Agreement between Clinical and Ultrasonographic Estimation of Abnormal Birth Weight of Term Fetus

Abstract

Background: The ultrasound examination and estimation of fetal parts has turned an integral part of current obstetric consideration. These estimations can serve for dates of pregnancies and evaluation of fetal development. Foundation of gestational age is imperative for the management of pregnancy, both normal and typical. Exact pre-birth estimation of fetal weight (EFW) in late pregnancy and labour is particularly useful in the management of delivery, allowing obstetricians to settle on decisions about the instruments of vaginal delivery and trial of labour after caesarean section and elective caesarean delivery for patients suspected of having macrosomic embryo. Aim: To determine the degree of agreement between clinical assessment and ultrasonography in the prediction of abnormal weight of fetus in term pregnancy. Methodology: This is a descriptive cross-sectional study and carried out at Divisional Head Quarter Hospital, Mirpur Azad Jamu Kashmir from 01-03-2017 to 28-02-2018. Results: In our study, 59.2% (n=148) were between 18-30 years and 40.8% (n=102) were between 31-40 years of age, Mean±SD was calculated as 28.25+5.02 years, clinical mean weight and ultrasound estimation of fetal weight was calculated as 3106.12+632.88 gram in clinical estimation while 3232.48+641.04 grams were recorded while estimation was done with ultrasound. Degree of agreement between clinical assessment and ultrasonography was calculated which reveals true positive i.e. 177 for both clinical and ultrasound while true negative for both i.e. 51, Kappa statistics were computed as 0.4491 (observed as proportion of maximum possible), which shows a significant agreement. Conclusion: •Ultrasound and clinical examination for estimation of birth weight are reliable and significantly agreed while clinical examination may be used for correct estimation where sonographic facilities are not available.