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BMC Pregnancy and Childbirth

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Open Access 01-12-2018 | Research article

Accuracy of immediate antepartum ultrasound estimated fetal weight and its impact on mode of delivery and outcome - a cohort analysis

Authors: Johannes Stubert, Adam Peschel, Michael Bolz, Änne Glass, Bernd Gerber

Published in: BMC Pregnancy and Childbirth | Issue 1/2018

Abstract

Background

The aim of the study was to investigate the accuracy of ultrasound-derived estimated fetal weight (EFW) and to determine its impact on management and outcome of delivery.

Methods

In this single-center cohort analysis, women with a singleton term pregnancy in the beginning stages of labor were included. Women with immediately antepartum EFW (N = 492) were compared to women without ultrasound (N = 515).

Results

EFW was correct (deviation from birth weight ≤ 10%) in 72.2% (355/492) of patients with fetal biometry; 19.7% (97/492) were underestimated, and 8.1% (40/492) were overestimated. Newborns with a lower birth weight were more frequently overestimated, and newborns with higher birth weight were more frequently underestimated. The mean difference between EFW and real birth weight was − 114.5 g (standard deviation ±313 g, 95% confidence interval 87.1–142.0). The rate of non-reassuring fetal heart tracing (9.8% vs. 1.9%, P < 0.001) and of caesarean delivery (9.1% vs. 5.0%, P = 0.013) was higher in women with EFW. Overestimation was associated with an increased risk for delivery by caesarean section (odds ratio 2.80; 95% confidence interval 1.2–6.5, P = 0.017). After adjustment, EFW remained associated with increased non-reassuring fetal heart tracing (odds ratio 4.73; 95% confidence interval 2.3–9.6) and caesarean delivery (odds ratio 1.86; 95% confidence interval 1.1–3.1). The incidence of perineal tears of grade 3/4, shoulder dystocia, postnatal depression and neonatal acidosis did not differ between groups.

Conclusions

Antepartum ultrasound-derived EFW does not improve maternal and fetal outcome and is therefore not recommended.

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Title: Accuracy of immediate antepartum ultrasound estimated fetal weight and its impact on mode of delivery and outcome - a cohort analysis
Authors: Johannes Stubert
Adam Peschel
Michael Bolz
Änne Glass
Bernd Gerber
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Pregnancy and Childbirth / Issue 1/2018
Electronic ISSN: 1471-2393
DOI: https://doi.org/10.1186/s12884-018-1772-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Accuracy of immediate antepartum ultrasound estimated fetal weight and its impact on mode of delivery and outcome - a cohort analysis

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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