Clinical Estimation of Fetal Weight: Is Accuracy Acquired with Professional Experience?

Levin, Ishai; Gamzu, Ronni; Buchman, Vladimir L.; Rapaport, Avital S.; Pauzner, David; Lessing, Joseph B.; Almog, Benny

doi:10.1159/000323149

Cited by 8 publications

(9 citation statements)

References 16 publications

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“…Indeed, Ben-Aroya et al [21] demonstrated that seniority levels of residency did not affect the accuracy of the clinical estimation, but that residents' fatigue did. Our findings are in concordance with others' [3,8,22] , implying that there is probably no additional value for obstetrics experience to the ability to perform EFW during the active stage of labor. Since the fetal head might be engaged deep in the maternal pelvis during the active stage of labor and would be an obstacle for the measurements of the fetal BPD and HC, we used in the current study 7 different formulas for the ultrasonographic EFW.…”

Section: Discussionsupporting

confidence: 92%

Comparison between Three Methods of Fetal Weight Estimation during the Active Stage of Labor Performed by Residents: A Prospective Cohort Study

et al. 2016

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Objective: To compare the accuracy of ultrasonographic, calculated, and clinical methods for the estimation of fetal weight (EFW) performed during active labor by residents. Methods: Parturients in active labor underwent prospectively EFW by 3 methods: ultrasonographic, clinical, and calculated (extrapolating EFW from a previous scan). Three different blinded residents evaluated each woman. Background variables were examined for their effect on the accuracy of each method. Comparison of the methods for the detection of macrosomia and small for gestational age (SGA) was also performed. Results: Among the 405 women recruited, the rates of accuracy of ultrasonographic, clinical, and calculated EFW (within ±10%) was 72.5, 74.3, and 71.1%, respectively. The correlation coefficient between the methods and actual birth weight (ABW) were 0.702-0.611 (using 7 Hadlock formulas), 0.649, and 0.622, respectively (all p < 0.001). By logistic regression, epidural analgesia was associated with higher and second stage of labor with lower accuracy of ultrasonographic EFW. For the detection of macrosomia, clinical (p < 0.001) and calculated EFWs (p = 0.035) were superior to ultrasonographic EFW. For the detection of SGA, ultrasonographic EFW was superior to calculated (p < 0.001) and clinical (p < 0.001) EFWs. Conclusion: All 3 methods performed by residents during labor correlated well with ABW. Clinical and calculated EFWs were superior for macrosomia detection, whereas ultrasonographic EFW was superior for SGA detection.

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Section: Discussionsupporting

confidence: 92%

Comparison between Three Methods of Fetal Weight Estimation during the Active Stage of Labor Performed by Residents: A Prospective Cohort Study

et al. 2016

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“…5 Levin et al also demonstrated an increased error in clinical estimation of birth weight in the subgroups of birth weight <2500 grams and >4000 grams. 6 Surprisingly, in our study, a significantly higher proportion of cases of macrosomia actually were identified in obese patients than in those patients with normal BMI. It is possible that the increased thickness of the abdominal wall in cases of obesity contributes to a higher clinical EFW and, therefore, a decreased chance of missing a case of macrosomia.…”

Section: Discussioncontrasting

confidence: 67%

“…Finally, we were unable to capture individual provider level of experience; however, a recent study demonstrated that provider experience and type of obstetrical training had no significant influence on the accuracy of clinical EFW. 6 We were, however, able to capture time of year of admission and demonstrated that increasing experience during residency training throughout the academic year did not have a significant impact on the accuracy of clinical EFW.…”

Section: Discussionmentioning

confidence: 86%

“…A prior study has demonstrated that provider experience does not significantly impact the accuracy of clinical EFW; therefore, although labor admissions are performed mostly by residents at these centers, it is still reasonable to study this high risk population of patients in order to evaluate other potential modifiers of clinical EFW in this teaching setting. 6 The objective of this study was 1) to determine whether clinical estimates of fetal weight at the time of labor admission correlate with actual birth weight and 2) to evaluate whether clinical characteristics, including maternal obesity, alter the accuracy of these clinical estimates in term pregnancies in a teaching hospital.…”

Section: Introductionmentioning

confidence: 99%

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Clinical accuracy of estimated fetal weight in term pregnancies in a teaching hospital

Goetzinger

Odibo

Shanks

et al. 2013

The Journal of Maternal-Fetal & Neonatal Medicine

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Objective To evaluate whether clinical characteristics alter the accuracy of clinical estimation of fetal weight (EFW) in term pregnancies in a teaching hospital. Methods Secondary analysis of a retrospective cohort study of patients presenting for labor at term. Clinical EFW was performed using Leopold maneuvers. A Spearman’s rank correlation coefficient (r) was used to evaluate the linear relationship between clinical EFW and actual birth weight (BW). Body mass index (BMI), gestational age, fetal station and admission diagnosis were evaluated with respect to their impact on clinical EFW. The primary outcome was an absolute error between clinical EFW and actual BW >500 grams. Results Of 3,797 patients, 941 (24.8%) had an absolute error in clinical EFW exceeding 500 grams. The overall correlation between clinical EFW and actual BW was weak (r=0.4). There was a significant trend of improved accuracy of clinical EFW with increasing gestational age; however, BMI, fetal station, and admission diagnosis did not have significant effects. 181 of 221 cases (81.9%) of fetal macrosomia (>4000 grams) were undetected by clinical EFW. Conclusion The correlation between clinical EFW and actual birth weight is overall weak, particularly in patients with macrosomic fetuses; however, BMI, admission diagnosis, and fetal station do not have a significant impact.

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“…Little difference in accuracy has been found between ultrasound and clinical measures of estimating fetal weight (e.g. fundal height) [6,7,8,9], regardless of the experience of the clinician [9]. Maternal estimates were as accurate as clinician estimates [10,11,12].…”

Section: Introductionmentioning

confidence: 99%

Deviation of Sonographic Estimated Fetal Weight from Actual Birth Weight in Two Consecutive Pregnancies of the Same Parturients

Aviram

Tenenbaum-Gavish

et al. 2014

Fetal Diagn Ther

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Objective: To determine whether maternal features affect the accuracy of sonographic estimated fetal weight (SEFW) by evaluating the consistency of the systematic error of SEFW with regards to the birth weight (BW) in two consecutive pregnancies of the same gravida. Methods: The cohort included women with SEFW within 1 week of delivery (32-42 weeks' gestation) in two consecutive singleton pregnancies from 2007 to 2012. The systematic error was calculated as (SEFW - BW)/BW × 100 and expressed as a percentage of the BW. Results: A total of 636 pregnancies (318 gravidas) were eligible for analysis. The BW and SEFW were correlated in both first examined (r = 0.873, p < 0.001) and consecutive (r = 0.843, p < 0.001) pregnancies. There was a significant difference in mean systematic error between first examined and consecutive pregnancies (3.13 ± 8.95 vs. 0.34 ± 8.75%, p < 0.001), with a very weak correlation between the two (r = 0.135, p = 0.16). Nulliparity or multiparity at the first examined pregnancy was not found to be a significant factor, and in both groups the error was higher in the first examined pregnancy. There were no significant differences between parturients with a minor (10% and below) or major (>10%) difference in the systematic error between the two pregnancies. Conclusion: The systematic error between the SEFW and BW in two consecutive pregnancies is inconsistent, suggesting that it is unaffected by maternal biometric features.

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Clinical Estimation of Fetal Weight: Is Accuracy Acquired with Professional Experience?

Cited by 8 publications

References 16 publications

Comparison between Three Methods of Fetal Weight Estimation during the Active Stage of Labor Performed by Residents: A Prospective Cohort Study

Comparison between Three Methods of Fetal Weight Estimation during the Active Stage of Labor Performed by Residents: A Prospective Cohort Study

Clinical accuracy of estimated fetal weight in term pregnancies in a teaching hospital

Deviation of Sonographic Estimated Fetal Weight from Actual Birth Weight in Two Consecutive Pregnancies of the Same Parturients

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