Predicting Big Babies: Using Amniotic Fluid and Baby Weight Estimates

Abstract

Background: Macrosomia or big baby is defined as a newborn with a birth weight of more than 4kg. Amniotic fluid index (AFI) which is estimated by adding length of deepest vertical pool in four corners of liquor in uterus is an indicator of fetal well-being. This parameter when combined with ultrasonographic estimated fetal weight can predict macrosomia accurately. Objective: To evaluate diagnostic accuracy of integrated examination with amniotic fluid index (AFI) and estimated fetal weight (EFW) for prediction of macrosomia. Study Design: Cross sectional study. Settings: Department of Obstetrics and Gynecology, Combined Military Hospital (CMH), Rawalpindi Pakistan. Duration: 6 months from 29th October 2019 to 28th April 2020. Methods: After meeting the inclusion criteria 250 females were enrolled. All patients underwent sonographic evaluation for AFI and EFW estimation. Patients were categorized as positive or negative for macrosomia. Then all females were followed-up in OPD till delivery. If birth weight was ≥4000 grams, then macrosomia was confirmed. Results: The average age of the females was 27.21 ± 4.59 years, there were 55(22%) females as nulliparous. The sensitivity, specificity, and diagnostic accuracy of integrated examination of AFI & EFW were 50%, 98.78%, & 98% for definition of macrosomia as base line. Conclusion: This study showed good diagnostic accuracy of integrated amniotic fluid index and ultrasound baby weight estimates as predictor of macrosomia having low sensitivity.