Abstract
BACKGROUND: Unfavorable outcomes for mothers and newborns are linked to fetal macrosomia. The antenatal diagnosis of macrosomia is frequently unreliable. For this, a range of ultrasonic measures have been employed. The accuracy of two-dimensional (2D) ultrasound biometry for the prediction of macrosomia was evaluated in a systematic review published in 2005. The results showed that ultrasound was generally a poor predictor of fetal macrosomia, regardless of whether fetal AC alone or estimated fetal weight (EFW), which is calculated from measurements of fetal head circumference (HC), abdominal circumference (AC), and femur length (FL), was used. Therefore, it is not advised to use ultrasonography to evaluate pregnant women in general who are thought to be large for dates based on clinical assessment. The assessment of high-risk pregnancies now includes an integrated component for the evaluation of cerebral blood flow in the fetus.
AIM: The aim of the study was to explore the relationship between cerebroplacental Doppler ratio and birth weight in cases of suspected fetal macrosomia.
MATERIAL AND METHOD: This is a prospective cohort study that the Obstetrics and Gynecology Department is conducting. Following their written agreement, consecutive parturient women with well-dated term pregnancies P>37 gestational weeks were admitted and recruited during the study period. The cohort of enrolled women was divided into two groups according to the fetal birth weight (FBW) i.e., >4 kg. Group I (LGA; n = 30) with large weight for gestational age babies and Group II (AGA; n = 50) with average weight for gestational age. Charts were reviewed for demographic and medical forms in thirteen patients. Fetal macrosomia and arterial cord pH, as well as maternal and perinatal problems, were the features, labor and delivery events, Apgar scores, and reason for elective CS in eight of these instances. prior voluntary cesarean delivery.
RESULTS: 80 pregnant women consented to participate in the study. The cohort of enrolled women was divided into two groups according to the fetal birth weight (FBW) i.e. >4 kg. Group I (LGA; n = 30) with large weight for gestational age babies and Group II (AGA; n = 50) with average weight for gestational age. BMI was significantly higher in the LGA than in AGA (32.3 vs. 25.1). The mean gestational age at the time of labor was around 38 gestational weeks and the median age was significantly higher in the LGA group than the AGA (3072 vs. 21557 g,). There is a significant difference between groups in abdominal circumference (AC), head circumference (HC), Biparital diameter (BPD), estimated fetal weight (EFW), and actual fetal weight with a mean difference of 82.7 g in the LGA group and 74 g in the AGA group.
CONCLUSION: To sum up, the sonographic examination is a sensitive and exact method for determining the weight of the fetus and, by extension, macrosomia. When it comes to predicting large-sized newborns and fetal macrosomia, AC is the most crucial sonographic marker. The only important parameters in the macrosomia prediction are the Doppler indices in the middle cerebral arteries; the Doppler indices in the umbilical arteries and the cerebroplacental Doppler ratio are not significant in the macrosomia prediction.
KEYWORDS: Fetal macrosomia; Shoulder dystocia and Caesarean section.