A scoring system for detection of macrosomia and prediction of shoulder dystocia: A disappointment
Objective. To develop a scoring system for the detection of a macrosomic fetus (birth weight (BW) ≥ 4000 g) and predict shoulder dystocia among large for gestational age fetuses. Study design. We retrospectively identified all singletons with accurate gestational age (GA) that were large for GA (abd...
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| Veröffentlicht in: | The journal of maternal-fetal & neonatal medicine 2006-11, Vol.19 (11), p.699-705 |
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| container_title | The journal of maternal-fetal & neonatal medicine |
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| creator | Chauhan, Suneet P. Lynn, Nancy N. Sanderson, Maureen Humphries, Joyce Cole, Jill H. Scardo, James A. |
| description | Objective. To develop a scoring system for the detection of a macrosomic fetus (birth weight (BW) ≥ 4000 g) and predict shoulder dystocia among large for gestational age fetuses.
Study design. We retrospectively identified all singletons with accurate gestational age (GA) that were large for GA (abdominal circumference (AC) or estimated fetal weight (EFW) ≥ 90% for GA) at ≥37 weeks with delivery within three weeks. The scoring system was: 2 points for biparietal diameter, head circumference, AC, or femur length ≥90% for GA, or if the amniotic fluid index (AFI) was ≥24 cm; for biometric parameters |
| doi_str_mv | 10.1080/14767050600797483 |
| format | Article |
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Study design. We retrospectively identified all singletons with accurate gestational age (GA) that were large for GA (abdominal circumference (AC) or estimated fetal weight (EFW) ≥ 90% for GA) at ≥37 weeks with delivery within three weeks. The scoring system was: 2 points for biparietal diameter, head circumference, AC, or femur length ≥90% for GA, or if the amniotic fluid index (AFI) was ≥24 cm; for biometric parameters <90% or with AFI <24 cm, 0 points. The predictive values for detection of shoulder dystocia were calculated.
Results. Of the 225 cohorts that met the inclusion criteria the rate of macrosomia was 39% and among vaginal deliveries (n = 120) shoulder dystocia occurred in 12% (15 120; 95% confidence interval (CI) 7-20%). The sensitivity of EFW ≥4500 g to identify a newborn with shoulder dystocia was 0% (95% CI 0-21%), positive predictive values 0% (95% CI 0-46%), and likelihood ratio of 0. For a macrosomia score >6, the corresponding values were 20% (4-48%), 25% (5-57%) and 2.3.
Conclusion. Though the scoring system can identify macrosomia, it offers no advantage over EFW. The scoring system and EFW are poor predictors of shoulder dystocia.</description><identifier>ISSN: 1476-7058</identifier><identifier>EISSN: 1476-4954</identifier><identifier>DOI: 10.1080/14767050600797483</identifier><identifier>PMID: 17127493</identifier><identifier>CODEN: JMNMAE</identifier><language>eng</language><publisher>England: Informa UK Ltd</publisher><subject>Dystocia - etiology ; estimated fetal weight ; Female ; Fetal Macrosomia - diagnosis ; Humans ; Macrosomia ; Pregnancy ; Retrospective Studies ; Shoulder ; shoulder dystocia</subject><ispartof>The journal of maternal-fetal & neonatal medicine, 2006-11, Vol.19 (11), p.699-705</ispartof><rights>2006 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted 2006</rights><rights>Copyright Taylor & Francis Ltd. Nov 2006</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c431t-b5ca11a8e102ffef13cb0e670c707b7dd5448b8af9e5c72be225a0600e0d19003</citedby><cites>FETCH-LOGICAL-c431t-b5ca11a8e102ffef13cb0e670c707b7dd5448b8af9e5c72be225a0600e0d19003</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.tandfonline.com/doi/pdf/10.1080/14767050600797483$$EPDF$$P50$$Ginformahealthcare$$H</linktopdf><linktohtml>$$Uhttps://www.tandfonline.com/doi/full/10.1080/14767050600797483$$EHTML$$P50$$Ginformahealthcare$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,59647,60436,61221,61402</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17127493$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chauhan, Suneet P.</creatorcontrib><creatorcontrib>Lynn, Nancy N.</creatorcontrib><creatorcontrib>Sanderson, Maureen</creatorcontrib><creatorcontrib>Humphries, Joyce</creatorcontrib><creatorcontrib>Cole, Jill H.</creatorcontrib><creatorcontrib>Scardo, James A.</creatorcontrib><title>A scoring system for detection of macrosomia and prediction of shoulder dystocia: A disappointment</title><title>The journal of maternal-fetal & neonatal medicine</title><addtitle>J Matern Fetal Neonatal Med</addtitle><description>Objective. To develop a scoring system for the detection of a macrosomic fetus (birth weight (BW) ≥ 4000 g) and predict shoulder dystocia among large for gestational age fetuses.
Study design. We retrospectively identified all singletons with accurate gestational age (GA) that were large for GA (abdominal circumference (AC) or estimated fetal weight (EFW) ≥ 90% for GA) at ≥37 weeks with delivery within three weeks. The scoring system was: 2 points for biparietal diameter, head circumference, AC, or femur length ≥90% for GA, or if the amniotic fluid index (AFI) was ≥24 cm; for biometric parameters <90% or with AFI <24 cm, 0 points. The predictive values for detection of shoulder dystocia were calculated.
Results. Of the 225 cohorts that met the inclusion criteria the rate of macrosomia was 39% and among vaginal deliveries (n = 120) shoulder dystocia occurred in 12% (15 120; 95% confidence interval (CI) 7-20%). The sensitivity of EFW ≥4500 g to identify a newborn with shoulder dystocia was 0% (95% CI 0-21%), positive predictive values 0% (95% CI 0-46%), and likelihood ratio of 0. For a macrosomia score >6, the corresponding values were 20% (4-48%), 25% (5-57%) and 2.3.
Conclusion. Though the scoring system can identify macrosomia, it offers no advantage over EFW. The scoring system and EFW are poor predictors of shoulder dystocia.</description><subject>Dystocia - etiology</subject><subject>estimated fetal weight</subject><subject>Female</subject><subject>Fetal Macrosomia - diagnosis</subject><subject>Humans</subject><subject>Macrosomia</subject><subject>Pregnancy</subject><subject>Retrospective Studies</subject><subject>Shoulder</subject><subject>shoulder dystocia</subject><issn>1476-7058</issn><issn>1476-4954</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kM2OFCEURolx4oyjD-DGEBfu2uFWUQ2lbjoTfyaZxI2uCQUXm0kVlEDF9NtLpTtO1DgrCJxzc7-PkBfA3gCT7Aq42ArWsS1johdcto_Ixfq24X3HH5_uFZDn5GnOd4w1wFn3hJyDgEbwvr0gw45mE5MP32k-5IITdTFRiwVN8THQ6OikTYo5Tl5THSydE1r_-zPv4zJarEq1o_H6Ld1R67Oe5-hDmTCUZ-TM6THj89N5Sb59_PD1-vPm9sunm-vd7cbwFspm6IwG0BKBNc6hg9YMDGs-I5gYhLUd53KQ2vXYGdEM2DSdXqMjs9Az1l6S18e5c4o_FsxFTT4bHEcdMC5ZbSVIyYWs4Ku_wLu4pFB3Uw2DlgOHFYIjtIbPCZ2ak590Oihgam1f_dN-dV6eBi_DhPbeONVdgfdHwIda86R_xjRaVfRhjMklHYzPqn1o_rs_9D3qseyNTnif4P_2L_RcpVA</recordid><startdate>20061101</startdate><enddate>20061101</enddate><creator>Chauhan, Suneet P.</creator><creator>Lynn, Nancy N.</creator><creator>Sanderson, Maureen</creator><creator>Humphries, Joyce</creator><creator>Cole, Jill H.</creator><creator>Scardo, James A.</creator><general>Informa UK Ltd</general><general>Taylor & Francis</general><general>Taylor & Francis Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>20061101</creationdate><title>A scoring system for detection of macrosomia and prediction of shoulder dystocia: A disappointment</title><author>Chauhan, Suneet P. ; Lynn, Nancy N. ; Sanderson, Maureen ; Humphries, Joyce ; Cole, Jill H. ; Scardo, James A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c431t-b5ca11a8e102ffef13cb0e670c707b7dd5448b8af9e5c72be225a0600e0d19003</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Dystocia - etiology</topic><topic>estimated fetal weight</topic><topic>Female</topic><topic>Fetal Macrosomia - diagnosis</topic><topic>Humans</topic><topic>Macrosomia</topic><topic>Pregnancy</topic><topic>Retrospective Studies</topic><topic>Shoulder</topic><topic>shoulder dystocia</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chauhan, Suneet P.</creatorcontrib><creatorcontrib>Lynn, Nancy N.</creatorcontrib><creatorcontrib>Sanderson, Maureen</creatorcontrib><creatorcontrib>Humphries, Joyce</creatorcontrib><creatorcontrib>Cole, Jill H.</creatorcontrib><creatorcontrib>Scardo, James A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of maternal-fetal & neonatal medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chauhan, Suneet P.</au><au>Lynn, Nancy N.</au><au>Sanderson, Maureen</au><au>Humphries, Joyce</au><au>Cole, Jill H.</au><au>Scardo, James A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A scoring system for detection of macrosomia and prediction of shoulder dystocia: A disappointment</atitle><jtitle>The journal of maternal-fetal & neonatal medicine</jtitle><addtitle>J Matern Fetal Neonatal Med</addtitle><date>2006-11-01</date><risdate>2006</risdate><volume>19</volume><issue>11</issue><spage>699</spage><epage>705</epage><pages>699-705</pages><issn>1476-7058</issn><eissn>1476-4954</eissn><coden>JMNMAE</coden><abstract>Objective. To develop a scoring system for the detection of a macrosomic fetus (birth weight (BW) ≥ 4000 g) and predict shoulder dystocia among large for gestational age fetuses.
Study design. We retrospectively identified all singletons with accurate gestational age (GA) that were large for GA (abdominal circumference (AC) or estimated fetal weight (EFW) ≥ 90% for GA) at ≥37 weeks with delivery within three weeks. The scoring system was: 2 points for biparietal diameter, head circumference, AC, or femur length ≥90% for GA, or if the amniotic fluid index (AFI) was ≥24 cm; for biometric parameters <90% or with AFI <24 cm, 0 points. The predictive values for detection of shoulder dystocia were calculated.
Results. Of the 225 cohorts that met the inclusion criteria the rate of macrosomia was 39% and among vaginal deliveries (n = 120) shoulder dystocia occurred in 12% (15 120; 95% confidence interval (CI) 7-20%). The sensitivity of EFW ≥4500 g to identify a newborn with shoulder dystocia was 0% (95% CI 0-21%), positive predictive values 0% (95% CI 0-46%), and likelihood ratio of 0. For a macrosomia score >6, the corresponding values were 20% (4-48%), 25% (5-57%) and 2.3.
Conclusion. Though the scoring system can identify macrosomia, it offers no advantage over EFW. The scoring system and EFW are poor predictors of shoulder dystocia.</abstract><cop>England</cop><pub>Informa UK Ltd</pub><pmid>17127493</pmid><doi>10.1080/14767050600797483</doi><tpages>7</tpages></addata></record> |
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| identifier | ISSN: 1476-7058 |
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| source | MEDLINE; Taylor & Francis:Master (3349 titles) |
| subjects | Dystocia - etiology estimated fetal weight Female Fetal Macrosomia - diagnosis Humans Macrosomia Pregnancy Retrospective Studies Shoulder shoulder dystocia |
| title | A scoring system for detection of macrosomia and prediction of shoulder dystocia: A disappointment |
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