Care Opinion

Text size

Theme

Language

Help with language translation
Help with reading or listening

Should Ultrasound be Used to Predict Baby Weight?

Posted By Why 60% Inductions?

"Should Ultrasound be Used to Predict Baby Weight?"

About: Bunbury Hospital / Maternity

(as a parent/guardian),

As I understand it, why is there a 60% induction rate in Western Australia?

We were told by the Ultrasound tech that our baby was 'in the 95th percentile' for birth weight. This raised doubt in our minds and caused stress about our ability to have a natural birth.

The GP said there was a 15% margin of error in the US, but the pressure for us to consent to Induction was real. Any risks with induction I felt were down played by the GP.

We ended up consenting to the induction at about 38 weeks. Our baby came out at 3500g. Not a large baby by any standard.

In speaking to the paediatrician, I recall they remarked that the baby could have been 15% to the heavy side. This I find a very awkward statement for someone that I hope would use good evidence to make decisions.

15% is not reliable enough to guide important birthing decisions IMO. 

In my opinion, ultrasound technicians should not be able to give results as they are not equipped to answer follow up questions.

More about:
Do you have a similar story to tell? Tell your story & make a difference ››

Responses

Response from Dr Lauren Megaw, Head of Department, Obstetrics, WA Country Health Services 8 months ago
Dr Lauren Megaw
Head of Department, Obstetrics,
WA Country Health Services

Submitted on 26/09/2024 at 5:14 PM
Published on Care Opinion Australia on 27/09/2024 at 9:12 AM

Dear Why 60% Inductions?

Congratulations on the recent addition to your family and thank you for taking the time to reach out regarding your experience in pregnancy, particularly in relation to the challenges associated with estimating fetal weight and the flow on effects of the inaccuracy of these tests on women. I'm sorry to hear this information and its conveyance added distress to the end of your pregnancy.

Estimating fetal weight in the term baby is very challenging, with both clinical assessment and ultrasound providing some information. However, the figure mentioned is correct that ultrasound has an error of around 15% either above or below the estimated fetal weight. As gestation advances, and babies get bigger, that 15% represents a proportionally larger amount of weight - meaning a proportion of babies estimated to be large, will in fact weigh less than 4kg at birth.

Estimating fetal weight is important information for families though - small babies are particularly vulnerable and need careful consideration, and large babies are also associated with more challenges. In lieu of a more accurate test, ultrasound, with all its limitations is what we use.

Sonographers generally don't discuss ultrasound findings, however when you have a third trimester ultrasound, the weight is visible on the screen and therefore often disclosed at an appointment, however the meaning of it is for discussion with a clinician.

Managing the suspected large baby is really a shared decision making space with families, and the evidence around how best to manage them is evolving. We look forward to the publication of the 'Big Baby' trial findings from the UK which is designed to answer some of these outstanding questions.

I hope this goes some way to explaining the challenge we face in this space, and if you'd like to provide any further feedback or suggestions for change please feel free to contact me via the consumer team at Bunbury Hospital on (08) 9722 1521 or swfeedback@health.wa.gov.au.

I too am hopeful for more accurate tests in the future that may reduce our use of induction of labour, and we are always striving to improve how we communicate with pregnant women, most recently by engaging in the 'Better births with consent' workshops.

Kind regards,

Dr Lauren Megaw

  • {{helpful}} {{helpful == 1 ? "person thinks" : "people think"}} this response is helpful
Response from Sharlene Abbott, Population Health Director-Southwest, Population Health, WACHS-SW 7 months ago
Sharlene Abbott
Population Health Director-Southwest, Population Health,
WACHS-SW

Submitted on 22/10/2024 at 8:13 PM
Published on Care Opinion Australia on 23/10/2024 at 10:13 AM

picture of Sharlene Abbott

Dear Why 60% Inductions?

I would like to reach out to you again, hoping that the response Dr Lauren Megaw provided was both informative and reassuring?

If you have any further queries, please don’t hesitate to contact us on 08 9722 1521 or swfeedback@health.wa.gov.au.

Hoping you and your baby are well and thriving.

Thank you again for providing your feedback.

Best wishes

Sharlene Abbott

Service Co-Director- Bunbury Hospital

  • {{helpful}} {{helpful == 1 ? "person thinks" : "people think"}} this response is helpful

Update posted by Why 60% Inductions? (a parent/guardian)

Hi, Thanks for the response. Baby is well, thanks.

All decisions, medical or otherwise, have a risk and reward aspect. In our circumstance the risks with induction, such as increased rate of C section, were minimised by the GP narrative that large babies necessitating induction are more at risk in general. This may be correct thinking but only if the data indicating heavy birth weight is reliable.

When do you concede that a test is not accurate enough to be used reliably?

In regards to the other issue, in my opinion, it should be a AHPRA infringement for the US tech to disclose or discuss birth weight with patients.

Kind Regards,

Response from Sharlene Abbott, Population Health Director-Southwest, Population Health, WACHS-SW 7 months ago
Sharlene Abbott
Population Health Director-Southwest, Population Health,
WACHS-SW

Submitted on 23/10/2024 at 7:15 PM
Published on Care Opinion Australia on 24/10/2024 at 10:00 AM

picture of Sharlene Abbott

Dear Why 60% Inductions?

Thank you for your response, we would love the opportunity to look into what has occurred for you to provide you with an individualised response. If you would like us to do this please contact us on 08 9722 1521 or swfeedback@health.wa.gov.au.

I’m really happy to hear your baby is well.

Best wishes

Sharlene Abbott

Service Co-Director- Bunbury Hospital

  • {{helpful}} {{helpful == 1 ? "person thinks" : "people think"}} this response is helpful
Opinions
Next Response j
Previous Response k