Abstract
BackgroundClinical fetal weight estimation is a common practice in obstetrics. This study aims to evaluate the accuracy of fetal weight estimation by midwives, and to identify factors that may lead to overestimation or underestimation of fetal weight.MethodsA cohort prospective study in a Lebanese university hospital, included weight estimation of singleton pregnancies above 35 weeks. Multiple pregnancies, unclear dating, growth retardation, malformations and stillbirths cases are excluded. The estimated fetal weight is recorded by midwives in a sealed envelope and compared to true weight later. The effects of BMI, weight gain, parity, diabetes, hypertension, neonate’s sex and weight, uterine contractions, rupture of membranes and daytime or nighttime shift on these estimations were assessed.ResultsOne hundred and sixty-six patients were included. Mean birth weight was 3246 ± 362 g. Mean absolute percentage error of weight estimation was 8.5 ± 6.7% (0–30.9%). Estimation was within the correct range of ±10% in 63% of cases. Maternal and fetal factors did not significantly change weight estimation. Fetuses with birth weights more than 4000 tended to be underestimated by midwives. Estimation improved over time (nonsignificant).ConclusionsMaternal and fetal factors, except for macrosomia, have limited impact on estimation of fetal birth weight. Macrosomia is challenging because of a consistent tendency of underestimation by midwives.
Highlights
Clinical fetal weight estimation is a common practice in obstetrics
The purpose of this study is to evaluate the accuracy of the estimated fetal weight performed during labor by midwives at the Obstetrics and Gynecology department of a University Hospital in Beirut and to evaluate maternal and fetal factors that might affect the variation of this estimation
A clinical estimation of the fetal weight by bimanual abdominal palpation (Leopold-Pavlik maneuver) was performed the midwife who was on duty (n = 4)
Summary
Clinical fetal weight estimation is a common practice in obstetrics. This study aims to evaluate the accuracy of fetal weight estimation by midwives, and to identify factors that may lead to overestimation or underestimation of fetal weight. Accurate estimation of fetal weight in late pregnancy provides valuable information for decision making in the management of birth, namely the mode and time of birth, as well as the subsequent management of the mother and the neonate [1]. This is especially true for fetuses at the extremes of birth weight, low birth weight and macrosomia [2]. The purpose of this study is to evaluate the accuracy of the estimated fetal weight performed during labor by midwives at the Obstetrics and Gynecology department of a University Hospital in Beirut and to evaluate maternal and fetal factors that might affect the variation of this estimation
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