Fetal macrosomia Maternal and Perinatal outcome

Abstract

Background: Fetal macrosomia represent a
continuing challenge in obstetrics and increasing in
it's occurrence as well as it is associated with maternal
and perinatal complications.
Objective : To determine the maternal and perinatal
outcome related to fetal macrosomia.
Design: A prospective case control study.
Patients and methods) :10th March-31st May, 2006
A prospective case control study had done over the
period from 10th March to 31st May, 2006 in Al-Batool
maternity teaching hospital in Mosul city .The study
group consisted from 633 singleton alive newborns
with gestational age ≥37weeks weighing 4000 grams
and heavier and mothers of these newborns compared
with control group which consisted from 4155
singleton alive newborn with gestational age
≥37weeks weighing 2500-3999 grams and mothers of
these newborns .The obstetrical outcome variables
which compared between the two groups include mode
of delivery, indication of caesarean section and
maternal and perinatal complications.
Results :
Macrosomic newborns (≥4000grams) delivered in this
study account for (12.45%) of total deliveries.
Newborns with a birth weight of ≥4500grams
constitute 2.65% from all deliveries .Male Newborns
(65.24%) was higher and statistically differed among
the study group (p value=0.001).
Instrumental vaginal delivery (P value=0.010,Odd
ratio :2.12, 95 %CI :1.19-3.76) and cesarean section
delivery (P value=0.000,Odd ratio:1.63, 95 %CI :
1.34-1.98), mainly the emergency cesarean section
(18.79%), were significantly different among the
study group .Failure of progress of labour and
cephalopelvic disproportion were the main indications
in study group and showed statistical significant
difference between the two groups.
Among the study group, there was neither maternal
death nor uterine rupture but there was higher
occurrence of postpartum hemorrhage, genital tract
trauma and shoulder dystocia which were significantly
different when it compared with control group .Erb's
palsy was the main perinatal complication and was
statistically different among macrosomic group (P
value=0.000) .
Conclusion: Fetal macrosomia was associated with
higher rate of instrumental vaginal delivery and
caesarean section mainly due to failure of progress of
labour and cephalopelvic disproportion .There were
higher rate of postpartum haemorrhage, genital tract
trauma as well as shoulder dystocia with neither
maternal death nor uterine rupture in study group .
Among macrosomic newborn, Erb's pulsy was the
main perinatal complication