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Suspected macrosomia? Better not tell

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Abstract

Objective

To evaluate the management policy of delivery in a suspected macrosomic fetus and to describe the outcome of this policy.

Study design

For this prospective observational study we followed the management by reviewing the medical records of 145 women and their infants. The study population included women at term admitted to the obstetrics department with suspected macrosomic infants, as was diagnosed by an obstetrician and/or by fetal sonographic weight estimation of ≥4,000 g. The comparison group (n = 5,943) consisted of all women who gave birth during the data collection period.

Results

Induction of labor and cesarean delivery rates in the macrosomic pregnancies (actual birth weight >4,000 g) of the study group were significantly higher when compared with the macrosomic pregnancies of the comparison group. When comparing the non-macrosomic to the macrosomic pregnancies (actual birth weight </>4,000 g) of the study group no significant difference was demonstrated regarding maternal or infant complications. The sensitivity, specificity and positive predictive value of the methods used for detecting macrosomia were 21.6, 98.6 and 43.5%, respectively.

Conclusion

Our ability to predict macrosomia is poor. Our management policy of suspected macrosomic pregnancies raises induction of labor and cesarean delivery rates without improving maternal or fetal outcome.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel

    D. Sadeh-Mestechkin, A. Walfisch, R. Shachar, I. Shoham-Vardi, H. Vardi & M. Hallak

  2. Epidemiology and Health Services Evaluation Department, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel

    D. Sadeh-Mestechkin, A. Walfisch, R. Shachar, I. Shoham-Vardi, H. Vardi & M. Hallak

Authors
  1. D. Sadeh-Mestechkin
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  2. A. Walfisch
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  3. R. Shachar
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  4. I. Shoham-Vardi
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  5. H. Vardi
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  6. M. Hallak
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Corresponding author

Correspondence to D. Sadeh-Mestechkin.

Additional information

Synopsis: Current management policy of delivery in suspected macrosomic fetuses raises the rates of induction of labor and cesarean delivery without improving maternal or fetal outcome.

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Sadeh-Mestechkin, D., Walfisch, A., Shachar, R. et al. Suspected macrosomia? Better not tell. Arch Gynecol Obstet 278, 225–230 (2008). https://doi.org/10.1007/s00404-008-0566-y

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  • DOI: https://doi.org/10.1007/s00404-008-0566-y

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