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Abstract
Discussion Forum (0)
Introduction:
An estimated fetal weight (EFW) is frequently determined near the time of delivery. We investigated whether discrepancy between EFW and birthweight was associated with increased rates of maternal or neonatal complications.

Methods:
We performed a secondary analysis of an IRB-approved retrospective cohort study including all women delivering non-anomalous, term singletons via scheduled cesarean from 2004-2014. EFW was determined by Leopold maneuvers or recent ultrasound. An accurate EFW was defined as within 20% of BW, while an inaccurate EFW was an EFW > or < 20% of BW. Neonatal and maternal outcomes were compared based on accuracy of EFW. Neonatal outcomes included APGAR < 7, death, hypoxic-ischemic encephalopathy, therapeutic hypothermia, intubation, respiratory distress, and seizures. Maternal outcomes included postpartum hemorrhage, transfusion, wound infection, and venous thromboembolism. Multivariable logistic regression was used to adjust for confounders.

Results:
The EFW was inaccurate in 223/1697 (13.1%) cases. Increasing maternal BMI and abnormal birthweight were associated with inaccurate EFW. The EFW overestimated birthweight in 72/167 (43.0%) of SGA neonates and underestimated birthweight in 47/238 (19.7%) of LGA neonates. Risk of postpartum hemorrhage was two-fold higher when EFW was inaccurate (aOR 2.09, 95% CI 1.02-4.31). All other surgical and neonatal outcomes were similar between groups.

Conclusion/Implications:
Inaccurate estimation of birthweight is more common in LGA and SGA neonates. Increased postpartum hemorrhage but no other adverse outcomes were seen when birthweight was inaccurately estimated. Future research should investigate the impact EFW-birthweight discordance has on outcomes after labor.
Introduction:
An estimated fetal weight (EFW) is frequently determined near the time of delivery. We investigated whether discrepancy between EFW and birthweight was associated with increased rates of maternal or neonatal complications.

Methods:
We performed a secondary analysis of an IRB-approved retrospective cohort study including all women delivering non-anomalous, term singletons via scheduled cesarean from 2004-2014. EFW was determined by Leopold maneuvers or recent ultrasound. An accurate EFW was defined as within 20% of BW, while an inaccurate EFW was an EFW > or < 20% of BW. Neonatal and maternal outcomes were compared based on accuracy of EFW. Neonatal outcomes included APGAR < 7, death, hypoxic-ischemic encephalopathy, therapeutic hypothermia, intubation, respiratory distress, and seizures. Maternal outcomes included postpartum hemorrhage, transfusion, wound infection, and venous thromboembolism. Multivariable logistic regression was used to adjust for confounders.

Results:
The EFW was inaccurate in 223/1697 (13.1%) cases. Increasing maternal BMI and abnormal birthweight were associated with inaccurate EFW. The EFW overestimated birthweight in 72/167 (43.0%) of SGA neonates and underestimated birthweight in 47/238 (19.7%) of LGA neonates. Risk of postpartum hemorrhage was two-fold higher when EFW was inaccurate (aOR 2.09, 95% CI 1.02-4.31). All other surgical and neonatal outcomes were similar between groups.

Conclusion/Implications:
Inaccurate estimation of birthweight is more common in LGA and SGA neonates. Increased postpartum hemorrhage but no other adverse outcomes were seen when birthweight was inaccurately estimated. Future research should investigate the impact EFW-birthweight discordance has on outcomes after labor.
Does Peripartum Miscalculation of Estimated Fetal Weight Increase Maternal or Fetal Complications?
Jinai Bharucha
Jinai Bharucha
ACOG ePoster. Bharucha J. 05/06/2022; 351081; A181
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Jinai Bharucha
Abstract
Discussion Forum (0)
Introduction:
An estimated fetal weight (EFW) is frequently determined near the time of delivery. We investigated whether discrepancy between EFW and birthweight was associated with increased rates of maternal or neonatal complications.

Methods:
We performed a secondary analysis of an IRB-approved retrospective cohort study including all women delivering non-anomalous, term singletons via scheduled cesarean from 2004-2014. EFW was determined by Leopold maneuvers or recent ultrasound. An accurate EFW was defined as within 20% of BW, while an inaccurate EFW was an EFW > or < 20% of BW. Neonatal and maternal outcomes were compared based on accuracy of EFW. Neonatal outcomes included APGAR < 7, death, hypoxic-ischemic encephalopathy, therapeutic hypothermia, intubation, respiratory distress, and seizures. Maternal outcomes included postpartum hemorrhage, transfusion, wound infection, and venous thromboembolism. Multivariable logistic regression was used to adjust for confounders.

Results:
The EFW was inaccurate in 223/1697 (13.1%) cases. Increasing maternal BMI and abnormal birthweight were associated with inaccurate EFW. The EFW overestimated birthweight in 72/167 (43.0%) of SGA neonates and underestimated birthweight in 47/238 (19.7%) of LGA neonates. Risk of postpartum hemorrhage was two-fold higher when EFW was inaccurate (aOR 2.09, 95% CI 1.02-4.31). All other surgical and neonatal outcomes were similar between groups.

Conclusion/Implications:
Inaccurate estimation of birthweight is more common in LGA and SGA neonates. Increased postpartum hemorrhage but no other adverse outcomes were seen when birthweight was inaccurately estimated. Future research should investigate the impact EFW-birthweight discordance has on outcomes after labor.
Introduction:
An estimated fetal weight (EFW) is frequently determined near the time of delivery. We investigated whether discrepancy between EFW and birthweight was associated with increased rates of maternal or neonatal complications.

Methods:
We performed a secondary analysis of an IRB-approved retrospective cohort study including all women delivering non-anomalous, term singletons via scheduled cesarean from 2004-2014. EFW was determined by Leopold maneuvers or recent ultrasound. An accurate EFW was defined as within 20% of BW, while an inaccurate EFW was an EFW > or < 20% of BW. Neonatal and maternal outcomes were compared based on accuracy of EFW. Neonatal outcomes included APGAR < 7, death, hypoxic-ischemic encephalopathy, therapeutic hypothermia, intubation, respiratory distress, and seizures. Maternal outcomes included postpartum hemorrhage, transfusion, wound infection, and venous thromboembolism. Multivariable logistic regression was used to adjust for confounders.

Results:
The EFW was inaccurate in 223/1697 (13.1%) cases. Increasing maternal BMI and abnormal birthweight were associated with inaccurate EFW. The EFW overestimated birthweight in 72/167 (43.0%) of SGA neonates and underestimated birthweight in 47/238 (19.7%) of LGA neonates. Risk of postpartum hemorrhage was two-fold higher when EFW was inaccurate (aOR 2.09, 95% CI 1.02-4.31). All other surgical and neonatal outcomes were similar between groups.

Conclusion/Implications:
Inaccurate estimation of birthweight is more common in LGA and SGA neonates. Increased postpartum hemorrhage but no other adverse outcomes were seen when birthweight was inaccurately estimated. Future research should investigate the impact EFW-birthweight discordance has on outcomes after labor.

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