TY - JOUR
T1 - Counseling for fetal macrosomia
T2 - An estimated fetal weight of 4,000 g is excessively low
AU - Peleg, David
AU - Warsof, Steven
AU - Wolf, Maya Frank
AU - Perlitz, Yuri
AU - Shachar, Inbar Ben
N1 - Publisher Copyright:
© 2015 by Thieme Medical Publishers, Inc.
PY - 2015/1
Y1 - 2015/1
N2 - 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).
AB - 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).
KW - cesarean section
KW - counseling
KW - estimated fetal weight
KW - macrosomia
KW - shoulder dystocia
UR - http://www.scopus.com/inward/record.url?scp=84900357585&partnerID=8YFLogxK
U2 - 10.1055/s-0034-1376182
DO - 10.1055/s-0034-1376182
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 24839149
AN - SCOPUS:84900357585
SN - 0735-1631
VL - 32
SP - 71
EP - 74
JO - American Journal of Perinatology
JF - American Journal of Perinatology
IS - 1
ER -