S. S. Anoon, D. E. E. Rizk, M. Ezimokhai
Obstetric outcome of excessively overgrown fetuses (?= 5000 g): a case-control study
Aims. To compare the obstetric outcome of excessively-and
appropriately-grown fetuses.
Methods. Medical records of mothers who delivered excessively
overgrown fetuses, defined as birthweight
? 5000 g, in our hospital between 1996 and 2000 (n = 47,
study group), and a control group who delivered fetuses
with normal birthweight (n = 47) were reviewed.
Results. Incidence of excessively overgrown fetuses was
0.24% and 68% were boys. Mothers in this group were
significantly older, overweight and multiparous (p <
0.0001) and had gestational diabetes mellitus (p < 0.0001)
and prolonged pregnancies (p = 0.04). A previous big
baby was also significant (p < 0.0001) and the commonest
risk factor. There were no obvious risk factors in nine
(19.1%) cases. More than half (n = 28,59.5%) of these babies
were delivered vaginally without clinical suspicion of
excessive fetal size. Duration of second stage of labor and
incidence of maternal trauma were similar in both groups.
Cesarean delivery (p = 0.0003), postpartum hemorrhage
(p = 0.004), birth asphyxia (p = 0.007), shoulder dystocia
(p < 0.0001) and fetal trauma (p = 0.03) were significantly
more frequent in the study group.
Conclusions. Excessively overgrown fetuses are associated
with the same risk factors as fetal macrosomia and
should be delivered by cesarean if diagnosed antenatally
because of increased maternal and perinatal morbidity
during vaginal delivery.
Journal of Perinatal Medicine, Walter de Gruyter
Print ISSN: 1619-3997
Volume: 31, 07/2003
Pages: 295 - 301
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