Antepartum Detection of Macrosomic Fetus Clinical Versus Sonographic Including Humeral Soft Tissue Thickness

Mohammed Al-Bayati, Maha

	Antepartum Detection of Macrosomic Fetus Clinical Versus Sonographic Including Humeral Soft Tissue Thickness
IRAQI JOURNALOF COMMUNITY MEDICINE
Article 1, Volume 25, Issue 2, 2012, Pages 108-113
Author
Maha Mohammed Al-Bayati
Abstract
Background: Neonatal mortality rates decrease with increasing birth weight until approximately 4000g, after which mortality increases. Maternal diabetes and obesity are among the predisposing factors for fetal macrosomia for which there are many fetal and maternal consequences like increasing incidence of birth injuries and caesarean section rates respectively. Objective: To compare clinical & sonographic estimation of birth weight using Hadlock’s (1) equation with other estimation technique that involve measurement of fetal humeral soft tissue thickness to identify newborns with excessive birth weight of at least 4000 grams. Patients & Methods: This study was conducted at the department of Gynaecology & Obstetrics in Al-Yermouk Teaching Hospital, Baghdad, Iraq. Ninety pregnant women were studied. They had gestational ages of 37 weeks or more and a suspicion of fetal macrosomia based on the presence of one or more of certain risk factors. About 24 hours prior to delivery of the fetus clinical estimation of fetal body weight using Leopold’s manoeuvre was done followed by sonographic fetal weight estimation using Hadlock’s (1) equation. Fetal humeral soft tissue thickness was measured by ultrasound three times and an average of the three readings was taken. Then a comparison of the three methods mentioned above was done regarding their validity in predicting fetal macrosomia. Results: Sonographic fetal humeral soft tissue thickness correlates with birth weight and found to be higher in macrosomic than the non-macrosomic newborns (14.35mm versus 11.6mm) and the difference was statistically significant (P value <0.001). The sonographic fetal humeral soft tissue thickness measurement was more sensitive in predicting fetal macrosomia than the sonographic fetal weight estimation (87.2 versus 75%) but less specific (74.2 versus 86%). The clinical estimation has the lowest accuracy in predicting fetal macrosomia compared with sonographic fetal weight estimation and sonographic fetal humeral soft tissue measurement. Conclusion: The sonographic measurement of fetal humeral soft tissue thickness positively correlates with newborn birth weight. It is more accurate than the clinical fetal weight estimation in predicting fetal macrosomia. On the other hand it is more sensitive but less specific than the sonographic fetal weight estimation using Hadlock’s (1) equation in predicting fetal macrosomia. Keywords: Fetal Macrosomia, humeral soft tissue thickness.
Keywords
Fetal Macrosomia; humeral soft tissue thickness

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