Keele Research Repository

Robinson, R, Walker, KF, White, VA, Bugg, GJ, Snell, KIE ORCID: https://orcid.org/0000-0001-9373-6591 and Jones, NW (2020) The test accuracy of antenatal ultrasound definitions of fetal macrosomia to predict birth injury: A systematic review. European Journal of Obstetrics & Gynecology and Reproductive Biology, 246. 79 - 85.

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Text The test accuracy of antenatal ultrasound definitions of fetal macrosomia to predict birth injury - a systematic review ACCEPTED VERSION.pdf - Accepted Version Available under License Creative Commons Attribution Non-commercial. Download (347kB) | Preview

Abstract

OBJECTIVES: To determine which ultrasound measurement for predicted fetal macrosomia most accurately predicts adverse delivery and neonatal outcomes. STUDY DESIGN: Four biomedical databases searched for studies published after 1966. Randomised trials or observational studies of women with singleton pregnancies, resulting in a term birth who have undergone an index test of interest measured and recorded as predicted fetal macrosomia ≥28 weeks. Adverse outcomes of interest included shoulder dystocia, brachial plexus injury (BPI) and Caesarean section. RESULTS: Twenty-five observational studies (13,285 participants) were included. For BPI, the only significant positive association was found for Abdominal Circumference (AC) to Head Circumference (HC) difference > 50 mm (OR 7.2, 95 % CI 1.8-29). Shoulder dystocia was significantly associated with abdominal diameter (AD) minus biparietal diameter (BPD) ≥ 2.6 cm (OR 4.2, 95 % CI 2.3-7.5, PPV 11 %) and AC > 90th centile (OR 2.3, 95 % CI 1.3-4.0, PPV 8.6 %) and an estimated fetal weight (EFW) > 4000 g (OR 2.1 95 %CI 1.0-4.1, PPV 7.2 %). CONCLUSIONS: Estimated fetal weight is the most widely used ultrasound marker to predict fetal macrosomia in the UK. This study suggests other markers have a higher positive predictive value for adverse outcomes associated with fetal macrosomia.

Item Type:	Article
Additional Information:	The final version of this accepted manuscript can be accessed online at https://www.sciencedirect.com/science/article/pii/S0301211520300270?via%3Dihub
Uncontrolled Keywords:	Fetal macrosomia; Shoulder dystocia; Ultrasound markers
Subjects:	R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine
Divisions:	Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Related URLs:	Author
Depositing User:	Symplectic
Date Deposited:	09 Mar 2020 15:27
Last Modified:	16 Jan 2021 01:30
URI:	https://eprints.keele.ac.uk/id/eprint/7780

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