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Can Macrosomia be detected during pregnancy?

During pregnancy, identifying Macrosomia (a condition where the fetus is larger than average) can be challenging, and there are some limitations to the methods currently used to be aware of.

Ultrasound is commonly used to detect Macrosomia before birth, but it may not always be accurate.

The sensitivity of ultrasound in detecting Macrosomia (a birth weight over 4,000 grams) varies from 12% to 75%, and the specificity ranges from 68% to 99%, depending on the formula used. That is because factors like maternal obesity, low levels of amniotic fluid, and fetal abnormalities can affect the accuracy of ultrasound results. Even with experienced professionals, there can be up to a 25% error in estimating fetal weight compared to the actual birth weight.

Additionally, ultrasound formulas used to estimate fetal weight may be better suited for normally developing babies rather than those with macrosomia. These formulas don’t always account for factors like the amount of fat under the baby’s skin, which can affect accuracy.

Unfortunately, there’s few reliable methods to diagnose Macrosomia definitively before delivery. Clinical assessments like measuring the height of the uterus and performing Leopold’s manoeuvre also have limited accuracy in detecting Macrosomia.

At the time of writing, the most accurate method remains weighing the newborn after delivery.


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