Counseling for fetal macrosomia: An estimated fetal weight of 4,000 g is excessively low

David Peleg, Steven Warsof, Maya Frank Wolf, Yuri Perlitz, Inbar Ben Shachar

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Results There were 238 neonates in the correctly suspected group and 205 neonates in the unsuspected macrosomia group, respectively. Vaginal delivery was accomplished in 52.1% of the suspected group and 90.7% of the unsuspected group, respectively, p < 0.001. There was no difference in the rates of shoulder dystocia. The odds ratio for CS was 9.0 (95% confidence interval, 5.3-15.4) when macrosomia was correctly suspected.

Conclusion The policy of discussing the risk of macrosomia with SEFW ≥ 4,000 g to women is not justified. A higher SEFW to trigger counseling for shoulder dystocia and CS, more consistent with American College of Obstetrics and Gynecology (ACOG) guidelines, should be considered.

Objective Because of the known complications of fetal macrosomia, our hospital's policy has been to discuss the risks of shoulder dystocia and cesarean section (CS) in mothers with a sonographic estimated fetal weight (SEFW) ≥ 4,000 g at term. The present study was performed to determine the effect of this policy on CS rates and pregnancy outcome.

Study Design We examined the pregnancy outcomes of the macrosomic (≥ 4,000 g) neonates in two cohorts of nondiabetic low risk women at term without preexisting indications for cesarean: (1) SEFW ≥ 4,000 g (correctly suspected macrosomia) and (2) SEFW < 4,000 g (unsuspected macrosomia).

Original languageEnglish
Pages (from-to)71-74
Number of pages4
JournalAmerican Journal of Perinatology
Issue number1
StatePublished - Jan 2015

Bibliographical note

Publisher Copyright:
© 2015 by Thieme Medical Publishers, Inc.


  • cesarean section
  • counseling
  • estimated fetal weight
  • macrosomia
  • shoulder dystocia


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