Fetal macrosomia (> or =4500 g): perinatal outcome of 231 cases according to the mode of delivery.
OBJECTIVE
To determine perinatal complications in infants >or = 4500 g according to delivery mode.


METHODS
Records of 231 mothers and live cephalic infants weighing >or = 4500 g over a 13-year period were retrospectively reviewed. Maternal and perinatal complications were compared in relation to delivery mode.


RESULTS
Vaginal delivery (NVD) was achievable in 168/189 (88.9%) of women allowed to labor, of which 36.9% were operative. The cesarean delivery (CS) rate was 27.3%. The NVD group had a lower incidence of diabetes; however, hypoglycemia and transient tachypnea were more common in the CS group. The frequency of low Apgar scores at 1 and 5 minutes was similar in both groups. A total of 13 (7.7%) major fetal injuries were documented in the NVD group (arm weakness 3, hematoma 3, clavicular fracture 2, and brachial plexus injury 5). Shoulder dystocia was documented in only 7/13 (53.8%).


CONCLUSIONS
Vaginal delivery is achievable in 88.9% of pregnancies with infants >or = 4500 g allowed to labor, at the expense of a 7.7% risk of perinatal trauma.
Nassar
Anwar H
AH
Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon.
Usta
Ihab M
IM
Khalil
Ali M
AM
Melhem
Ziad I
ZI
Nakad
Toufic I
TI
Abu Musa
Antoine A
AA
D001720:Birth Injuries / Q000209:etiology; D020516:Brachial Plexus Neuropathies / Q000209:etiology; D002585:Cesarean Section; D036861:Delivery, Obstetric; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005320:Fetal Macrosomia / Q000150:complications*; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies