Arrest of descent in second stage of labour secondary to macrosomia: a case report.
BACKGROUND
Fetal macrosomia, defined as birth weight greater than 4000 g, complicates 10% of pregnancies and is a well-documented cause of prolonged second stage of labour, as well as of arrest of descent of the fetal presenting part.


METHODS
A multigravida woman with gestational diabetes mellitus was admitted in labour at term, and progressed to full dilatation. The fetal vertex failed to descend beyond -3 station. An emergency Caesarean section was performed and a 6452 g male infant was delivered.


CONCLUSIONS
Physicians should be aware of the possibility of macrosomia as the cause of failure of descent in the second stage. A heightened state of suspicion should be maintained, particularly in a multigravida woman with a prior macrosomic baby and the presence of other predisposing factors such as gestational diabetes mellitus.
Karimu
Ande L
AL
Thompson General Hospital, University of Manitoba, Thompson, MB, Canada.
Ayoade
Gbade
G
Nwebube
Nwachukwu I
NI
D000328:Adult; D002585:Cesarean Section; D016640:Diabetes, Gestational; D003937:Diagnosis, Differential; D004420:Dystocia / Q000150:complications / Q000175:diagnosis*; D005260:Female; D005320:Fetal Macrosomia / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007748:Labor Stage, Second; D010298:Parity; D011247:Pregnancy