Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
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.
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Suspected large for gestational age (LGA) | Women with pregnancies suspected to be complicated by fetuses weighing more than the 90th centile on customised growth chart and induced for this reason prior to 287 days as the main indication without diabetes. |
| |
| Women with diabetes (DM) | Women with diabetes in pregnancy induced at between 259 and 266 days if on treatment and 273 days if gestational diabetes managed with diet alone. |
| |
| Control | All other women induced at or after 280 days of gestation |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Induction of labour | Procedure | Induction of labour using amniotomy, vaginal prostaglandin administration and syntocinon in combination as per protocol. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Mode of delivery | Caesarean section and assisted delivery rates | through study completion, an average of 1 year |
| Shoulder dystocia rate | Any clinically diagnosed cases of shoulder dystocia where the shoulders did not deliver with routine axial traction on the next contraction after the head was delivered. | through study completion, an average of 1 year |
| Estimated blood loss | Blood loss as estimated by the clinical team | through study completion, an average of 1 year |
| Obstetric Anal Sphincter Injury | Any tear involving the external anal sphincter and/or rectal mucosa | through study completion, an average of 1 year |
| Admission to special care baby unit (SCBU) | Admission of neonate to neonatal unit from labour ward | through study completion, an average of 1 year |
| Epidural rate | Use of epdiural analgesia intrapartum | through study completion, an average of 1 year |
| Birthweight | Neonatal weight as taken following delivery | through study completion, an average of 1 year |
Not provided
| Measure | Description | Time Frame |
|---|---|---|
| Prediction of WHO birthweight >90th centile by scan estimated weight centile on WHO chart | As above | through study completion, an average of 1 year |
| Birthweight centile as per customised chart | Birthweight centile given birthweight and maternal characteristics as per perinatal institute |
Inclusion Criteria:
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
Not provided
Not provided
Not provided
Not provided
Pregnant women booked for their care at Northumbria Healthcare Trust in North East England: a predominantly white British female population with rates of obesity above the national average.
Not provided
Not provided
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Benjamin Simpson | Newcastle upon Tyne | Tyne and Wear | NE24HH | United Kingdom |
| Type | Date | Date Unknown |
|---|---|---|
| Release | Jul 11, 2022 | |
| Reset | Jun 9, 2023 |
Not provided
Not provided
| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Jul 11, 2022 | Jun 9, 2023 |
| ID | Term |
|---|---|
| D007751 | Labor, Induced |
| ID | Term |
|---|---|
| D036861 | Delivery, Obstetric |
| D013513 | Obstetric Surgical Procedures |
| D013514 | Surgical Procedures, Operative |
Not provided
Not provided
Not provided
Not provided
Not provided
| through study completion, an average of 1 year |
| Birthweight centile as per WHO population chart | Based on Kiserud T, Piaggio G, Carroli G, Widmer M, Carvalho J, et al. (2017) The World Health Organization Fetal Growth Charts: A Multinational Longitudinal Study of Ultrasound Biometric Measurements and Estimated Fetal Weight. PLOS Medicine 14(1): e1002220. https://doi.org/10.1371/journal.pmed.1002220 | through study completion, an average of 1 year |
| Scan error as a percentage of estimated fetal weight | Difference between birthweight and what it was expected to be based on estimated weight (using perinatal institutes calculator) at scan, given as a percentage of that estimated weight | through study completion, an average of 1 year |
| Prediction of Customised growth chart birthweight >90th centile by estimated weight on scan | As above | through study completion, an average of 1 year |
| Prediction of birthweight >4kg based on projected weight at time of delivery from scan estimated weight | As above | through study completion, an average of 1 year |