Reliability of a clinical method in estimating fetal weight and predicting route of delivery in term parturients monitored at a voluntary agency hospital in Southwest Nigeria

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Temitope Yomibo-Sofolahan

National Postgraduate Medical College of Nigeria, Nigeria

: Androl Gynecol: Curr Res

Abstract

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Introduction: Antepartum estimation of fetal weight is a major determinant of the route of delivery. The limitations to the use of the gold standard obstetric ultrasonography in estimating fetal weight make clinical estimation methods attractive alternatives, especially in resource-constrained settings. The study was conducted in Sacred Heart Hospital, Lantoro a voluntary mission agency hospital in South-Western Nigeria. Aim of the study: To assess the relationship between clinically estimated fetal weight in labour and the mode of delivery among term parturient, in order to initiate a protocol for prompt interventions and early referral when necessary. Materials and methods: A cross sectional study of 291 booked term parturient selected by systematic random sampling was carried out between June to September 2017. Informed consent was obtained from women who met with the selection criteria. FW was estimated clinically using Johnson’s formula calculated as [FW = (SFH- n) x 155]. Macrosomic estimates, (4kg and above) were predicted would deliver via caesarean section (CS) while FW less than 4kg were predicted to be delivered vaginally. Results: Accuracy of Johnson’s formula to predict the ABW was 59.5% while for the mode of delivery, it was 130(75.1%) for SVD and 43(24.9%) for CS. The sensitivity of the accuracy of Johnson’s formula to predict the mode of delivery was 75.1%, with a specificity of 35.6%, a positive predictive value of 63.1% and a negative predictive value of 49.4%. Conclusion: The intrapartum clinical estimation of fetal weight at term using Johnson’s formula was reliably predictive of ABW and SVD but it was unreliable in predicting the need for a CS. Keywords: Estimated fetal weight, Actual birth weight, Johnson’s formula, Parturient, Intrapartum.

Biography

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Yomibo-S0folahan T.A (M.B.Ch.B, FMCFM) is a fellow of the National Postgraduate Medical College of Nigeria. She works as a Consultant Family Physician with a special interest in geriatrics, fetal and maternal medicine. She has over the years developed the ability to work in low resource settings while still delivering safe and effective health care. She speaks English fluently, enjoys adventures and new innovations in the field of medicine.