MACROSOMIA , PREDICTION AND MODE OF DELIVERY

Abstract

The concept of fetal macrosomia and its adverse outcomes has been recognized in medicine and literary reports throughout the ages , Attempts at perinatal diagnosis of macrosomia have been useful in some cases. The mode of delivering a borderline macrosomia is a matter of discrepancy. Fetal macrosomia has been defined in several different ways including birth weight of [4000-4500 gm] or birth weight greater than 90% for gestational age after correcting for sex and ethnicity. Based on these definitions macrosomia affect 1- 10 % of pregnancies. It`s an analytic study aims to detect the possibility of antenatal prediction of fetal macrosomia and the decision for the safe mode of delivery . The study was done at the obstetric unit of Misurata Teaching Hospital–Libya, over a period of two years from the first of January 2010 till December 2011. During this period, a total of 17234 deliveries occurred. 100 patients whom delivered babies weighing >4, 500 kg were included in this study. They were randomly selected. maternal complications were observed. The 100 macrosomic infants delivered in the study period were their birth weight >4500 gm constituted 0,7% of all deliveries; There was a statistically significant increased incidence of macrosomia in the age group 30–40 years which is 50%. The highest incidence of macrosomic pregnancy in women P1 to P3 41% and then P4 to P6 which is 32% and the incidence decreases. In grand multiparous women and also in primigravida were it 13% in both, The complications were recorded in 20% of all deliveries ,in particular shoulder dystocia 4% of all macrosomic births, various bone fracture is 3%of all deliveries which occurred more frequently with operative vaginal deliveries. The ability to estimate the fetal weight appears to be of great importance in identification of macrosomic fetus Clinical estimation along with ultrasound estimation can serve a useful guide to prevent maternal and fetal complications. Most of complicated cases of macrosomic deliveries are from the unpredicted group.