This study was designated to evaluate the clinical problems which might arise during pregnancy, labor & postpartum by macromsomia, birth weight 4,000gm or more.
We analized 567 cases of the macrosomia among the 15,734 cases of the total deliveries at the department of Obstetrics & Gynecology, Wonkwang university hospital from January 1, 1983 to December 31, 1993.
1. The incidence of the macrosomia weighing 4,000 gm or more was 3.6% of the fetal cases and that of the 4,500 gm or more was 0.36% and that of the 5,000 gm or more was 0.04%
2. the macrosomia were more frequently delivered in multiparas 60.3%, and 39.7%in nulliparas.
3. Most macrosomia were born to mother between the age of 25 and 29 years.
4. According to gestational age, 67.9% of the macrosomias were born between 40~41 wks of gastation, and 22.1% in 42 or more weeks,
5. Male to female ratio was 200:100.
6. Of the total macrosomia, 36.9% were delivered by c/sec and the most common indication for c/sec was cephalopelvic disproportion.
7. Maternal complications were prolonged second stage of labor (19.6%), and preeclampsia (1.6%), postpartum urinary retension (1.2%), multiple genital tract laceration (0.9%), postpartum hemorrhage (0.7%), shoulder dystocia (0.5%), 3rd degree
laceration (0.5%).
8. Neonatal complications were asphyxia 1.8%, congenital anomalites (0.9%) cephalhematoma (0.4%), aspiration pneumonia (0.2%)
9. Perinatal death is due to intrauterine fetal death (1.0%), trauma during labor (0.4%), neonatal death (0.2%),
10. Antepartum & postpartum glucose tolerance test was done in 288 cases and of the 29.8% had a abnormal glucose tolerance test.
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