Abstract

Objective: To determine the diagnostic accuracy of clinical estimation of birth-weight using examination of the abdomen in the estimation of fetal macrosomia keeping actual birth weight as gold standard.
Methodology: This cross-sectional validation study was done at department of Obstetrics and Gynecology, Railway General Hospital, Rawalpindi from 1st July 2023 to 31st December 2023. A total of 476 pregnant women with gestational ages greater than 37 weeks were included in the study. All underwent clinical assessment, and fundal height and abdominal girth were measured; once the neonate was delivered, their birth weight was measured.
Result: The age range was 18 and 42 years (mean 30.048±3.60), mean weight by clinical estimation of 3182.905±435.08 grams and mean actual birth weight of 3091.991±437.17 grams. Clinical analysis of birth weight showed a sensitivity of 54.8%, specificity of 97.5% and diagnostic accuracy of 95%, PPV of 60.7%, and NPV 96.9% in the diagnosis of fetal macrosomia, while LR+ was 22.2 and LR- was 0.46.
Conclusion: Clinical estimation of birth weight has a role in the management of labor and delivery in a term pregnancy.

Key words: Macrosomia, birth weight, diagnostic accuracy.