The rate of intrapartum cesarean delivery based on estimated fetal weight in comparison to previous child’s birth weight

Author(s):  
Tetsuya Kawakita ◽  
Shobha Sridhar ◽  
Neggin Mokhtari ◽  
Helain J. Landy

Objective: To examine whether an estimated fetal weight of the current pregnancy greater than previous birth weight is associated with increased odds of intrapartum cesarean delivery. Study design: We conducted a retrospective cohort study of all women who had more than one singleton pregnancy at 23 weeks’ gestation or greater at a single Labor and Delivery unit. We only analyzed the second pregnancy in the dataset. We excluded women who had preterm birth in the second pregnancy. Women were categorized according to the difference between estimated fetal weight and previous birth weight - estimated fetal weight close to previous birth weight within 500 grams (Similar Weight Group); estimated fetal weight significantly (more than 500 grams) greater than previous birth weight (Larger Weight Group); and estimated fetal weight significantly (more than 500 grams) lower than previous birth weight (Smaller Weight Group). The primary outcome was intrapartum cesarean delivery. Multivariable logistic regression was performed to calculate adjusted odds ratios (aOR) with 95% confidence interval (95%CI) after adjusting for predefined covariates. Results: Of 1,887 women, there were 1,415 (75%) in the Similar Weight Group, 384 (20%) in the Greater Weight Group, and 88 (5%) in the Smaller Weight Group. Individuals in the Larger Weight Group compared to those in the Similar Weight Group had higher odds of undergoing intrapartum cesarean delivery (11.2% vs. 4.5%; aOR 2.91; 95%CI 1.91-4.45). The odds of intrapartum cesarean delivery in the Smaller Weight Group compared to those in the Similar Weight Group were not increased (3.4% vs. 4.5%; crude OR 0.75; 95%CI 0.23-2.42). Conclusion: The difference between current estimated fetal weight and previous birth weight plays an important role in assessing the risk of intrapartum cesarean delivery.

2012 ◽  
Vol 10 (2) ◽  
pp. 15-17
Author(s):  
Sadikchya Singh Rana

Introduction: Teenage childbearing is linked to a host of negative social, economic and medical consequences for both mother and child. Maternal mortality among girls under 18 years is two to five times higher than that of women in their 20s. This study was conducted to determine the relationship between maternal age on fetal weight. Method: It was a prospective, hospital based study, carried out in 491 primigravidas with fullterm singleton pregnancy. The study population was divided into two groups, women who were 19 and less than 19 years of age and women who were more than 19 years of age. Fetal weight as the outcome variable was compared between these groups. Results: The age of the mother ranged from 16 to 37 years. 24.8% women in the study population were <19 years of age. Although the difference was not clinically significant (p=0.51), 1/3rd of the mothers who were <19 had low birth weight. Conclusion: the relation of low birth weight and young maternal age could not be proven in this study. DOI: http://dx.doi.org/10.3126/mjsbh.v10i2.6457 Medical Journal of Shree Birendra Hospital July-Dec 2011 10(2) 15-17


Author(s):  
Nasreen Noor ◽  
Akanksha Jain ◽  
Shazia Parveen ◽  
Syed Manazir Ali

Background: The human placenta develops with the principal function of providing nutrients and oxygen to the fetus. Objective of present study was to assess the relationship between placental thickness with estimated fetal weight.Methods: The present study was a prospective observational study and includes 152 pregnant women with known last menstrual period, history of regular menstruation, singleton pregnancy and aged between 20 and 35 years. After Institutional Ethics Committee approval all recruited women were observed for baseline demographic and obstetric data including age, parity and past medical events at first antenatal visit. All women provided an informed written consent and underwent ultrasound evaluation of placental thickness at 18 to 40 weeks of gestation.Results: In the present study the mean placental thickness between the ranges of 18-40mm was 31.63±4.79mm and the mean estimated fetal birth weight was 2145.86±121.24grams. The pearson’s correlation coefficient between the two was 0.982. Thus, proving the significant positive correlation between placental thickness and estimated fetal birth weight (p-value <0.001).Conclusions: Estimated fetal weight is a very important component of antenatal care in which ultrasonography plays an important role. Placental thickness measured at the level of umblical cord insertion can be used as an accurate sonographic indicator in the assessment of fetal weight because of its linear correlation. Therefore, it can be used as an additional sonographic tool in assessing fetal weight.


2021 ◽  
Vol 15 (1) ◽  
pp. 68
Author(s):  
Lusiana Lusia Sirait ◽  
Riwalsen Purba

One of the causes of complicating labor is the fetal factor, namely the fetus's size. If it is not treated immediately, it will increase maternal and neonatal mortality rates. Accurate estimation of fetal birth weight in pregnancy and delivery is an important indicator in determining fetal well-being. Birth weight is important to measure before labor starts, which helps anticipate possible complications in pregnancy, childbirth, and the puerperium. The accuracy of estimation of fetal body weight either by measuring the fundal height or other means will affect labor management. One way to predict the estimated fetal weight, including the Dare's Formula method, is to measure the circumference of the mother's abdomen (abdominal girth) in centimeters, the measurement results times the Fundus Uterine Height (TFU) in centimeters, and the modified Niswander formula (1.12 TFU). - 7,7) 100 (gr). The design used in this study is a Quasi Experiment. Assessment The estimated fetal weight obtained from the measurement is then compared with the newborn's body weight (actual body weight). The population in this study were all pregnant women, both primiparous and multiparous. While the sample to be taken must meet the inclusion criteria that have been set. The results of the study were based on statistical tests using independent t-test, it was found that the p value (0.000) <α (0.05) means that there is a significant difference between the difference in body weight of babies born with Dare's formula and the difference in body weight of babies born with Niswander's modification, the estimated fetal weight is more. Effective using Dare's formula rather than Niswander modification.


2019 ◽  
Vol 17 (2) ◽  
pp. 228-232
Author(s):  
Peru Pradhan ◽  
Binita Neupane ◽  
Sona Shrestha ◽  
Ganesh Dangal

Background: Fetal weight estimation is of utmost need to determine the course of labour and complications for its management. This study intents to compare the fetal weight determined through Johnson’s method and Hadlock’s method with actual birth weight in term pregnancies. Methods: This is an observational study carried out over a period of six months in Kirtipur Hospital among 200 samples of term, singleton pregnancy with cephalic presentation using convenience sampling technique.Results: The mean maternal age was 25.9±4.3 years whereas mean gestational age was 39.1 weeks. Less than half (49.1%) of the babies’ weight ranged between 3.0 - 3.5 kgs. The mean error of estimated weight by Johnson’s method was less compared to Hadlock’s method 185.1±191.1 grams and 355.8±225.7 grams respectively. It was also observed that estimation of fetal weight by Johnson’s method was closer to the actual birth weight than by Hadlock’s method.Conclusions: Johnson’s method requires some basic skills and knowledge with flexibility to apply as and where needed beyond the health facilities irrespective of the availability of the equipment. Furthermore, it was also observed to be slightly more specific in its estimation of birth weight among the term pregnancies compared to Hadlock’s method. Hence, it should be promoted widely among the clinicians. However, Hadlock’s method is equally important for detection of anomalies and high-risk factors coupled with confirmation of the estimation made through Johnson’s method.Keywords: Actual birth weight; estimated fetal weight; hadlock’s method; johnson’s method.


2019 ◽  
Vol 11 (1) ◽  
pp. 32-38
Author(s):  
Naznin Rashid Shewly ◽  
Menoka Ferdous ◽  
Hasina Begum ◽  
Shahadat Hossain Khan ◽  
Sheema Rani Debee ◽  
...  

Background: In obstetric management fetal weight estimation is an important consideration when planning the mode of delivery in our day to day practice. In Bangladesh low birth weight is a major public health problem & incidence is 38% - 58%. Neonatal mortality and morbidity also yet high. So accurate antenatal estimation of fetal weight is a good way to detect macrosomia or small for date baby. Thus to improve the pregnancy outcome and neonatal outcome decreasing various chance of neonatal mortality and morbidity antenatal fetal weight prediction is an invaluable parameter in some situation where to identify the at risk pregnancy for low birth weight become necessary. Reliable method for prenatal estimation of fetal weight two modalities have got popularity - Clinical estimation and another one is ultrasonic estimation. This study was designed to determine the accuracy of clinical versus ultrasound estimated fetal weight detecting the discrepancy with actual birth weight at third trimester. So that we can verify more reliable and accurate method. Objectives: To find out more accurate and reliable modality of fetal weight estimation in antenatal period during obstetric management planning. To compare clinical versus ultrasound estimated fetal weight & to determine discrepancy of both variable with actual birth weight. Method: This prospective, cross sectional analytical study was carried out in Dhaka Medical College Hospital from January 2006 to December 2006. By purposive sampling 100 pregnant women fulfilling inclusion criteria were included in my study in third trimester (29wks-40wks). In clinical weight estimation procedure SFH (Symphysio Fundal Height) was measured in centimeter. On pervaginal finding whether vertex below or above the ischial spine was determined. By Johnson’s formula fetal weight in grams was estimated. Then by ultrasound scan different biometric measurements were taken and finally by Hadlock’s formula fetal weight was estimated. Eventually actual birth weight was taken after birth by Globe Brand weighing machine. Accuracy of both modalities were compared and which one was more reliable predictor was determined by statistical analysis. Results: After data collection were analyzed by computer based software (SPSS). There was gradual and positive relationship between symphysiofundal height and estimated birth weight. Discrepancy between clinical and actual birth weight at third trimester was statistically significant – Paired Student’s ‘t’ test was done where p value was <0.001. Whereas discrepancy between sonographically estimated fetal weight with actual birth weight was not statistically significant (by paired ‘t’ test where p value was >0.05). That implies discrepancy between ultrasound estimated fetal weight and actual birth weight was significantly less than that of clinically estimated fetal weight. 14% clinically and 46% sonographically estimated fetal weight were observed within £ 5% of actual birth weight. 31% clinical and 42% sonographically estimates observed within 6% to 10% of actual birth weight and 55% clinical and 12% sonographically estimate were >10% of actual birth weight. That is about 88% sonographical versus 45% clinical estimates were within 10% of actual birth weight. Conclusion: There is no doubt about importance of fetal weight in many obstetric situations. Clinical decisions at times depends on fetal weight. Whether to use oxytocin, to use forceps or vacuum for delivery or extend of trial or ended by Caesarian section immediately or no scope of trial to be largely depend on fetal size and weight. So more accurate modality for antenatal fetal weight estimation has paramount importance. In my study sonographically estimated weight have more accuracy than that of clinical estimate in predicting actual birth weight. Sonographically estimated fetal weight is more reliable, accurate and reproducible rather than other modality. J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 32-38


2016 ◽  
Vol 214 (1) ◽  
pp. S270
Author(s):  
Nathan S. Fox ◽  
Kathy C. Matthews ◽  
John Williamson ◽  
Simi Gupta ◽  
Jennifer Lam-Rachlin ◽  
...  

2012 ◽  
Vol 207 (4) ◽  
pp. 309.e1-309.e6 ◽  
Author(s):  
Sarah E. Little ◽  
Andrea G. Edlow ◽  
Ann M. Thomas ◽  
Nicole A. Smith

2000 ◽  
Vol 84 (10) ◽  
pp. 583-590 ◽  
Author(s):  
Masahiro Maki ◽  
Toshihiko Terao ◽  
Tsuyomu Ikenoue ◽  
Kazuo Satoh ◽  
Masao Nakabayashi ◽  
...  

SummaryA double-blind, randomized, placebo-controlled trial was conducted to evaluate whether treatment with Antithrombin (AT) concentrates improved the clinical and perinatal outcome in patients with severe preeclampsia. Severe preeclamptic patients (24 to 35 weeks of gestation, Gestosis Index (GI) > 6 points) were randomized into two groups: 66 received AT and 67 received placebo. There were no statistical differences in the clinical profiles of the two groups. Study drugs were given intravenously once daily for 7 consecutive days. Maternal symptoms were evaluated from the difference of GI between before and after treatment, and fetal findings were evaluated from the changes of the biophysical profile score and the estimated fetal weight gain. Improvement was significantly greater in the AT group for both the GI (p = 0.020) and the estimated fetal weight gain (p = 0.029). The improvement of coagulation parameters was also evaluated. The D-dimer levels increased significantly in the placebo group (p = 0.026), but did not change in the AT group. Gestation was significantly prolonged (p = 0.007), and the number of low-birth weight infants was significantly smaller (p = 0.011) in the AT group. No adverse events related to AT were observed. It is revealed that AT concentrate therapy for preeclampsia is effective and safe, leading to an improved perinatal outcome.


Author(s):  
Shripad Hebbar ◽  
Sukriti Malaviya ◽  
Sunanda Bharatnur

Objective: The objective of the study was to find whether incorporation of MTSTT in fetal weight estimation formulae which are traditionally based on biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) improves birth weight (BW) estimation. Methods: In a prospective observational study, MTSTT was measured within 1 week of delivery in 100 women with term singleton pregnancy along with other standard biometric parameters, i.e. BPD, HC, AC and FL, and MTSTT. Multiple regression analysis was carried out using PHOEBE regression software using different combinations of biometric variables to find out the best fit model of fetal weight estimation. The predicted BW was compared with actual neonatal BW soon after delivery and regression coefficients (R2) were determined for each of prediction models for comparing the accuracies. Results: Mean gestational age at delivery was 38.4±1.08 weeks and the BW of neonates varied between 2.18 kg and 4.38 kg (mean ± standard deviation: 3.07±0.43 kg). By adding MTSTT to BPD, HC, AC, and FL, we obtained the formula Log 10 (BW) = −0.14783+0.00725 *BPD +0.00043 *HC +0.00436 *AC +0.01942 *FL +0.16299 *MTSTT, which had a very good Pearson regression coefficient ((r2: 0.89 p<0.001) compared to conventional models based on standard fetal biometry. All prediction models had better strength of correlation when combined with MTSTT (p<0.001). The routine four parameter formula could identify 45% and 80% of fetuses within 5% and 10% weight range; pick up rate was further increased to 61% and 95% by addition of MTSTT. Conclusion: It is evident that addition of MTSTT to other biometric variables in models of fetal weight estimation improves neonatal BW prediction (r2=0.89).


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