The Dangers of Fetal Macrosomia

Walker, DW

doi:10.3109/01443619109007772

Cited by 5 publications

(5 citation statements)

References 5 publications

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“…Shoulder dystocia is associated with high fetal morbidity 1,2 and is mainly due to fetal macrosomia 3,4 . The incidence in unselected vaginal deliveries is variously reported to range from 0.37% to 1.1% 2,5 , and it increases with increasing birthweights 6 .…”

Section: Introductionmentioning

confidence: 99%

Risk factors and fetal outcome in cases of shoulder dystocia compared with normal deliveries of a similar birthweight

Bahar¹

1996

BJOG

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Objective To compare risk factors and fetal morbidity in deliveries complicated by shoulder dystocia with deliveries of similar infant birthweights but not complicated by shoulder dystocia. Design A retrospective case‐controlled study. Setting Kuwait Maternity Hospital. Participants Sixty‐nine cases of true shoulder dystocia and 138 controls matched for exact infant's birth‐weight. Methods Demographic data and data regarding history of previous shoulder dystocia, diabetes mellitus, labour course, method of delivery and newborns' condition were collected from patients and case notes following delivery. The mothers' height and weight were measured. Oral glucose tolerance test were performed on patients who were not known as diabetics. The infants' head and chest circumferences and bisacromial diameter were measured. Results There were no significant differences between cases and controls when mean age, parity, height, weight and gestational ages were compared. The cases demonstrated a higher incidence of previous shoulder dystocia (P < 0.01), diabetes mellitus (P < 0.001), use of oxytocin for acceleration of labour (P < 0.01) and operative vaginal deliveries (P < 0.01). Differences between cases and controls in their newborn infants' head and chest circumferences were not significant, but the newborns of cases have a longer mean bisacromial diameter and a shorter head circumference: bisacromial diameter ratio (P < 0.001 and P < 0.001, respectively). Thirty‐seven infants (53.6%) from cases and two from controls (1.4%) sustained birth injuries. There were two stillbirths among the cases. Conclusions Although fetal macrosomia is the principal risk factor for shoulder dystocia, other important risk factors include diabetes mellitus, previous history of shoulder dystocia, prolonged labour, delay in the second stage of labour and fetal shoulder width which appear to be independent of fetal weight.

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Section: Introductionmentioning

confidence: 99%

Risk factors and fetal outcome in cases of shoulder dystocia compared with normal deliveries of a similar birthweight

Bahar¹

1996

BJOG

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“…Of infants delivered by caesarean section in the second stage, 20.4 per cent weighed over 4 kg, compared with 8.6 per cent of a control group. If the increased number of macrosomic babies represents an important clinical problem, and the higher neonatal morbidity amongst these babies suggests that this is the case (Boyd et al, 1983;Walker, 1991), then perhaps the policy for induction of labour for postmaturity should be reviewed. Cardozo (1993) argues against 'routine' induction of labour before 42 weeks gestational age, quoting the increased risk of postpartum haemorrhages, instrumental deliveries and low Apgar scores following induced labours.…”

Section: Discussionmentioning

confidence: 98%

“…In addition, Walker (1991) noted a high incidence of shoulder dystocia if a baby weighed more than 4.5 kg. We attempted to analyse the factor or factors responsible for the observed increase in babies weighing over 4 kg.…”

Section: Introductionmentioning

confidence: 96%

Fetal macrosomia; an analysis of the possible causes of the increasing incidence

Baker

Wood

Lever

1993

Journal of Obstetrics and Gynaecology

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“…13 The mother of a macrosomic infant is at increased risk of prolonged labor, operative vaginal delivery, perineal trauma, and caesarean section. 9,12,14,15 The effect of BW on neonatal risk, morbidity, and mortality was studied in a retrospective review in Birmingham, AL, between 1995 and 1997. 6 From this review, it was concluded that babies ≥4.5 kg were at greater risk of labor complications such as cesarean section, shoulder dystocia, brachial plexus injuries, and neonatal morbidity.…”

Section: Introductionmentioning

confidence: 99%

“…8 The macrosomic fetus is at risk of perinatal complications such as shoulder dystocia, brachial plexus injury, clavicular fracture, and meconium aspiration. 3,[9][10][11][12] In the neonatal period, macrosomic infants are at risk of hypoglycemia, hyperbilirubinemia, and hypomagnesemia. 13 The mother of a macrosomic infant is at increased risk of prolonged labor, operative vaginal delivery, perineal trauma, and caesarean section.…”

Section: Introductionmentioning

confidence: 99%