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ABSTRACT Objective
Evaluation of the effectiveness of third trimester fetal biometry and Doppler studies in predicting the birth of a large for gestational age neonate (LGA ≥ 95th centile). Assessment of the value of integrated models (combining maternal characteristics, first trimester parameters, third trimester fetal biometry) and the usefulness of contingency strategies.
MethodObservational cross‐sectional study on 2308 uncomplicated singleton pregnancies examined at 11 to 14 weeks and at 30 to 34 weeks.
ResultsUltrasound estimated fetal weight (EFW, area under the curve (AUC) = 0.83) was the best single predictor of LGA. Maternal weight, delta nuchal translucency and EFW were independent predictors for the integrated model, but the latter was not statistically better (AUC = 0.84) than using EFW alone. The detection rates for LGA were 72.5% and 73.7% for a 25% screen positive rate, by EFW and the third trimester integrated model respectively.
A contingency strategy of rescanning 50% of the population in the third trimester according to the risk estimation by a first trimester prediction model results in detection rate of 64.7% for LGA for the same 25% screen positive rate (AUC = 0.78).
ConclusionsThird trimester ultrasound is an effective screening modality for identifying fetal macrosomia. A contingency strategy utilizing first trimester parameters can reduce the need for unnecessary examinations. © 2012 John Wiley & Sons, Ltd.
| Authors: | Athanasios Pilalis, Athena P. Souka, Ioannis Papastefanou, Vasiliki Michalitsi, Perikles Panagopoulos, Charalambos Chrelias, Dimitrios Kassanos | |
| Journal: | Prenatal Diagnosis | |
| Year: | 2012 | |
| Pages: | 1 | |
| DOI: | 10.1002/pd.3918 | |
| Publication date: | 25-06-2012 |
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