DIAGNOSTIC VALUE OF MACROSOMIAS PREDICTOR
Determination of the expected weight of the fetus and the diagnosis of complications in childbirth remains debated issue. To select the optimum tactics of labor with large fetus and reduce the complications accurate methods of prenatal prediction of macrosomia are required.
Research objectives: to evaluate the diagnostic value of ultrasound measurement of abdominal circumference, as a predictor of macrosomia.
Materials and Methods: Study design: US -skrining. The study group included 147 birth stories with large fetus. Selection of cases in the control group held "random digits generator Randomus-" in the program. The control group included 328 physiological childbirth. Statistical processing performed using SPSS software, version 20.
Results: The regression analysis was conducted to evaluate the linear relationship between abdominal circumference (OC), biparietal diameter (BPD), the length of the thigh bone (LTB), and birth weight (BW). The relative prognostic importance of the independent variable - AC ≥350 mm., has a statistical significance at p = 0,001. For variables LTB and BPD, which are the main indicators to measure the supposed fetal weight, p-value at the level of 0.793 and 0.803 respectively, indicating a low significance of these measurement in the prediction of fetal weight.
Sensitivity = a / a + c = 125/147 = 85%, the test result indicates that, when the AC ≥ 350 mm, 85% of the child will be born with a body weight of more than 4000 grams. Specificity = d / a + d = 312/328 = 95%, 95% excludes women without large fetus. Evaluation of diagnostic accuracy of the expected weight of the fetus with a measuring of AC more than 350mm, is a highly sensitive and highly specific method. The positive predictive value was 88.6%, and a negative result - 93.4%.
Conclusions: The diagnosis of a large fetus by ultrasound measurement of the circumference of the abdomen is the most informative (p = 0.001). Given the sensitivity of 85% and specificity of 95%, AC ≥350 mm may be used as a predictor of macrosomia
Gulyash A. Tanysheva, http://orcid.org/0000-0002-9074-6302
Sholpan K. Kinayatova,
Mariyash S. Zhelpakova,
Dolores A. Kurmangaliyeva,
Olga G. Sidorova
State Medical University of Semey, Semey, Kazakhstan
Department of internship in obstetrics and gynecology
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24. Hirnle L. et al. The analysis of risk factors for fetal macrosomia and the complications in thecourse of pregnancy and delivery of macrosomic baby. Ginekol.Pol. 2007. Vol. 78, N 4. P. 280-283.
25. Houzé de l'Aulnoit A., Closset E., Deruelle P. Accuracy of ultrasound estimated fetal weight performed by OB-GYN residents at due date. Gynecologie Obstetrique Fertililité. 2009. 37(4). P. 367–71. [PubMed]
26. Jazayeri A., Heffron J.A., Phillips R. Macrosomia prediction using ultrasound fetalabdominal circumference of 35 centimeters or more. Obstetrics and gynecology. 1999. 93(4). P. 523.
27. Ratchanikon Loetworawanit, Apichart Chittacharoen, Somsak Sututvoravut. Intrapartum fetal abdominal circumference by ultrasonography for predicting fetal macrosomia. J Med Assoc Thai. 2006. 89. P. 60–4.
28. Saleh A., Al-Sultan S.M., Moria A.M. et al. Fetal macrosomia greater than or equal to 4000 grams. Comparing maternal and neonatal outcomes in diabetic and nondiabeticwomen. Saudi Med. J. 2008. Vol.29 (10). P. 1463-1469.
29. Stella С.L. et al. The coexistence of gestational hypertension and diabetes: influence on pregnancy outcome. Am. J. Perinatol. 2008. Vol. 25. N 6. P. 325-329.
30. Sun W.J., Yang H.X. Maternal and fetal outcomes in pregnant women with abnormal glucose metabolism. Zhonghua Fu Chan KeZaZhi. 2007. Vol. 42, N6. P. 377-381.
31. Wojcicki J.M., Hessol N.A., Heyman M.B. Risk factors for macrosomia ininfants born to Latina women. J. Perinatol. 2008. Vol. 28, N 11. P. 743-749.
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Танышева Г.А., Кинаятова Ш.К., Желпакова М.С., Курмангалиева Д.А., Сидорова О.Г. Диагностическая ценность предиктора макросомии / / Наука и Здравоохранение. 2016. №4. С. 84-92. Tanysheva G.A., Kinayatova Sh.K., Zhelpakova M.S., Kurmangaliyeva D.A., Sidorova O.G. Diagnostic value of macrosomia’s predictor. Nauka i Zdravookhranenie [Science & Healthcare]. 2016, 4, pp. 84-92. Танышева Г.А., Кинаятова Ш.К., Желпакова М.С., Курмангалиева Д.А., Сидорова О.Г. Макросомия предикторының диагностикалық маңызы / / Ғылым және Денсаулық сақтау. 2016. №4. Б. 84-92.Related publications:
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