The Utility of Customised Growth Charts for Identifying Macrosomia and the Effect of Intervention
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Obstetric Complication
- Sponsor
- Newcastle University
- Enrollment
- 845
- Locations
- 1
- Primary Endpoint
- Mode of delivery
- Status
- Completed
- Last Updated
- 5 years ago
Overview
Brief Summary
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.
Detailed Description
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.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Induced labour of a singleton pregnancy at Northumbria Healthcare Foundation trust resulting in a delivery between 01/01/2018 and 31/12/
- •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 ng
- •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
- •Cases of induction for suspected LGA are to be excluded if there is a co-indication of obstetric cholestasis, hypertensive disorder or diabetes.
Outcomes
Primary Outcomes
Mode of delivery
Time Frame: through study completion, an average of 1 year
Caesarean section and assisted delivery rates
Shoulder dystocia rate
Time Frame: through study completion, an average of 1 year
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.
Estimated blood loss
Time Frame: through study completion, an average of 1 year
Blood loss as estimated by the clinical team
Obstetric Anal Sphincter Injury
Time Frame: through study completion, an average of 1 year
Any tear involving the external anal sphincter and/or rectal mucosa
Admission to special care baby unit (SCBU)
Time Frame: through study completion, an average of 1 year
Admission of neonate to neonatal unit from labour ward
Epidural rate
Time Frame: through study completion, an average of 1 year
Use of epdiural analgesia intrapartum
Birthweight
Time Frame: through study completion, an average of 1 year
Neonatal weight as taken following delivery