gynecology and obstetrics medical project, gynecology journal, obstetrics, gynecologic oncology, reproductive medicine, gynecological endoscopy, ultrasonography, gynecology articles

Ginekologia i Poloznictwo
ISSN 1896-3315 e-ISSN 1898-0759

Can Ultrasound Evaluation of the Fetal Weight Justify Operative Delivery to Avoid Shoulder Dystocia?


Author(s): Marek Kudła, Grzegorz Chromy, Monika Bojdys-Szyndlar, Łukasz Szwaczka, Adam Nowara, Andrzej Witek

Backgrond. The aim of the study was to assess usefulness of fetal mass ultrasound examination done in advance to labor to predict fetal macrosomia and risk of fetal shoulder dystocia. Material and methods. The study group consisted of 115 pregnancies with estimated fetal weight over 3500g. Cases were divided into two subgroups – first, a study group with estimated fetal weights above 4000g fulfilling definition of macrosomia and a second, control group with estimated weights within the range of 3500g to 4000g.We compared precision of ultrasound weight calculation using AC and Hadlock method in both groups. In the following step we devided group of 115 known neonate weights into two subgroups below and above 4000g respectively. Real and estimated differences in fetal weights were compared (by AC and by Hadlock metod). Conclusions 1. Ultrasound weight evaluation in the group of the birth weight above 4000g is difficult and not precise. 2. Ultrasound weight evaluation with Hadlock method is more precise than weight evaluation done with abdominal circumference (AC) measurement. 3. The accuracy of ultrasound fetal weight evaluation in a group of macrosomic fetuses seems similar to that of smaller fetuses if more complicated methods are applied such as Hadlock method, although acuracy seems not sufficiently trustworthy enough to use ultrasound alone as a method to justify recognition of threat from shoulder dystocia