Accuracy of clinical fetal weight estimation by Midwives

Abstract

BackgroundClinical fetal weight estimation is a common practice in obstetrics. This study aims to evaluate the accuracy of fetal weight estimation by midwives, and to identify factors that may lead to overestimation or underestimation of fetal weight.MethodsA cohort prospective study in a Lebanese university hospital, included weight estimation of singleton pregnancies above 35 weeks. Multiple pregnancies, unclear dating, growth retardation, malformations and stillbirths cases are excluded. The estimated fetal weight is recorded by midwives in a sealed envelope and compared to true weight later. The effects of BMI, weight gain, parity, diabetes, hypertension, neonate’s sex and weight, uterine contractions, rupture of membranes and daytime or nighttime shift on these estimations were assessed.ResultsOne hundred and sixty-six patients were included. Mean birth weight was 3246 ± 362 g. Mean absolute percentage error of weight estimation was 8.5 ± 6.7% (0–30.9%). Estimation was within the correct range of ±10% in 63% of cases. Maternal and fetal factors did not significantly change weight estimation. Fetuses with birth weights more than 4000 tended to be underestimated by midwives. Estimation improved over time (nonsignificant).ConclusionsMaternal and fetal factors, except for macrosomia, have limited impact on estimation of fetal birth weight. Macrosomia is challenging because of a consistent tendency of underestimation by midwives.

Accuracy of sonographic fetal weight estimation in full-term singleton pregnant women

“…Hence, fetal weight estimation has become an important aspect of examinations in the late period of pregnancy. To this end, various techniques, including clinical examinations, such as Leopold’s maneuvers2, sonography3, and magnetic resonance imaging4, have been used. However, sonography has become the most common method for estimating fetal weight worldwide, because of its objectivity and ease of use.…”

Role of thigh circumference in predicting the fetal weight: Comparison with other ultrasound methods—A prospective observational study

“…It is a crucial tool to detect fetal growth abnormalities such as low birth weight and macrosomia; thus, it could help in reducing the perinatal morbidity and death rates. [1][2][3][4] Many methods have been introduced to estimate the weight in utero, and many studies have evaluated their effectiveness to detect the most accurate method. [5][6][7][8] The most common methods are the clinical and sonographic methods.…”