The Utility of Customised Growth Charts for Identifying Macrosomia and the Effect of Intervention

Newcastle University845 enrolled

Overview

Best management of suspected large for gestational age (LGA) fetuses is unclear. In some hospitals women with an LGA fetus by customised growth charts are are offered earlier induction. This study aimed to examine scan accuracy for this group and the outcome with intervention.

This is a retrospective cohort study of pregnant women taken from 3 groups; women with a suspected LGA fetus (LGA), women with diabetes (DM) and a control group of women that underwent induction of labour at or after 40 weeks. Scan accuracy using GROW and WHO charts in the LGA and DM cohorts was assessed using ROC curves and outcomes between the cohorts was compared.

Study Type

OBSERVATIONAL

Enrollment

845

Conditions

Obstetric Complication Ultrasound Induction of Labor Affected Fetus / Newborn Fetal Growth Complications

Interventions

Induction of labourPROCEDURE

Induction of labour using amniotomy, vaginal prostaglandin administration and syntocinon in combination as per protocol.

Eligibility

Sex: FEMALE

Medical Language ↔ Plain English

Inclusion Criteria: * Induced labour of a singleton pregnancy at Northumbria Healthcare Foundation trust resulting in a delivery between 01/01/2018 and 31/12/2018. Inclusion in the LGA group means that the main indication for induction is recorded as suspected macrosomia. Inclusion in the Diabetic group means diabetes was pre-existing or arose in pregnancy, diagnosed by oral glucose tolerance testing from 24-30 weeks or by home blood glucose monitoring with standard thresholds as per NICE ng3. Induction had to be undertaken with diabetes as the (co)indication. Inclusion criteria for the control group was induction of labour at or after 280 days gestation Exclusion Criteria: Previous caesarean section Multiple pregnancy Fetal concerns pre-induction: abnormal antenatal trace or abnormal doppler flow studies on antenatal ultrasound * Cases of induction for suspected LGA are to be excluded if there is a co-indication of obstetric cholestasis, hypertensive disorder or diabetes.

Locations (1)

Benjamin Simpson

Newcastle upon Tyne, Tyne and Wear, United Kingdom