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© 2008 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 27:1029-1032 • 0278-4297

Use of the Amniotic Fluid Index Combined With Estimated Fetal Weight Within 10 Days of Delivery for Prediction of Macrosomia at Birth

Avi Ben-Haroush, MD, Nir Melamed, MD, Reuven Mashiach, MD, Israel Meizner, MD and Yariv Yogev, MD

Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel; and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Address correspondence to Avi Ben-Haroush, MD, Department of Obstetrics and Gynecology, Helen Schneider’s Hospital for Women, Rabin Medical Center, 49100 Petach Tikva, Israel. E-mail: yudavi{at}inter.net.il

Objective. The purpose of this study was to assess the value of combining the sonographically estimated fetal weight (EFW) and amniotic fluid index (AFI) measured within 10 days of term delivery for prediction of macrosomia at birth. Methods. Prospective sonographic fetal biometric measurements and delivery ward data of a single center, uploaded separately over a 4-year period, were retrospectively linked to yield an unselected sample of nondiabetic pregnancies with live-born term neonates. Results. Of the 1925 pregnancies evaluated, 140 (7.2%) were macrosomic (birth weight ≥4000 g). The AFI was significantly higher in the macrosomic group (P < .001). On receiver operating characteristic curve analysis, the area under the curve was larger for predictions based on the EFW alone than on the AFI. An EFW of 4000 g or higher had a positive predictive value of 46.6% for macrosomia at birth. Use of the previously suggested combined EFW and AFI cutoffs of 3689 g and 119 mm, respectively, yielded a positive predictive value of 30.3%. Conclusions. Combined use of the EFW and AFI rather than the EFW alone does not improve prediction of macrosomia at birth.

Key Words: amniotic fluid index • estimated fetal weight • macrosomia

Abbreviations: AFI, amniotic fluid index • AUC, area under the curve • BW, birth weight • EFW, estimated fetal weight • LGA, large-for-gestational-age • NPV, negative predictive value • PPV, positive predictive value • ROC, receiver operating characteristic

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Copyright © 2008 by the American Institute of Ultrasound in Medicine.