabetic mothers and those infants with a birth weight of 2500 g or more, the clinical estimate of birth weight is more accurate; however, in preterm diabetic pregnancies, clinical and sonographic estimates are equal.
ABSTRACT
Objective: To evaluate the negative fetal fibronectin (fFN) assay in patients with twin gestations who are symptomatic for preterm labor (PTL).Study Design: Fetal fibronectin expression in 955 symptomatic patients combined from two prospective multicenter trials was studied. Of the 955 patients, 43 had twin gestations in PTL with intact amniotic membranes at 24 and 35 weeks. Fetal fibronectin expression was evaluated in relation to delivery within 7 days of the symptomatic episode for PTL.Results: Of the 43 eligible patients, 11 had a positive fFN assay and 6 delivered
