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- W2897418501 abstract "Shoulder dystocia can lead to severe morbidity, but prediction for non-macrosomic fetuses is poor. We investigated whether fetuses who demonstrate increasing estimated fetal weight (EFW) or abdominal circumference (AC) centiles across the third trimester are at increased risk of shoulder dystocia. We performed a prospective, longitudinal study of 347 nulliparous women. EFW and AC centile were measured at 28 and 36 weeks, and the change in EFW or AC centile over exactly 8 weeks was calculated. Only live births delivered vaginally were included. We excluded cases of EFW >95th centile at 36 week ultrasound, as these fetuses are already known to be at increased shoulder dystocia risk. We calculated the relative risk (RR) of shoulder dystocia for fetuses who demonstrated an increase in EFW or AC of >30 centiles over 8 weeks, irrespective of birthweight centile, compared to the rest of the cohort. We also correlated AC and EFW change in centile with neonatal body fat percentage and Ponderal Index. 36 week EFW >95th centile demonstrated 81.8% sensitivity and 91.0% specificity for birthweight >95th centile. Of the 347 participants, 39(11.2%) had EFW >95th centile at 36 week ultrasound and were excluded. Of the 308 participants remaining, 226(73.4%) delivered their baby vaginally and were included in the analysis, with 6(2.7%) cases of shoulder dystocia. Increasing EFW and AC centile were both significantly associated with increased shoulder dystocia risk. An increase in EFW by >30 centiles over 8 weeks was associated with a RR of 8.9 (p=0.03) for shoulder dystocia, and an increase in AC by >30 centiles over 8 weeks was associated with a RR of 7.7 (p=0.02). Change in EFW and AC centile were both significantly correlated with neonatal fat measures. Increasing EFW or AC centile across the third trimester is significantly associated with increased risk of shoulder dystocia in normal weight fetuses. This may assist the prediction of shoulder dystocia for the non-macrosomic infant." @default.
- W2897418501 created "2018-10-26" @default.
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- W2897418501 date "2018-10-01" @default.
- W2897418501 modified "2023-10-18" @default.
- W2897418501 title "OC17.05: Increasing fetal growth velocity increases the risk of shoulder dystocia among non-macrosomic fetuses" @default.
- W2897418501 doi "https://doi.org/10.1002/uog.19322" @default.
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