title: Regimens of fetal surveillance of suspected large-for-gestational-age fetuses for improving health outcomes.
abstract: BACKGROUND
  Policies and protocols vary widely for fetal surveillance in a pregnancy where the fetus is suspected to be large-for-gestational-age (LGA). All ultimately culminate in decisions about the mode and timing of birth. LGA is known to be associated with increased risks to both the mother and baby. Interventions based on surveillance regimen findings may be associated with risks to the mother and baby.
  
  
  OBJECTIVE
  To assess the effectiveness or efficacy of different antenatal surveillance methods for the suspected LGA fetus on important health outcomes for the mother and baby.
  
  
  METHODS
  We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 August 2015), ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP) (21 August 2015).
  
  
  METHODS
  Published and unpublished randomised, quasi-randomised and cluster-randomised trials comparing the effects of described antenatal fetal surveillance regimens for women with suspected LGA infants.
  
  
  METHODS
  We identified no studies that met the inclusion criteria for this review.
  
  
  RESULTS
  There are no included trials.
  
  
  CONCLUSIONS
  We found no randomised controlled trials that assessed the effect of antenatal fetal surveillance regimens of a suspected LGA fetus on important health outcomes for the mother and baby.There has been a rise in the prevalence of LGA babies over the past few decades in many countries. Research is therefore required on regimens of antenatal surveillance of suspected LGA infants, in order to guide practice and improve the health outcomes for the mother and infant. In particular, randomised control trials to investigate whether serial antenatal clinic and ultrasound assessments of suspected LGA infants (including liquor volume and markers of fetal adiposity) would be useful, to assess whether surveillance methods improve health outcomes. In addition, as there are concerns that identifying suspected LGA fetuses may lead to unnecessary maternal anxiety, investigations and interventions, any such trial would need to assess the risks as well as benefits of regimens of fetal surveillance for suspected LGA fetuses.
authors.affiliation: Obstetrics and Gynaecology Department, Taranaki Base Hospital, David Street, Westown, New Plymouth, New Zealand, 4310.
authors.forename: Katherine A T
authors.initials: KA
authors.lastname: Culliney
authors.forename: Graham K
authors.initials: GK
authors.lastname: Parry
authors.forename: Julie
authors.initials: J
authors.lastname: Brown
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Crowther
mesh_terms: D005260:Female; D005320:Fetal Macrosomia / Q000175:diagnosis*; D005323:Fetal Monitoring / Q000379:methods*; D006801:Humans; D011247:Pregnancy