Sonographic prediction of fetal macrosomia: the consequences of false diagnosis.
OBJECTIVE
The purpose of this study was to determine the effect of false diagnosis of macrosomia (<4500 g) on maternal/perinatal outcomes.


METHODS
We conducted a case-control study of women (n = 1938) in whom sonographically estimated fetal weight (EFW) was determined up to 3 days before delivery and actual birth weight (BW) was 3500 to 4499 g. Women with false-positive and -negative findings for macrosomia were compared, respectively, with women with true-negative and -positive findings for outcome variables.


RESULTS
The cesarean delivery (CD) rate was 2 to 2.5 times higher when EFW was 4000 to 4499 g, regardless of actual BW. Failure to detect macrosomia was associated with higher rates of perineal trauma, 5-minute Apgar scores less than 7, and neonatal trauma, mostly related to the higher rate of surgical vaginal deliveries. The use of another sonographic model with a lower false-positive rate could theoretically reduce the CD rate by approximately 5%.


CONCLUSIONS
False diagnosis of macrosomia substantially increases the CD rate and leads to maternal/neonatal complications.
Melamed
Nir
N
Helen Schneider Hospital for Women, Rabin Medical Center, Beilinson Campus, 49100 Petach Tikva, Israel. yudavi@inter.net.il
Yogev
Yariv
Y
Meizner
Israel
I
Mashiach
Reuven
R
Ben-Haroush
Avi
A
D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D015897:Comorbidity; D005189:False Positive Reactions; D005260:Female; D005320:Fetal Macrosomia / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007557:Israel / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D011247:Pregnancy; D018570:Risk Assessment; D012307:Risk Factors; D016216:Ultrasonography, Prenatal / Q000706:statistics & numerical data*