Does Peripartum Miscalculation of Estimated Fetal Weight Increase Maternal or Fetal Complications? [A181]. (May 2022)

• Record Type: Journal Article
• Authors: Bharucha, Jinai; Rimsza, Rebecca; Raghuraman, Nandini; Bligard, Katherine H.
• Is Part Of: Obstetrics and gynecology. Volume 139(2022)Supplement 1
• Page Start: 52S
• Page End: 53S
• Publication Date: 2022-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000826000.75463.31
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: An estimated fetal weight (EFW) is frequently determined near the time of delivery. We investigated whether discrepancy between EFW and birth weight was associated with increased rates of maternal or neonatal complications. METHODS: We performed a secondary analysis of an institutional review board‒approved retrospective cohort study including all women delivering non-anomalous, term singletons via scheduled cesarean delivery from 2004 to 2014. EFW was determined by Leopold maneuvers or recent ultrasound. An accurate EFW was defined as within 20% of BW, while an inaccurate EFW was an EFW >20% or <20% of BW. Neonatal and maternal outcomes were compared based on accuracy of EFW. Neonatal outcomes included Apgar<7, death, hypoxic ischemic encephalopathy, therapeutic hypothermia, intubation, respiratory distress, and seizures. Maternal outcomes included postpartum hemorrhage, transfusion, wound infection, and venous thromboembolism. Multivariable logistic regression was used to adjust for confounders. RESULTS: The EFW was inaccurate in 223/1, 697 (13.1%) cases. Increasing maternal BMI and abnormal birth weight were associated with inaccurate EFW. The EFW overestimated birth weight in 72/167 (43.0%) of SGA neonates and underestimated birth weight in 47/238 (19.7%) of LGA neonates. Risk of postpartum hemorrhage was two-fold higher when EFW was inaccurate (aOR, 2.09; 95% CI, 1.02–4.31). All other surgical and neonatal outcomes were similar between groups. CONCLUSION: Inaccurate estimation of birth weight is more common in LGA and SGA neonates. Increased postpartum hemorrhage, but no other adverse outcomes, were seen when birth weight was inaccurately estimated. Future research should investigate the impact EFW–birth weight discordance has on outcomes after labor.