Can we reliably identify large babies before birth?

We will discuss “Antenatal magnetic resonance imaging versus ultrasound for predicting neonatal macrosomia: a systematic review and meta-analysis.” by Malin and co-workers from 26 August 2015 for 7 days.

*This paper is an open-access article and is now on early view!

We are now on LinkedIn too: http://linkd.in/1BVrpad (simply ask to join)!

Start date: 26 August 2015 (the discussion will open for 7 days between 26 August to 2 September 2015)

First hosted discussion session(s) starts at: BST 7pm (UK time)

Host: @BlueJCHost

Platforms: Twitter and LinkedIn

BJOG_BlueJC_160x600WebBanner_Mar15_(reoriented)_3The Blue Journal Club is an international journal club on women’s health research based on Twitter (as @BlueJCHost). We start our conversation on the last Wednesday of every month and use the hashtag #BlueJC for our tweets. Simply add this hashtag (“#BlueJC”) to each tweet and we will capture it. Each #BlueJC opens for 7 days with an advertised start time. All BJOG #BlueJC papers also have complementary slide sets suitable for face-to-face journal clubs with your local colleagues. You can access the slide set of this paper here (find the title paper and click on the “discussion point” tab).

The discussion points are attached below (quoted from the published manuscript)

 

 

Scenario

A midwife referred an African-Caribbean woman at 33 weeks of her first pregnancy because of ‘large for dates’ on abdominal palpation (symphysis fundal height= 37cm).

Her oral glucose tolerance test at 28 weeks was normal. She is overweight (body mass index= 27 kg/m2), but has no other risk factors. She has no family history of obstetrics complication. How would you counsel this woman?

 

Description of research

Participants Women with a singleton pregnancy
Intervention 2D or 3D ultrasound scan or MRI performed in the third trimester to detect fetal macrosomia.
Comparison Another index test (if used)
Outcomes Birthweight >4000 g, >4500 g, >90th or >95th centile
Study design Systematic review and meta-analysis


Discussion Points

  • How common is macrosomia in your practice?
  • How do you currently counsel women similar to the one in the scenario?
  • How did the authors assess the quality of individual studies? (also see suggested reading
  • What were the problems identified by their quality assessment of individual studies?
  • Critically appraise this meta-analysis using the PRISMA checklist (http://bit.ly/1CIZNHw).
  • Can you briefly summarise the results of this study as a one-sentence take-home message
  • Would the results of this study influence your management of the woman in the scenario
  • How would the results of this study influence your daily practice?

Suggested reading

  • Coomarasamy A, Connock M, Thornton J, Khan KS. Accuracy of ultrasound biometry in the prediction of macrosomia: a systematic quantitative review. BJOG. 2005 Nov;112(11):1461-6.
  • Schünemann HJ, et al; GRADE Working Group. Grading quality of evidence and strength of recommendations for diagnostic tests and strategies. BMJ. 2008 May 17;336(7653):1106-10.

For those who want to understand hashtags, this may be a useful guide. For an introduction to #BlueJC, please refer to BJOG 2013;120:657–60. Follow @BlueJCHostthis blog and our Facebook page to receive news about #BlueJC.