Ultrasound screening may be limited in ability to predict perinatal complications

Date:
October 13, 2020
Source:
PLOS
Summary:
Delivering a newborn with macrosomia (weighing more than 8 pounds,
13 ounces at birth) may be associated with higher risk of adverse
outcomes, including perinatal death and injuries related to
traumatic delivery, such as stuck shoulders (shoulder dystocia).



FULL STORY ========================================================================== Delivering a newborn with macrosomia (weighing more than 8 pounds, 13
ounces at birth) may be associated with higher risk of adverse outcomes, including perinatal death and injuries related to traumatic delivery,
such as stuck shoulders (shoulder dystocia). A study in PLOS Medicine by
Gordon Smith at the University of Cambridge and colleagues suggests that
third trimester fetal ultrasound screening has the ability to identify
more pregnancies with macrosomia.


==========================================================================
The diagnostic effectiveness of ultrasound screening in predicting
the delivery of a macrosomic infant, shoulder dystocia and associated
neonatal morbidity is not well established. To better understand
the relationship between estimated fetal weight (EFW), macrosomia,
and perinatal complications, researchers systematically reviewed the
literature from four different clinical databases.

The authors then analyzed 41 studies involving 112,034 non-high risk
patients who had undergone a third trimester ultrasound screening as
part of universal screening.

The authors found that a third trimester ultrasonic EFW showing increased
risk of a large baby reliably predicted delivery of a macrosomic
infant. However, a larger EFW was not strongly associated with the risk
of shoulder dystocia in low and medium-risk pregnancies. The study was
limited by variation in included studies representing differences in
screening in various countries.

According to the authors, "We recommend caution prior to introducing
universal third trimester screening for macrosomia as it would increase
the rates of intervention, with potential iatrogenic harm, without clear evidence that it would reduce neonatal morbidity."

========================================================================== Story Source: Materials provided by PLOS. Note: Content may be edited
for style and length.


========================================================================== Journal Reference:
1. Alexandros A. Moraitis, Norman Shreeve, Ulla Sovio, Peter
Brocklehurst,
Alexander E. P. Heazell, Jim G. Thornton, Stephen C. Robson,
Aris Papageorghiou, Gordon C. Smith. Universal third-trimester
ultrasonic screening using fetal macrosomia in the prediction of
adverse perinatal outcome: A systematic review and meta-analysis
of diagnostic test accuracy. PLOS Medicine, 2020; 17 (10): e1003190
DOI: 10.1371/ journal.pmed.1003190 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/10/201013141754.htm

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