Fetal Clavicular Measurement to Predict Fetal Macrosomia

NCT ID: NCT06283277

Last Updated: 2024-02-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

NOT_YET_RECRUITING

Total Enrollment

240 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-05-01

Study Completion Date

2027-10-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Macrosomia is associated with increased risks for both the mother and the baby, including complications during delivery, injuries, and even death. The accurate diagnosis of macrosomia is often difficult before birth. There are a number of factors that can increase the risk of macrosomia, such as maternal obesity, diabetes, and excessive weight gain during pregnancy. There are also a number of different techniques that can be used to try to predict macrosomia, but none of them are perfect.

The aim of this study is to evaluate sensitivity of measuring fetal clavicle length in third trimester compared with biacromial diameter and Hadlock formula IV for prediction of fetal macrosomia.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Two terms are applied for fetal overgrowth, Large for gestational age (LGA) meaning fetal birth weight (BW) more than 90th percentile for specific gestational age while macrosomia is an absolute value regardless of gestational age which historically defined as 4000-4500 gm. Those two groups have increased risks for neonatal and maternal complications compared to general population and increase sharply when BW \>4500gm, the risks of macrosomia are continuum without threshold defining safe and risky outcome, some authors classify macrosomia into 3 grades, grade 1 (4000gm-4499gm), grade 2(4500-4999), grade 3 (≥5000gm).

Despite its implications, the accurate diagnosis is after birth and its prenatal prediction is poor although published formulas for estimating fetal weight shows correlation with BW, however the variability of the estimate is up to 20% with most of formulas, meta-analysis of 29 studies showed sensitivity of 56% and specificity of 92% in predicting BW ≥ 4000gm accuracy of ultrasound decreases with increasing BW, BW\>4500 accurate prediction is only 33-44 % of cases. Given the poor predictability of macrosomia, variety of other techniques and formulas are investigated, neither repeated US examination nor growth curves improves predictability, Youssef's formula measuring biacromial diameter (distance by between both acromial processes which joins clavicles at acromioclavicular joints) and macrosomic specific formula seems to be predictive. In study evaluating clavicle length for shoulder dystocia, it found that measuring clavicle was significant for macrosomia however the limitation is small sample size and its comparison with other fetal biometrics may be needed.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Macrosomia, Fetal Large for Gestational Age Shoulder Dystocia

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Observational Model Type

COHORT

Study Time Perspective

CROSS_SECTIONAL

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Singleton pregnant women at gestational age between 37-42 weeks

estimated fetal weight measured by ultrasound using Hadlock IV formula and Youssef's formula compared with the sensitivity of fetal clavicular measurement.

Obstetric Ultrasound

Intervention Type DEVICE

Measuring fetal clavicular length and estimated fetal weight using Hadlock IV formula and Youssef's formula.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Obstetric Ultrasound

Measuring fetal clavicular length and estimated fetal weight using Hadlock IV formula and Youssef's formula.

Intervention Type DEVICE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Singleton pregnancy.
* Gestational age between 37-42 weeks.
* Accepting to be included in the study.

Exclusion Criteria

* Congenital fetal malformation affecting birth weight or affecting clavicle.
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Assiut University

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Khaled Mustafa Attyia

principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Alaa ElDin Abdelhamid Yusef Hasan

Role: STUDY_DIRECTOR

Emeritus Professor of obstetrics and gynecology

Ahmed Mohamed Abbas Sobh

Role: STUDY_DIRECTOR

Assistant Professor of obstetrics and gynecology

Mohamed Mahmoud Abdallah Mahmoud

Role: STUDY_DIRECTOR

Lecturer of obstetrics and gynecology

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Khaled M Attyia

Role: CONTACT

+201005503250

References

Explore related publications, articles, or registry entries linked to this study.

Barth WH, Jackson R. ACOG PRACTICE BULLETIN Clinical Management Guidelines for Obstetrician-Gynecologists. American collage of obstetricians and gynocologists [Internet]. 2020 Jan;135:18-35. Available from: http://journals.lww.com/greenjournal

Reference Type BACKGROUND

Nesbitt TS, Gilbert WM, Herrchen B. Shoulder dystocia and associated risk factors with macrosomic infants born in California. Am J Obstet Gynecol. 1998 Aug;179(2):476-80. doi: 10.1016/s0002-9378(98)70382-5.

Reference Type BACKGROUND
PMID: 9731856 (View on PubMed)

Boulet SL, Alexander GR, Salihu HM, Pass M. Macrosomic births in the united states: determinants, outcomes, and proposed grades of risk. Am J Obstet Gynecol. 2003 May;188(5):1372-8. doi: 10.1067/mob.2003.302.

Reference Type BACKGROUND
PMID: 12748514 (View on PubMed)

Zhang X, Decker A, Platt RW, Kramer MS. How big is too big? The perinatal consequences of fetal macrosomia. Am J Obstet Gynecol. 2008 May;198(5):517.e1-6. doi: 10.1016/j.ajog.2007.12.005.

Reference Type BACKGROUND
PMID: 18455528 (View on PubMed)

Doty MS, Chen HY, Sibai BM, Chauhan SP. Maternal and Neonatal Morbidity Associated With Early Term Delivery of Large-for-Gestational-Age But Nonmacrosomic Neonates. Obstet Gynecol. 2019 Jun;133(6):1160-1166. doi: 10.1097/AOG.0000000000003285.

Reference Type BACKGROUND
PMID: 31135729 (View on PubMed)

Hadlock FP, Deter RL, Harrist RB, Park SK. Estimating fetal age: computer-assisted analysis of multiple fetal growth parameters. Radiology. 1984 Aug;152(2):497-501. doi: 10.1148/radiology.152.2.6739822.

Reference Type BACKGROUND
PMID: 6739822 (View on PubMed)

Malin GL, Bugg GJ, Takwoingi Y, Thornton JG, Jones NW. Antenatal magnetic resonance imaging versus ultrasound for predicting neonatal macrosomia: a systematic review and meta-analysis. BJOG. 2016 Jan;123(1):77-88. doi: 10.1111/1471-0528.13517. Epub 2015 Jul 29.

Reference Type BACKGROUND
PMID: 26224221 (View on PubMed)

Scioscia M, Vimercati A, Ceci O, Vicino M, Selvaggi LE. Estimation of birth weight by two-dimensional ultrasonography: a critical appraisal of its accuracy. Obstet Gynecol. 2008 Jan;111(1):57-65. doi: 10.1097/01.AOG.0000296656.81143.e6.

Reference Type BACKGROUND
PMID: 18165393 (View on PubMed)

Zafman KB, Bergh E, Fox NS. Accuracy of sonographic estimated fetal weight in suspected macrosomia: the likelihood of overestimating and underestimating the true birthweight. J Matern Fetal Neonatal Med. 2020 Mar;33(6):967-972. doi: 10.1080/14767058.2018.1511697. Epub 2018 Sep 3.

Reference Type BACKGROUND
PMID: 30099910 (View on PubMed)

Sandmire HF. Whither ultrasonic prediction of fetal macrosomia? Obstet Gynecol. 1993 Nov;82(5):860-2.

Reference Type BACKGROUND
PMID: 8414339 (View on PubMed)

Aviram A, Yogev Y, Ashwal E, Hiersch L, Danon D, Hadar E, Gabbay-Benziv R. Different formulas, different thresholds and different performance-the prediction of macrosomia by ultrasound. J Perinatol. 2017 Dec;37(12):1285-1291. doi: 10.1038/jp.2017.134. Epub 2017 Sep 14.

Reference Type BACKGROUND
PMID: 28906497 (View on PubMed)

Zhang J, Kim S, Grewal J, Albert PS. Predicting large fetuses at birth: do multiple ultrasound examinations and longitudinal statistical modelling improve prediction? Paediatr Perinat Epidemiol. 2012 May;26(3):199-207. doi: 10.1111/j.1365-3016.2012.01261.x. Epub 2012 Feb 10.

Reference Type BACKGROUND
PMID: 22471679 (View on PubMed)

Costantine MM, Mele L, Landon MB, Spong CY, Ramin SM, Casey B, Wapner RJ, Varner MW, Rouse DJ, Thorp JM Jr, Sciscione A, Catalano P, Caritis SN, Sorokin Y, Peaceman AM, Tolosa JE, Anderson GD; Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network, Bethesda, Maryland. Customized versus population approach for evaluation of fetal overgrowth. Am J Perinatol. 2013 Aug;30(7):565-72. doi: 10.1055/s-0032-1329188. Epub 2012 Nov 12.

Reference Type BACKGROUND
PMID: 23147078 (View on PubMed)

Youssef AEA, Amin AF, Khalaf M, Khalaf MS, Ali MK, Abbas AM. Fetal biacromial diameter as a new ultrasound measure for prediction of macrosomia in term pregnancy: a prospective observational study. J Matern Fetal Neonatal Med. 2019 Aug;32(16):2674-2679. doi: 10.1080/14767058.2018.1445714. Epub 2018 Mar 7.

Reference Type BACKGROUND
PMID: 29478363 (View on PubMed)

Porter B, Neely C, Szychowski J, Owen J. Ultrasonographic Fetal Weight Estimation: Should Macrosomia-Specific Formulas Be Utilized? Am J Perinatol. 2015 Aug;32(10):968-72. doi: 10.1055/s-0035-1545664. Epub 2015 Mar 2.

Reference Type BACKGROUND
PMID: 25730134 (View on PubMed)

Terzi E. A new approach to predicting shoulder dystocia: fetal clavicle measurement. Turk J Med Sci. 2021 Aug 30;51(4):1932-1939. doi: 10.3906/sag-2011-145.

Reference Type BACKGROUND
PMID: 33843172 (View on PubMed)

Yarkoni S, Schmidt W, Jeanty P, Reece EA, Hobbins JC. Clavicular measurement: a new biometric parameter for fetal evaluation. J Ultrasound Med. 1985 Sep;4(9):467-70. doi: 10.7863/jum.1985.4.9.467.

Reference Type BACKGROUND
PMID: 3903198 (View on PubMed)

Sherer DM, Sokolovski M, Dalloul M, Khoury-Collado F, Osho JA, Lamarque MD, Abulafia O. Fetal clavicle length throughout gestation: a nomogram. Ultrasound Obstet Gynecol. 2006 Mar;27(3):306-10. doi: 10.1002/uog.2706.

Reference Type BACKGROUND
PMID: 16450360 (View on PubMed)

Shmueli A, Salman L, Hadar E, Aviram A, Bardin R, Ashwal E, Gabbay-Benziv R. Sonographic prediction of macrosomia in pregnancies complicated by maternal diabetes: finding the best formula. Arch Gynecol Obstet. 2019 Jan;299(1):97-103. doi: 10.1007/s00404-018-4934-y. Epub 2018 Oct 16.

Reference Type BACKGROUND
PMID: 30327863 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

fetal macrosomia

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Newborns of Obese Mothers
NCT02681588 COMPLETED NA