Third trimester ultrasound soft-tissue measurements accurately predicts macrosomia.
OBJECTIVE
To evaluate the accuracy of sonographic measurements of fetal soft tissue in the prediction of macrosomia.


METHODS
Electronic databases were searched from their inception until September 2015 with no limit for language. We included only studies assessing the accuracy of sonographic measurements of fetal soft tissue in the abdomen or thigh in the prediction of macrosomia  ≥34 weeks of gestation. The primary outcome was the accuracy of sonographic measurements of fetal soft tissue in the prediction of macrosomia. We generated the forest plot for the pooled sensitivity and specificity with 95% confidence interval (CI). Additionally, summary receiver-operating characteristics (ROC) curves were plotted and the area under the curve (AUC) was also computed to evaluate the overall performance of the diagnostic test accuracy.


RESULTS
Three studies, including 287 singleton gestations, were analyzed. The pooled sensitivity of sonographic measurements of abdominal or thigh fetal soft tissue in the prediction of macrosomia was 80% (95% CI: 66-89%) and the pooled specificity was 95% (95% CI: 91-97%). The AUC for diagnostic accuracy of sonographic measurements of fetal soft tissue in the prediction of macrosomia was 0.92 and suggested high diagnostic accuracy.


CONCLUSIONS
Third-trimester sonographic measurements of fetal soft tissue after 34 weeks may help to detect macrosomia with a high degree of accuracy. The pooled detection rate was 80%. A standardization of measurements criteria, reproducibility, building reference charts of fetal subcutaneous tissue and large studies to assess the optimal cutoff of fetal adipose thickness are necessary before the introduction of fetal soft-tissue markers in the clinical practice.
a Department of Neuroscience , Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II , Naples , Italy.
Giuseppe Maria
GM
Maruotti
a Department of Neuroscience , Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II , Naples , Italy.
Gabriele
G
Saccone
a Department of Neuroscience , Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II , Naples , Italy.
Pasquale
P
Martinelli
D005260:Female; D005320:Fetal Macrosomia / Q000175:diagnosis*; D005333:Fetus / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D007231:Infant, Newborn; D007233:Infant, Postmature; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011379:Prognosis; D012680:Sensitivity and Specificity; D013848:Thigh / Q000000981:diagnostic imaging / Q000473:pathology; D016216:Ultrasonography, Prenatal / Q000379:methods*
Diabetes; fetal weight; meta-analysis; review; ultrasound