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OR POLYHYDRAMNIOS CUNEYT OZCAN, AVRAHAM OREN, YUVAL GIELCHINSKY, CHEN SELA, VANIA WALLACH, RACHEL PICARD, ORLY SHOSHANI, DAVID MANKUTA, Hadassah University Hospital Jerusalem, Obstetrics and Gynecology, Jerusalem, Israel, Hadassah University Hospital Jerusalem, Center for quality and Safety, Jerusalem, Israel OBJECTIVE: To study the accuracy of clinical and ultrasonic fetal weight estimation in women with obesity or with polyhydramnios. STUDY DESIGN: In a prospective study, 270 singleton pregnancies between 37 and 42 weeks had clinical (Leopold) and sonographic (Hadlock) fetal weight estimation. All pregnant women were within one week of delivery .The patients were stratified into 3 groups: 100 Obese pregnant women (BMI >30 and normal AFI), 70 normal weight women with polyhydramnios (AFI >20) and 100 controls with normal weight and normal amniotic fluid (BMI !26 and AFI !20). Clinical estimations were performed by a resident and a specialist in obstetrics or MFM. All observers were blinded to all other estimation results. Absolute percent error was calculated for each specific method. RESULTS: The accuracy of the clinical estimation was greatest in the control group; it declined in the polyhydramnios group and was significantly worse in the obese group (P = .04). There were no significant differences between the clinical estimation of residents and specialists. In the clinical estimation method physicians have a tendency to underestimate the fetal weight (P = .04) while in the obese group to overestimate the fetal weight (P = .05).Sonographic estimation was not more accurate than the clinical. CONCLUSION: When the pregnant women’s abdomen is large due to obesity or polyhydramnios, the accuracy of clinical fetal weight estimation is significantly reduced. This information may be important for clinical decisionmaking, patient consultation as well as medico legal aspects. |
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