Disadvantages of a weight estimation formula for macrosomic fetuses: the Hart formula from a clinical perspective.

Abstract:

PURPOSE:Sonographic fetal weight (FW) estimation to detect macrosomic fetuses is an essential part of everyday routine work in obstetrics departments. Most of the commonly used weight estimation formulas underestimate FW when the actual birth weight (BW) exceeds 4000 g. One of the best-established weight estimation formulas is the Hadlock formula. In an effort to improve the detection rates of macrosomic infants, Hart et al. published a specially designed formula including maternal weight at booking. The usefulness of the Hart formula was tested. METHODS:Retrospective study of 3304 singleton pregnancies, birth weight ≥ 3500 g. The accuracy of the Hadlock and Hart formula were tested. A subgroup analysis examined the influence of the maternal weight. The Chi-squared test and one-way analysis of variation were carried out. For all analyses, p < 0.05 was considered statistically significant. RESULTS:The overall percentages of births falling within ± 5% and ± 10% of the BW using the Hadlock formula were 27% and 53%, respectively. Using the Hart formula, 24% and 54% were identified within these levels. With the Hart formula, 94% of all weight estimations fall within 4200 g ± 5% and nearly 100% fall within 4200 g ± 10%. CONCLUSIONS:Applying the Hart formula results in an overestimation of fetal weight in neonates with a birth weight < 4000 g and fails to identify high-risk fetuses. We, therefore, do not consider Hart's formula to be of clinical relevance.

journal_name

Arch Gynecol Obstet

authors

Weiss C,Oppelt P,Mayer RB

doi

10.1007/s00404-018-4917-z

subject

Has Abstract

pub_date

2018-12-01 00:00:00

pages

1101-1106

issue

6

eissn

0932-0067

issn

1432-0711

pii

10.1007/s00404-018-4917-z

journal_volume

298

pub_type

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