Antenatal magnetic resonance imaging versus ultrasound for predicting neonatal macrosomia: a systematic review and meta-analysis

Malin, G.L. and Bugg, George and Takwoingi, Yemisi and Thornton, Jim and Jones, Nia W. (2016) Antenatal magnetic resonance imaging versus ultrasound for predicting neonatal macrosomia: a systematic review and meta-analysis. BJOG: An International Journal of Obstetrics and Gynaecology, 123 (1). pp. 77-88. ISSN 1470-0328

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Abstract

BACKGROUND:

Fetal macrosomia is associated with an increased risk of adverse maternal and neonatal outcomes.

OBJECTIVES:

To compare the accuracy of antenatal two-dimensional (2D) ultrasound, three-dimensional (3D) ultrasound, and magnetic resonance imaging (MRI) in predicting fetal macrosomia at birth.

SEARCH STRATEGY:

Medline (1966-2013), Embase, the Cochrane Library and Web of Knowledge.

SELECTION CRITERIA:

Cohort or diagnostic accuracy studies of women with a singleton pregnancy, who had third-trimester imaging to predict macrosomia (>4000 g, >4500 g or >90th or >95th centile).

DATA COLLECTION AND ANALYSIS:

Two reviewers screened studies, performed data extraction and assessed methodological quality. The bivariate model was used to obtain summary sensitivities, specificities and likelihood ratios.

MAIN RESULTS:

Fifty-eight studies (34 367 pregnant women) were included. Most were poorly reported. Only one study assessed 3D ultrasound volumetry. For predicting birthweight >4000 g or >90th centile, the summary sensitivity for 2D ultrasound (Hadlock) estimated fetal weight (EFW) >90th centile or >4000 g (29 studies) was 0.56 (95% CI 0.49-0.61), 2D ultrasound abdominal circumference (AC) >35 cm (four studies) was 0.80 (95% confidence interval [95% CI] 0.69-0.87) and MRI EFW (three studies) was 0.93 (95% CI 0.76-0.98). The summary specificities were 0.92 (95% CI 0.90-0.94), 0.86 (95% CI 0.74-0.93) and 0.95 (95% CI 0.92-0.97), respectively.

CONCLUSION:

There is insufficient evidence to conclude that MRI EFW is more sensitive than 2D ultrasound AC (which is more sensitive than 2D EFW); although it was more specific. Further primary research is required before recommending MRI EFW for use in clinical practice.

Item Type: Article
Keywords: Estimated fetal weight, Macrosomia, Magnetic resonance imaging, Pregnancy, Three-dimensional ultrasound, Two dimensional ultrasound
Schools/Departments: University of Nottingham UK Campus > Faculty of Medicine and Health Sciences
University of Nottingham UK Campus > Faculty of Medicine and Health Sciences > School of Medicine > Division of Child Health, Obstetrics and Gynaecology
University of Nottingham UK Campus > Faculty of Medicine and Health Sciences > School of Medicine
Identification Number: https://doi.org/10.1111/1471-0528.13517
Depositing User: Thornton, Jim
Date Deposited: 19 Feb 2016 14:50
Last Modified: 15 Sep 2016 17:05
URI: http://eprints.nottingham.ac.uk/id/eprint/31857

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