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Related Experiment Video

Updated: Jul 7, 2026

External Cephalic Version: Is it an Effective and Safe Procedure?

External Cephalic Version: Is it an Effective and Safe Procedure?

Published on: June 6, 2020

Suspected macrosomia? Better not tell.

D Sadeh-Mestechkin¹, A Walfisch, R Shachar

¹Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel. mestechk@bgu.ac.il

Archives of Gynecology and Obstetrics

|February 27, 2008

Summary

Predicting fetal macrosomia is challenging. Current management policies increase labor induction and cesarean delivery rates without improving maternal or infant outcomes.

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Area of Science:

Obstetrics and Gynecology
Perinatal Medicine
Maternal-Fetal Medicine

Background:

Fetal macrosomia, defined as estimated fetal weight of 4,000 grams or more, presents management challenges in obstetrics.
Accurate prediction of macrosomia is crucial for optimizing delivery strategies and minimizing maternal and infant complications.

Purpose of the Study:

To evaluate the effectiveness of a specific management policy for suspected fetal macrosomia.
To describe the maternal and infant outcomes associated with this management policy.

Main Methods:

Prospective observational study involving 145 women with suspected macrosomic infants (≥4,000 g).
Inclusion criteria: term pregnancies diagnosed with macrosomia via obstetrician assessment and/or sonographic estimation.
Comparison group: 5,943 women delivering during the same period.

Main Results:

Induction of labor and cesarean delivery rates were significantly higher in the study group with suspected macrosomia compared to the comparison group.
No significant differences in maternal or infant complications were observed between non-macrosomic and macrosomic pregnancies within the study group.
Diagnostic accuracy for macrosomia: sensitivity 21.6%, specificity 98.6%, positive predictive value 43.5%.

Conclusions:

The ability to accurately predict fetal macrosomia is limited.
The current management policy for suspected macrosomic pregnancies leads to increased rates of labor induction and cesarean delivery.
This policy does not appear to improve maternal or fetal outcomes.