Ultrasound examination in the diagnosis of fetal macrosomia

Abstract

Ultrasound examination in obstetrics is a method of screening of pregnant women including identification of fetal macrosomia. Diagnosis of macrosomia is extremely important, along with other indications the conclusion about the presence of a large fetus may affect the tactics of giving birth. Gestational diabetes (GD) is a known clinical risk factor for fetal macrosomia and accounts for the majority of all types of diabetes observed during pregnancy. In women with GD fetal macrosomia is the main complication, which often together with others serves as an indication for a planned cesarean section in order to reduce potentially possible perinatal complications, as macrosomia of diabetic origin is characterized by disproportional distribution of subcutaneous adipose tissue in the fetus with predominant localization in the upper half of the trunk, which increases the probability of dystocia of the shoulders and damage to the brachial plexus. In perinatal morbidity and mortality the major proportion is presented by newborns weighing more than 4 kg but there is insufficient data in the literature on how prenatal ultrasound should be monitored in cases of suspected macrosomia in the fetus, especially in patients without diabetes. At the moment, to determine the estimated weight of the fetus, the formulas created more than 30 years ago are used and their accuracy is not always high. The difficulty is caused by the lack of data on the diagnostic accuracy of macrosomal markers. A search is being made for additional parameters capable of increasing the diagnostic value of ultrasound method for determining the estimated weight of the fetus.