Amniotic fluid index and estimated fetal weight for prediction of fetal macrosomia: a prospective observational study.
OBJECTIVE
The purpose of this study was to assess the value of combining the estimated fetal weight (EFW) and amniotic fluid index (AFI) measured in term patients early in labor with intact membranes for prediction of macrosomia.


METHODS
In a single center, prospective observational study, 600 patients in the first stage of labor before rupture of membranes in whom ultrasonography was performed to measure AFI and EFW, and these data were analyzed statistically to evaluate prediction of fetal macrosomia.


RESULTS
Macrosomia occurred in 64 cases (10.6%). The AFI was significantly higher in the macrosomic group (p = 0.001). It was noted that the area under receiver operating characteristic (ROC) curves for EFW was 0.93 and that of AFI was 0.67. Based on suggested combined EFW and AFI cutoffs of 4000 g and 164 mm, respectively, the positive predictive value (PPV) for combined parameters (92.3%) was higher than that of EFW (75%) and that of AFI (27%) and the likelihood ratio for combination (93.7%) was higher than that of EFW (24.7%) and that of AFI (21%).


CONCLUSIONS
Combined use of EFW and AFI improves prediction of macrosomia at birth rather than the EFW alone.
a Obstetrics and Gynecology Department , Faculty of Medicine, Menoufia University , Shibin Elkom , Egypt.
Nabih I
NI
El Khouly
a Obstetrics and Gynecology Department , Faculty of Medicine, Menoufia University , Shibin Elkom , Egypt.
Osama A
OA
Elkelani
a Obstetrics and Gynecology Department , Faculty of Medicine, Menoufia University , Shibin Elkom , Egypt.
Said A
SA
Saleh
D000328:Adult; D000653:Amniotic Fluid; D005260:Female; D005320:Fetal Macrosomia / Q000175:diagnosis*; D020567:Fetal Weight; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D055815:Young Adult
Amniotic fluid; fetal weight; macrosomia; prediction; ultrasonography