Antepartum detection of macrosomic fetus: the effect of misdiagnosis

Tunis Med. 2013 Apr;91(4):240-2.

Abstract

Aim: To determine the effect of misdiagnosis of macrosomia on maternal and perinatal outcomes.

Methods: We conducted a retrospective study ,between January 2007 and December 2008 of women (n = 464) who delivered singleton neonates with actual birth weight over 4000g and in whom fetal weight was estimated, by both methods :sonographic and clinical, up to 3 days before delivery.Statistical comparisons were made between patients in whom fetal macrosomia was predicted : «prediction » group (n=336)and those in whom it was not « non prediction »group (n=128) for outcome variables.

Results: The cesarean delivery was performed in 35.9% in « non predicted » group, and in 35.7% in the « predicted » group.The difference was not statistically significant. Failure to detect macrosomia was associated with higher rates of maternal and fetal complications in the group « non predicted » compared with the group « predicted » :perineal trauma,post partum hemorrhage, 5- minute Apgar scores less than 7, and shoulder dystocia, mostly related to the higher rate of surgical vaginal deliveries.

Conclusions: The misdiagnosis of fetal macrosomia substantially did not modify the cesarean section rate but leads to increase the maternal and neonatal complications.

MeSH terms

  • Adult
  • Cesarean Section / statistics & numerical data
  • Diagnostic Errors*
  • Female
  • Fetal Macrosomia / diagnosis*
  • Humans
  • Infant, Newborn
  • Obstetric Labor Complications*
  • Pregnancy
  • Prenatal Diagnosis
  • Retrospective Studies