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Overestimation of fetal weight by ultrasound: does it influence the likelihood of cesarean delivery for labor arrest?

2009; Elsevier BV; Volume: 200; Issue: 3 Linguagem: Inglês

10.1016/j.ajog.2008.12.043

1097-6868

Sean C. Blackwell, Jerrie Refuerzo, Rati Chadha, Carlos Carreño,

Maternal and fetal healthcare

Objective We sought to determine whether the overestimation of ultrasound-derived estimated fetal weight (EFW) is associated with increased diagnosis of labor arrest. Study Design This is a historical cohort study of nulliparous women with term pregnancies who underwent bedside ultrasound examination for EFW before labor induction. Labor outcomes of women with EFW overestimation > 15% the actual birthweight were compared with those with EFW not overestimated. Results Overestimation of EFW occurred in 9.5% of cases (23/241). The rate of cesarean delivery (CD) for labor arrest was higher for those with EFW overestimation (34.8% vs 13.3%; P = .01) even though there were no differences in length of the induction duration. After adjusting for confounding factors, EFW overestimation remained associated with CD for labor arrest (odds ratio, 4.8; 95% confidence interval, 1.5-15.2). Conclusion Our finding suggests that an overestimation of EFW may be associated with a lower threshold for CD for labor arrest. We sought to determine whether the overestimation of ultrasound-derived estimated fetal weight (EFW) is associated with increased diagnosis of labor arrest. This is a historical cohort study of nulliparous women with term pregnancies who underwent bedside ultrasound examination for EFW before labor induction. Labor outcomes of women with EFW overestimation > 15% the actual birthweight were compared with those with EFW not overestimated. Overestimation of EFW occurred in 9.5% of cases (23/241). The rate of cesarean delivery (CD) for labor arrest was higher for those with EFW overestimation (34.8% vs 13.3%; P = .01) even though there were no differences in length of the induction duration. After adjusting for confounding factors, EFW overestimation remained associated with CD for labor arrest (odds ratio, 4.8; 95% confidence interval, 1.5-15.2). Our finding suggests that an overestimation of EFW may be associated with a lower threshold for CD for labor arrest.