Dissertation (MMed Obstetrics and Gynecology)
Background: Prediction of fetal weight accurately is an important parameter in planning proper managements of labor and delivery, so as to reduce the rate of complications associated with the delivery of macrosomic or low birth weight fetus especially in second stage of labor and during puerperium. Fetal weight can be estimated correctly by various clinical methods but require selection of the valid method. In the present study, an effort was done to find which formula is more accurate in estimating fetal weight as compared to actual birth weight.
Objectives: This study aimed to assess the accuracy of clinical methods for the estimation of fetal weight in single tone pregnancy at term.
Methods: This analytical cross section study with quantitative research approach was conducted on 401 single tone pregnant women by a convenient sampling technique in latent phase of labor or who were admitted for elective cesarean delivery with a gestational age of 37- 40 weeks. Structured questionnaire was used to collect social demographic characteristics, fetal weight was estimated clinically by Johnson’s, Insler’s and Dawn’s formula and actual birth weight was measured within 15 minutes after delivery. Analysis was done by SPSS vision25; frequency and percentage were used to present categorical variables. Wilcoxon signed-rank test was used to find the similarities and mean absolute error and mean absolute percentage error was used to find the accuray. P-value of< 0.05 was considered significant.
Results: The mean weights obtained from three formulas under the study were compared with the mean of actual birth weight. Mean of Johnson’s formula (3.470kg) and Insler’s formula (3.412 kg) were almost similar to the mean actual birth weight (3.18), while Dawn’s formula had higher mean birth weight (4.574kg). Also correlation between three formulas and actual birth weight was done by Pearson’s correlation coefficient (r) which found to be 0.495, 0.508 and 0.479 for Johnson’s, Insler’s and Dawn’s respectively. Mean absolute error and mean absolute percentage error was used in order to find the accuracy of the formulas hence Johnson’s formula found to have less error in all birth weight categories followed by Insler’s except in underweight and Dawn’s being the least.
Conclusion: In this study it was found that Johnson’s found to be more accurate than the other formulas in estimating fetal weight.