Although the definition of fetal macrosomia is variable by many authors, the delivery of the fetus weighting 4,000g or more brings many dangerous obstetrical and neonatal complications including shoulder dystocia, birth canal injuries, postpartum
bleeding, voiding difficulty in the mother and brachial plexus injury, humerus & clavicular fracture, meconium aspiration syndrome, hypoglycemia, and pneumothorax etc. in the neonate that lead to the increse in perinatal morbidity and mortality
rate.
The author studied 115 cases of women who gave birth to the large babies weighting more than 4,000g among 4,151 cases of total deliveries in Kon-Kuk University Hospital during past 4 years from Jan., 1, 1992 to Dec., 31, 1995 with the brief
review
of
literatures.
@ES The results were as follows.
@EN 1. The number and incidence of macrosomia weighing 4,000g or more was 115 and 2.77%, and those of macrosomia weighing more than 4,500g was 9 and 0.22% of total deliveries.
2. The mean birthweight of the 115 cases of macrosomia was 4,210±20g.
3. The mean age of the mothers who gave birth to the macrosomia was 27.82±0.37 year and the age distribution of the mother was highest in the 25~29 year group.
4. There was no tendency of the increase in the incidence of macrosomia as the parity increases.
5. The mean gestational age in the macrosomia group was 40.41±0.13wks and this was statistically significant from that of normal birthweight group(39.26±0.14wks.)
6. The results of postpartum oral GTT were abnormal in 11 cases (9.6%) and this is not significant from that of normal birthweight group.
7. The mean weight of the mother who gave birth to the macrosomia and normal birthweight baby were 58.03±0.78Kg and 51.65±0.78Kg and this difference was statistically significant(P<0.05). The mean bodyweight at term in both groups were
71.99±0.78Kg
and 64.29±0.74Kg, and also this difference was statistically significant(P<0.05). The mean weight gain during pregnancy in both groups were 13.91±0.41Kg and 12.66±0.38Kg, and this difference was statistically significant, too(P<0.05).
8. 12 women (17.9%) of multiparous macrosomia group had the previous history of delivering macrosomia.
9. Male to female ratio was 259:100 in the macrosomia group and this was quite significant from that of normal birthweight group(105:100).
10. 55 patients(47.8%) of the macrosomia group and 43 patients (37.4%) of the normal birthweight group were delivered by cesarean section and this difference was not statistically significant.
11. The indications for cesarean section in the macrosomia group were in the order of large baby (59.2%), previous cesarean section (20.3%), and fetal distress(11.1%).
12. The most common maternal antepartum complication was anemia(18.2%). And others were pregnancy induced hypertension(5.2%) and diabetes mellitus(2.6%).
13. The mean hemoglobin concentrations at delivery were 10.88±0.13g/dL in the macrosomia group and this was not statistically significant from that of normal birthweight group.
14. The most common intra and postpartum maternal complication was urinary tract in fection(17.4%). And others were birth canal laceration(7.0%) and postpartum bleeding(6.1%).
15. The 1 minute and 5 minute Apgar scores in macrosomia group were quite significant from those of normal birthweight group(P<0.05).
16. Neonatal complications in macrosomia were severely depressed infant(1.7%), cephalhematoma(0.9%), brachial plexus injury(0.9%) and clavicular fracture(0.9%). There was no perinatal death in the macrosomia group.
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