Antenatal magnetic resonance imaging versus ultrasound for predicting neonatal macrosomia: a systematic review and meta-analysis
Malin, G.L.; Bugg, George; Takwoingi, Yemisi; Thornton, Jim; Jones, Nia W.
JIM THORNTON firstname.lastname@example.org
Professor of Obstetrics and Gynaecology
NIA BRIDGEWATER Nia.Jones@nottingham.ac.uk
Clinical Associate Professor
Fetal macrosomia is associated with an increased risk of adverse maternal and neonatal outcomes.
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.
Medline (1966-2013), Embase, the Cochrane Library and Web of Knowledge.
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.
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.
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.
Malin, G., Bugg, G., Takwoingi, Y., Thornton, J., & Jones, N. 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), doi:10.1111/1471-0528.13517
|Journal Article Type||Article|
|Publication Date||Jan 1, 2016|
|Deposit Date||Feb 19, 2016|
|Publicly Available Date||Feb 19, 2016|
|Journal||BJOG: An International Journal of Obstetrics and Gynaecology|
|Peer Reviewed||Peer Reviewed|
|Keywords||Estimated fetal weight, Macrosomia, Magnetic resonance imaging, Pregnancy, Three-dimensional ultrasound, Two dimensional ultrasound|
|Copyright Statement||Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc-nd/4.0|
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc-nd/4.0
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