Accuracy of Antenatal Ultrasound in Predicting Large for Gestational Age Babies: Population Based Cohort Study.
Hadlock
birthweight
customized
estimated fetal weight
fetal weight
large for gestational age
macrosomia
ultrasound
Journal
American journal of obstetrics and gynecology
ISSN: 1097-6868
Titre abrégé: Am J Obstet Gynecol
Pays: United States
ID NLM: 0370476
Informations de publication
Date de publication:
07 May 2024
07 May 2024
Historique:
received:
22
02
2024
revised:
30
04
2024
accepted:
30
04
2024
medline:
10
5
2024
pubmed:
10
5
2024
entrez:
9
5
2024
Statut:
aheadofprint
Résumé
Pregnancies with large for gestational age fetuses are at increased risk of adverse maternal and neonatal outcomes. There is uncertainty about how to manage birth in such pregnancies. Current guidelines recommend a discussion with women of the pros and cons of options including expectant management, induction of labour and caesarean birth. For women to be able to make an informed decision about birth, antenatal detection of large for gestational age is essential. To investigate the ability of antenatal ultrasound scans to predict large for gestational age at birth. In this retrospective cohort study, we analysed data from a routinely collected database from the West Midlands, United Kingdom. We included pregnancies that had an antenatal ultrasound estimated fetal weight between 35+0 and 38+0 weeks gestation for any indication, as well as a subgroup where the reason for scan was that the fetus was suspected to be big. Large for gestational age was defined as >90 The study cohort consisted of 26,527 pregnancies which on average had a scan at 256 days gestation and delivered 20 days later at a median of 276 days (interquartile range 15). In total 2241 (8.4%) of neonates were large for gestational age by customized centiles, of which 1459 (65.1%) had a scan estimated fetal weight >90 Late third trimester ultrasound estimation of fetal weight for any indication has good ability to identify and predict large for gestational age at birth, and improves with the use of a customised standard. Detection rate is better when ultrasound is performed for a suspected large fetus, however at the risk of higher false positive diagnosis. Our results provide information for women and clinicians to aid antenatal decision making about birth of a fetus suspected of being large for gestational age.
Sections du résumé
BACKGROUND
BACKGROUND
Pregnancies with large for gestational age fetuses are at increased risk of adverse maternal and neonatal outcomes. There is uncertainty about how to manage birth in such pregnancies. Current guidelines recommend a discussion with women of the pros and cons of options including expectant management, induction of labour and caesarean birth. For women to be able to make an informed decision about birth, antenatal detection of large for gestational age is essential.
OBJECTIVE
OBJECTIVE
To investigate the ability of antenatal ultrasound scans to predict large for gestational age at birth.
STUDY DESIGN
METHODS
In this retrospective cohort study, we analysed data from a routinely collected database from the West Midlands, United Kingdom. We included pregnancies that had an antenatal ultrasound estimated fetal weight between 35+0 and 38+0 weeks gestation for any indication, as well as a subgroup where the reason for scan was that the fetus was suspected to be big. Large for gestational age was defined as >90
RESULTS
RESULTS
The study cohort consisted of 26,527 pregnancies which on average had a scan at 256 days gestation and delivered 20 days later at a median of 276 days (interquartile range 15). In total 2241 (8.4%) of neonates were large for gestational age by customized centiles, of which 1459 (65.1%) had a scan estimated fetal weight >90
CONCLUSION
CONCLUSIONS
Late third trimester ultrasound estimation of fetal weight for any indication has good ability to identify and predict large for gestational age at birth, and improves with the use of a customised standard. Detection rate is better when ultrasound is performed for a suspected large fetus, however at the risk of higher false positive diagnosis. Our results provide information for women and clinicians to aid antenatal decision making about birth of a fetus suspected of being large for gestational age.
Identifiants
pubmed: 38723984
pii: S0002-9378(24)00578-7
doi: 10.1016/j.ajog.2024.04.052
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.