Foetal Macrosomia and Foetal-Maternal Outcomes at Birth

Türkmen, Şahruh; Johansson, Simona; Dahmoun, Marju

doi:10.1155/2018/4790136

Cited by 47 publications

(40 citation statements)

References 31 publications

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“…With regard to data already published, the occurrence of shoulder dystocia in our collective is comparatively low. However, the frequency is indicated with a large range (1.9 – 10% in the case of 4000 – 4499 g, 2.5 – 20% in the case of 4500 – 5000 g and 10 – 20% in the case of ≥ 5000 g), which can possibly be attributed to the inconsistent definition and individual estimation 16 , 17 , 18 , 19 , 20 . Shoulder dystocia is diagnosed in our clinic if, after the birth of the childʼs head, the head retracts back into the vulva-perineal region in a “turtle” phenomenon and, despite traction in a dorsal and caudal direction, the anterior shoulder can only be delivered through further manoeuvres 21 .…”

Section: Discussionmentioning

confidence: 97%

“…Im Hinblick auf bereits publizierte Daten war das Auftreten einer Schulterdystokie in unserem Kollektiv vergleichsweise gering. Allerdings wird die Häufigkeit mit einer großen Spannbreite angegeben (1,9 – 10% bei 4000 – 4499 g, 2,5 – 20% bei 4500 – 5000 g und 10 – 20% bei ≥ 5000 g), was möglicherweise auf die uneinheitliche Definition und individuelle Einschätzung zurückzuführen ist 16 , 17 , 18 , 19 , 20 . Die Diagnose einer Schulterdystokie wird in unserer Klinik gestellt, wenn nach der Geburt des kindlichen Kopfes dieser im Sinne eines Turtle-Phänomens in den Vulva-Dammbereich zurückweicht und trotz Traktion nach dorsal und kaudal die anteriore Schulter nur durch weitergehende Manöver entwickelt werden kann 21 .…”

Section: Diskussionunclassified

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Influence of Foetal Macrosomia on the Neonatal and Maternal Birth Outcome

Pahlitzsch

Hanne

Henrich

et al. 2019

Geburtshilfe Frauenheilkd

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Introduction Foetal macrosomia is associated with various obstetrical complications and is a common reason for inductions and primary or secondary Caesarean sections. The objective of this study is the generation of descriptive data on the mode of delivery and on maternal and foetal complications in the case of foetal macrosomia. The causes and consequences of foetal macrosomia as well as the rate of shoulder dystocia are examined in relation to the severity of the macrosomia. Patients The study investigated all singleton births ≥ 37 + 0 weeks of pregnancy with a birth weight ≥ 4000 g at the Charité University Medicine Berlin (Campus Mitte 2001 – 2017, Campus Virchow Klinikum 2014 – 2017). Results 2277 consecutive newborns (birth weight 4000 – 4499 g [88%], 4500 – 4999 g [11%], ≥ 5000 g [1%]) were included. Maternal obesity and gestational diabetes were more common in the case of newborns weighing ≥ 4500 g than newborns weighing 4000 – 4499 g (p = 0.001 and p < 0.001). Women with newborns ≥ 5000 g were more often ≥ 40 years of age (p = 0.020) and multipara (p = 0.025). The mode of delivery was spontaneous in 60% of cases, vaginal-surgical in 9%, per primary section in 14% and per secondary section in 17%. With a birth weight ≥ 4500 g, a vaginal delivery was more rare (p < 0.001) and the rate of secondary sections was increased (p = 0.011). Women with newborns ≥ 4500 g suffered increased blood loss more frequently (p = 0.029). There was no significant difference with regard to the rate of episiotomies or serious birth injuries. Shoulder dystocia occurred more frequently at a birth weight of ≥ 4500 g (5 vs. 0.9%, p = 0.000). Perinatal acidosis occurred in 2% of newborns without significant differences between the groups. Newborns ≥ 4500 g were transferred to neonatology more frequently (p < 0.001). Conclusion An increased birth weight is associated with an increased maternal risk and an increased rate of primary and secondary sections as well as shoulder dystocia; no differences in the perinatal outcome between newborns with a birth weight of 4000 – 4499 g and ≥ 4500 g were seen. In our collective, a comparably low incidence of shoulder dystocia was seen. In the literature, the frequency is indicated with a large range (1.9 – 10% at 4000 – 4499 g, 2.5 – 20% at 4500 – 5000 g and 10 – 20% at ≥ 5000 g). One possible cause for the low rate could be the equally low prevalence of gestational diabetes in our collective. A risk stratification of the pregnant women (e.g. avoidance of vacuum extraction, taking gestational diabetes into account during delivery planning) is crucial. If macrosomia is presumed, it is recommended that delivery take place at a perinatal centre in the presence of a specialist physician, due to the increased incidence of foetal and maternal complications.

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Section: Discussionmentioning

confidence: 97%

Section: Diskussionunclassified

Influence of Foetal Macrosomia on the Neonatal and Maternal Birth Outcome

Pahlitzsch

Hanne

Henrich

et al. 2019

Geburtshilfe Frauenheilkd

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“…The reason for this was a slight difference regarding head circumference between the waterbirth group and the comparison group, whereas birth weight >4 000 gram gave the same results. A large baby could mean less likelihood of a waterbirth as labor dystocia and need for EDA are more common in these births (174,175).…”

Section: Confoundermentioning

confidence: 99%

Testing the waters — A cross-sectional survey of views about waterbirth among Swedish health professionals

2020

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“…Gestational diabetes mellitus (GDM) is a common complication of pregnancy, which occurs in 7.9%‐25.5% 1,2 of pregnancies in different populations, shown as previous epidemiological studies. A large number of studies have demonstrated that GDM plays an important role in adverse outcomes of mothers and offspring whether in the short term or the long term, 3‐5 including newborn macrosomia, postpartum hemorrhage, and abnormal blood glucose metabolism etc 6,7 . Thus, preventing GDM is essential and imperative for improving the health quality of the population.…”

Section: Introductionmentioning

confidence: 99%

“…A large number of studies have demonstrated that GDM plays an important role in adverse outcomes of mothers and offspring whether in the short term or the long term, [3][4][5] including newborn macrosomia, postpartum hemorrhage, and abnormal blood glucose metabolism etc. 6,7 Thus, preventing GDM is essential and imperative for improving the health quality of the population.…”

Section: Introductionmentioning

confidence: 99%

Hemoglobin concentration and iron supplement during pregnancy were associated with an increased risk of gestational diabetes mellitus

Shen

Xing

et al. 2020

Journal of Diabetes

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Background Hemoglobin (Hb) measurement is a conventional test during perinatal visits. Hb concentration is related to iron supplement. However, studies focusing on Hb levels, iron supplement, and pregnancy outcomes are scarce. This study aimed to determine whether Hb levels and iron supplement were associated with the risk of gestational diabetes mellitus (GDM). Methods A running hospital‐based cohort was conducted from August, 2011. The demographic data and medical information were collected individually through questionnaires and patient medical records. Multiple linear regression was applied for the association between Hb levels, iron supplement, and blood glucose. Multiple logistic regression was used for evaluating odds ratios between Hb levels, iron supplement, and GDM. Results Hb levels during first (T1) and second trimester (T2) of pregnancy were significantly and positively associated with blood glucose and GDM risk. After adjusting for age, prepregnancy body mass index, and other risk factors, pregnant women with Hb ≥ 11 g/dL and iron supplement had higher postprandial blood glucose at 1 hour (Hb ≥ 11 g/dL in T2 and iron supplement in T1: β = 0.860，P = <0.001; Hb ≥ 11 g/dL in T2 and iron supplement in T2: β = 0.960，P < 0.001; Hb ≥ 11 g/dL in T1 and iron supplement in T2: β = 1.133, P = 0.033) and GDM risks (odds ratio [OR] = 1.53, 95% confidence interval [CI]: 1.05‐2.24; OR = 1.92, 95% CI: 1.13‐3.35; OR = 2.15, 95% CI: 1.07‐4.34, respectively), compared with those with Hb < 11 g/dL and without iron supplement. Conclusion High Hb concentration and iron supplements without anemia increased postprandial blood glucose and risks for GDM. It indicates that pregnant women with good Hb levels should not be advised to take iron supplements during pregnancy.

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Foetal Macrosomia and Foetal-Maternal Outcomes at Birth

Cited by 47 publications

References 31 publications

Influence of Foetal Macrosomia on the Neonatal and Maternal Birth Outcome

Influence of Foetal Macrosomia on the Neonatal and Maternal Birth Outcome

Testing the waters — A cross-sectional survey of views about waterbirth among Swedish health professionals

Hemoglobin concentration and iron supplement during pregnancy were associated with an increased risk of gestational diabetes mellitus

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