Macrosomic Babies

Cheung, Tak‐Hong; Leung, Ares; Chang, Artemis

doi:10.1111/j.1479-828x.1990.tb02019.x

Cited by 17 publications

(11 citation statements)

References 6 publications

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“…23 However, such a difference does not imply that the degree of severity of shoulder dystocia in our cohort would have been milder, as the incidence of macrosomia in our general population was only 4%, compared with 6-15% in Western populations. 23,24 Thus, macrosomia was associated with a 7.75-fold (31/4) increased risk of shoulder dystocia in our population, which is similar to the six-to eight-fold among Western populations. 23 In this series, the five infants with HIE had a lower AS5 than those who did not have HIE; yet, they only had a moderate degree of acidosis (pH from 7.074 to 7.199 and BE from )7.20 to )15.20), which was statistically indistinguishable from that of the rest of the cohort.…”

Section: Discussionsupporting

confidence: 74%

“…As our cohort consisted of Chinese and Asian pregnant women, the incidence of infant macrosomia, defined by a birth weight of ≥4 kg, was 31% among our shoulder dystocia cases, which is lower than the value of 44–64% reported in Western populations 23 . However, such a difference does not imply that the degree of severity of shoulder dystocia in our cohort would have been milder, as the incidence of macrosomia in our general population was only 4%, compared with 6–15% in Western populations 23,24 . Thus, macrosomia was associated with a 7.75‐fold (31/4) increased risk of shoulder dystocia in our population, which is similar to the six‐to eight‐fold among Western populations 23 …”

Section: Discussioncontrasting

confidence: 53%

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Head-to-body delivery interval and risk of fetal acidosis and hypoxic ischaemic encephalopathy in shoulder dystocia: a retrospective review

Leung

Stuart

Sahota

et al. 2010

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

119

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Objective To examine the association between head-to-body delivery interval (HBDI) and cord arterial pH and base excess (BE), and the risk of development of hypoxic ischaemic encephalopathy (HIE). Design Retrospective review.Setting A university hospital.Population Pregnancies complicated with shoulder dystocia during the period 1995-2009.Methods Cases were identified from a search of the hospital electronic delivery records. Cord arterial pH and BE, and the incidence of HIE and perinatal death, were retrieved from medical records and correlated with HBDI, birth weight, mode of delivery and presence of nonreassuring fetal heart rate pattern and maternal diabetes using univariate analysis, followed by multivariate analysis.Main outcome measures Any association between cord pH and HBDI.Results Of the 200 cases identified, the mean (standard deviation) HBDI was 2.5 minutes (1.5 minutes). Both HBDI and the presence of nonreassuring fetal heart rate pattern were independent factors for pH, and HBDI was the only significant factor for BE. Arterial pH dropped at a rate of 0.011 per minute [95% confidence interval (95% CI), 0.017-0.004; P = 0.002] with HBDI. The mode of delivery, birth weight and maternal diabetes did not affect blood gas levels. The respective risks of severe acidosis (pH < 7) and HIE with HBDI of <5 minutes were 0.5% and 0.5% versus 5.9% and 23.5% with HBDI ‡ 5 minutes.Conclusions Cord arterial pH drops with HBDI during shoulder dystocia, but the risk of acidosis or HIE is very low with HBDI < 5 minutes.Keywords Acidosis, base excess, head-to-body delivery interval, hypoxic ischaemic encephalopathy, shoulder dystocia, umbilical cord pH.

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Section: Discussionsupporting

confidence: 74%

Section: Discussioncontrasting

confidence: 53%

Head-to-body delivery interval and risk of fetal acidosis and hypoxic ischaemic encephalopathy in shoulder dystocia: a retrospective review

Leung

Stuart

Sahota

et al. 2010

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

119

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“…The median (25 per cent, 75 per cent) duration of tube feeds for survivors was 3 (2, 8) days. The median (25 per cent, 75 per cent) age at discharge home for survivors varied from 8 (6, 12) days for infants not sedated on day 3 ( n =41), to 28 (24.5, 30.5) days for infants who were sedated on both days 3 and 7 ( n =12).…”

Section: Resultsmentioning

confidence: 99%

Do very sick neonates born at term have antenatal risks?

Sutton¹,

Sayer²,

Bajuk³

et al. 2001

Acta Obstet Gynecol Scand

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“…Although instrumental delivery is a known risk factor causing shoulder dystocia [21, 22], its association with failure of M+/−S is a new finding and the underlying mechanism is not well known. In spontaneous vaginal delivery, uterine contractions and maternal effort cause gradual and synchronized descent of the fetal head and shoulders.…”

Section: Discussionmentioning

confidence: 99%

Predictive factors for the success of McRoberts’ manoeuvre and suprapubic pressure in relieving shoulder dystocia: a cross-sectional study

Lok

Cheng

Leung

2016

BMC Pregnancy Childbirth

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BackgroundMcRoberts’ and suprapubic pressure are often recommended as the initial choices of manoeuvres to manage shoulder dystocia, as they are believed to be less invasive compared to other manoeuvres. However, their success rates range from 23 to 40 %. This study aims to investigate the predictive factors for the success of McRoberts’ manoeuvre with or without suprapubic pressure (M+/−S).MethodsAll cases of shoulder dystocia in a tertiary hospital in South East Asia were recruited from 1995 to 2009. Subjects were analysed according to either ‘success’ or ‘failure’ of M+/−S. Maternal and fetal antenatal and intrapartum factors were compared by univariate and multivariate analysis.ResultsAmong 198 cases of shoulder dystocia, M+/−S as the primary manoeuvre was successful in 25.8 %. The other 74.2 % needed either rotational or posterior arm manoeuvres or combination of manoeuvres. Instrumental delivery was the single most significant factor associated with an increased risk of failed M+/−S on logistic regression (p < 0.001, OR 4.88, 95 % CI 2.05–11.60). The success rate of M+/−S was only 15.0 % if shoulder dystocia occurred after instrumental delivery but was 47.7 % after spontaneous vaginal delivery.ConclusionsWhen shoulder dystocia occurs after instrumental vaginal delivery, the chance of failure of M+/−S is 85 %, which is 4.7 times higher than that after spontaneous vaginal delivery. Hence all operators performing instrumental delivery should be proficient in performing all manoeuvres to relieve shoulder dystocia when M+/−S cannot do so.

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Macrosomic Babies

Cited by 17 publications

References 6 publications

Head-to-body delivery interval and risk of fetal acidosis and hypoxic ischaemic encephalopathy in shoulder dystocia: a retrospective review

Head-to-body delivery interval and risk of fetal acidosis and hypoxic ischaemic encephalopathy in shoulder dystocia: a retrospective review

Do very sick neonates born at term have antenatal risks?

Predictive factors for the success of McRoberts’ manoeuvre and suprapubic pressure in relieving shoulder dystocia: a cross-sectional study

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