Antenatal magnetic resonance imaging versus ultrasound for predicting neonatal macrosomia: a systematic review and meta-analysis

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 macros...

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Main Authors: Malin, G.L., Bugg, George, Takwoingi, Yemisi, Thornton, Jim, Jones, Nia W.
Format: Article
Published: Wiley 2016
Subjects:
Online Access:https://eprints.nottingham.ac.uk/31857/
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author Malin, G.L.
Bugg, George
Takwoingi, Yemisi
Thornton, Jim
Jones, Nia W.
author_facet Malin, G.L.
Bugg, George
Takwoingi, Yemisi
Thornton, Jim
Jones, Nia W.
author_sort Malin, G.L.
building Nottingham Research Data Repository
collection Online Access
description 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.
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spelling nottingham-318572020-05-04T20:04:40Z https://eprints.nottingham.ac.uk/31857/ 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. 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. Wiley 2016-01 Article PeerReviewed Malin, G.L., Bugg, George, Takwoingi, Yemisi, Thornton, Jim and Jones, Nia 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). pp. 77-88. ISSN 1470-0328 Estimated fetal weight Macrosomia Magnetic resonance imaging Pregnancy Three-dimensional ultrasound Two dimensional ultrasound http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.13517/abstract;jsessionid=70B22BB9687A48527FFA9225790EC1FA.f02t02? doi:10.1111/1471-0528.13517 doi:10.1111/1471-0528.13517
spellingShingle Estimated fetal weight
Macrosomia
Magnetic resonance imaging
Pregnancy
Three-dimensional ultrasound
Two dimensional ultrasound
Malin, G.L.
Bugg, George
Takwoingi, Yemisi
Thornton, Jim
Jones, Nia W.
Antenatal magnetic resonance imaging versus ultrasound for predicting neonatal macrosomia: a systematic review and meta-analysis
title Antenatal magnetic resonance imaging versus ultrasound for predicting neonatal macrosomia: a systematic review and meta-analysis
title_full Antenatal magnetic resonance imaging versus ultrasound for predicting neonatal macrosomia: a systematic review and meta-analysis
title_fullStr Antenatal magnetic resonance imaging versus ultrasound for predicting neonatal macrosomia: a systematic review and meta-analysis
title_full_unstemmed Antenatal magnetic resonance imaging versus ultrasound for predicting neonatal macrosomia: a systematic review and meta-analysis
title_short Antenatal magnetic resonance imaging versus ultrasound for predicting neonatal macrosomia: a systematic review and meta-analysis
title_sort antenatal magnetic resonance imaging versus ultrasound for predicting neonatal macrosomia: a systematic review and meta-analysis
topic Estimated fetal weight
Macrosomia
Magnetic resonance imaging
Pregnancy
Three-dimensional ultrasound
Two dimensional ultrasound
url https://eprints.nottingham.ac.uk/31857/
https://eprints.nottingham.ac.uk/31857/
https://eprints.nottingham.ac.uk/31857/