Sonographic markers of fetal adiposity and risk of Cesarean delivery.

Published on Sep 1, 2019in Ultrasound in Obstetrics & Gynecology5.571
· DOI :10.1002/UOG.20263
Mark P. Hehir3
Estimated H-index: 3
(RCSI: Royal College of Surgeons in Ireland),
Naomi Burke5
Estimated H-index: 5
(Rotunda Hospital)
+ 14 AuthorsFergal D. Malone62
Estimated H-index: 62
(RCSI: Royal College of Surgeons in Ireland)
Sources
Abstract
OBJECTIVE: Increased fetal size is associated with shoulder dystocia during labor and subsequent need for assisted delivery. We sought to investigate if increased fetal adiposity diagnosed sonographically in late pregnancy is associated with increased risk of operative delivery. METHODS: This secondary analysis of the Genesis Study recruited 2392 nulliparous women with singleton pregnancy in cephalic presentation, in a prospective, multicenter study, to examine prenatal and intrapartum predictors of Cesarean delivery. Participants underwent ultrasound and clinical evaluation between 39 + 0 and 40 + 6 weeks' gestation. Data on fetal biometry were not revealed to patients or to their managing clinicians. A fetal adiposity composite of fetal thigh adiposity and fetal abdominal wall thickness was compiled for each infant in order to determine whether fetal adiposity > 90th centile was associated with an increased risk of Cesarean or operative vaginal delivery. RESULTS: After exclusions, data were available for 2330 patients. Patients with a fetal adiposity composite > 90th centile had a higher maternal body mass index (BMI) (25 ± 5 kg/m2 vs 24 ± 4 kg/m2 ; P = 0.005), birth weight (3872 ± 417 g vs 3585 ± 401 g; P   90th centile were more likely to require Cesarean delivery than were those with adiposity composite ≤ 90th centile (P   90th centile remained a risk factor for Cesarean delivery (P   90th centile was more predictive of the need for unplanned Cesarean delivery than was an estimated fetal weight > 90th centile (odds ratio, 2.20 (95% CI, 1.65-2.94; P   90th centile was not associated with an increased likelihood of operative vaginal delivery when compared with having an adiposity composite ≤ 90th centile (P = 0.37). CONCLUSIONS: Fetuses with increased adipose deposition are more likely to require Cesarean delivery than are those without increased adiposity. Consideration should, therefore, be given to adding fetal thigh adiposity and abdominal wall thickness to fetal sonographic assessment in late pregnancy. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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42 CitationsSource
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Cited By3
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#1Gwinyai MasukumeH-Index: 11
#1Gwinyai Masukume (UCC: University College Cork)H-Index: 11
#2Ali S. Khashan (UCC: University College Cork)H-Index: 36
Last. Fergus P. McCarthy (UCC: University College Cork)H-Index: 23
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Background Several studies reported an association between Caesarean section (CS) birth and childhood obesity. However, there are several limitations in the current literature. These include an inability to distinguish between planned and emergency CS, small study sample sizes and not adjusting for pre-pregnancy body-mass-index (BMI). We examined the association between CS delivery and childhood obesity using the United Kingdom Millennium Cohort Study (MCS). Methods Mother-infant pairs were recr...
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#1Eleonora Mazzone (University of Parma)H-Index: 4
#2Andrea Dall'Asta (University of Parma)H-Index: 14
Last. Tiziana Frusca (University of Parma)H-Index: 28
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Abstract Objective The estimation of the fetal weight by three-dimensional (3D) ultrasound (US) with fractional thigh volume (TVol) has been suggested to be more accurate compared to two-dimensional (2D) US particularly within the context of fetuses at risk of macrosomia. The objective of this study was to compare the accuracy of 2D US and 3D US with two different methods of projection for the identification of fetal macrosomia at term. Study design Prospective study which included women at risk...
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