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.

Abstract

BACKGROUND:

Fetal macrosomia is associated with an increased risk of adverse maternal and neonatal outcomes.


OBJECTIVES:

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.

SEARCH STRATEGY:


Medline (1966-2013), Embase, the Cochrane Library and Web of Knowledge.

SELECTION CRITERIA:

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.


MAIN RESULTS:

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.


CONCLUSION:

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.

Citation

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), https://doi.org/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
• Print ISSN: 1470-0328
• Electronic ISSN: 1471-0528
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 123
• Issue: 1
• DOI: https://doi.org/10.1111/1471-0528.13517
• Keywords: Estimated fetal weight, Macrosomia, Magnetic resonance imaging, Pregnancy, Three-dimensional ultrasound, Two dimensional ultrasound
• Public URL: https://nottingham-repository.worktribe.com/output/979001
• Publisher URL: http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.13517/abstract;jsessionid=70B22BB9687A48527FFA9225790EC1FA.f02t02?