OBJECTIVE: To determine if birth weights greater than 4000 g can be predicted by ultrasound measurements of abdominal circumferences. METHODS: In 1996, 254 newborns delivered at Tampa General Hospital weighed at least 4000 g, 84 of whom had ultrasound examinations within 2 weeks of delivery. Those were compared with 84 neonates with recent ultrasounds who weighed less than 4000 g. Data were abstracted retrospectively from maternal medical records. RESULTS: The best linear predictor of birth weight was ultrasound measurement of abdominal circumference (AC), which had a correlation coefficient of 0.95. An AC measurement of 35 cm or more predicted 93% of macrosomic infants. Among 177 macrosomic infants born vaginally, 23 (13%) had shoulder dystocia. In that group, induction of labor was associated with a greater than three-fold increase in risk of shoulder dystocia (odds ratio [OR] 3.4, 95% confidence interval [CI] 1.4, 8.2; P < .01). Labor augmentation was not associated with increased risk of shoulder dystocia. CONCLUSION: Abdominal circumference measurements were useful in screening for suspected macrosomia. An AC measurement of 35 cm or more identified more than 90% of macrosomic infants who were at risk for shoulder dystocia. Induction of labor in macrosomic patients increased the risk of shoulder dystocia.
OBJECTIVE: To determine if birth weights greater than 4000 g can be predicted by ultrasound measurements of abdominal circumferences. METHODS: In 1996, 254 newborns delivered at Tampa General Hospital weighed at least 4000 g, 84 of whom had ultrasound examinations within 2 weeks of delivery. Those were compared with 84 neonates with recent ultrasounds who weighed less than 4000 g. Data were abstracted retrospectively from maternal medical records. RESULTS: The best linear predictor of birth weight was ultrasound measurement of abdominal circumference (AC), which had a correlation coefficient of 0.95. An AC measurement of 35 cm or more predicted 93% of macrosomic infants. Among 177 macrosomic infants born vaginally, 23 (13%) had shoulder dystocia. In that group, induction of labor was associated with a greater than three-fold increase in risk of shoulder dystocia (odds ratio [OR] 3.4, 95% confidence interval [CI] 1.4, 8.2; P < .01). Labor augmentation was not associated with increased risk of shoulder dystocia. CONCLUSION: Abdominal circumference measurements were useful in screening for suspected macrosomia. An AC measurement of 35 cm or more identified more than 90% of macrosomic infants who were at risk for shoulder dystocia. Induction of labor in macrosomic patients increased the risk of shoulder dystocia.
Authors: W Siggelkow; M Schmidt; C Skala; D Boehm; S von Forstner; H Koelbl; A Tresch Journal: Arch Gynecol Obstet Date: 2010-02-20 Impact factor: 2.344
Authors: Ute M Schaefer-Graf; Luise Wendt; David A Sacks; Öemer Kilavuz; Bettina Gaber; Sabine Metzner; Klaus Vetter; Michael Abou-Dakn Journal: Diabetes Care Date: 2010-09-23 Impact factor: 19.112