Reliability of a clinical method in estimating foetal weight and predicting route of delivery in term parturient monitored at a voluntary agency hospital in Southwest Nigeria

Abstract

Background: The antepartum estimation of foetal weight is a major determinant of the route of delivery and this has become vital in modern day obstetrics. The limitations to the use of obstetric ultrasonography, considered as the gold standard in estimating foetal weight, make clinical estimation methods attractive alternatives, especially in resource- constrained settings where many un-booked women may report for delivery.Aim: To determine the reliability of intrapartum clinical foetal weight estimation in predicting the actual birth weight (ABW) and route of delivery among term parturient.Setting: The study was conducted at the Sacred Heart Hospital, Lantoro, a voluntary mission agency hospital in Southwest Nigeria.Methods: This cross-sectional study was conducted among 291 term parturient recruited by systematic random sampling between June and September 2017. The clinical estimation of foetal weight was carried out using Johnson’s formula.Results: The accuracy of Johnson’s formula to predict the ABW was 59.5%; while for the mode of delivery, it was 130 (75.1%) for spontaneous vaginal delivery (SVD) and 43 (24.9%) for caesarean section (CS). The sensitivity of the accuracy of Johnson’s formula to predict the mode of delivery was 75.1%, with a specificity of 35.6%, a positive predictive value (PPV) of 63.1%, and a negative predictive value (NPV) of 49.4%.Conclusion: The intrapartum clinical foetal weight estimation at term determined by Johnson’s formula was reliably predictive of ABW and SVD, but it was unreliable in predicting the need for a CS.