Study to evaulate the management policy of delivery in suspected macrosomicfetus (large baby -or large head)

Department of Obstetrics and Gynecology, Facultyof Health Sciences, Soroka University Medical Center, Ben-GurionUniversity of the Negev, Beer-Sheva, Israel,

mestechk@bgu.ac.il.OBJECTIVE:To evaluate the management policy of delivery in a suspected macrosomicfetus and to describe the outcome of this policy. STUDY DESIGN: Forthis prospective observational study we followed the management byreviewing the medical records of 145 women and their infants. The studypopulation included women at term admitted to the obstetrics departmentwith suspected macrosomic infants, as was diagnosed by an obstetricianand/or by fetal sonographic weight estimation of >/=4,000 g. Thecomparison group (n = 5,943) consisted of all women who gave birthduring the data collection period. RESULTS: Induction of labor andcesarean delivery rates in the macrosomic pregnancies (actual birthweight >4,000 g) of the study group were significantly higher whencompared with the macrosomic pregnancies of the comparison group. Whencomparing the non-macrosomic to the macrosomic pregnancies (actualbirth weight 4,000 g) of the study group no significantdifference was demonstrated regarding maternal or infant complications.The sensitivity, specificity and positive predictive value of themethods used for detecting macrosomia were 21.6, 98.6 and 43.5%,respectively. CONCLUSION: Our ability to predict macrosomia is poor.Our management policy of suspected macrosomic pregnancies raisesinduction of labor and cesarean delivery rates without improvingmaternal or fetal outcome.PMID: 18299867 [PubMed - as supplied by publisher]