[The delivery of macrosomic infants weighing 4500 g and more. A report of 61 cases].
The objective of this study is to review the difficulties in prediction of great macrosomia, to assess trial of labor results, and to confirm the increased risk of perinatal complications.


METHODS
in this retrospective study we analyzed 61 deliveries of infants with birth weights > 4500 g in one year period. This group was compared with a group of infants weighing between 4000 and 4500 g (339 cases) born during the same period. Elective cesarean delivery was performed for 3 cases of the second group because of overestimation of fetal weight. 38 cases of the first group (62.3%) were delivered vaginally after underestimation of fetal weight. Incidence of shoulder dystocia in vaginal delivery was 13.5% in the first group and 5.32% in the second one, but difference was not statistically significant (p = 0.07). Difference between incidence of hypoglycemia in the first group (18.03%) and in the second one (2.06%) was highly significant (p = 0.00006) There is no reliable method for prediction of fetal weight > than 4500 g. With literature review, we confirm the increased risk of shoulder dystocia, birth asphyxia and hypoglycemia for these infants. So, we believe that cesarean delivery is justified in all cases of fetal weight estimation > 4500g.
Kraïem
Jamel
J
Clinique Universitaire de Gynécologie-Obstétrique, Hôpital Mohamed Telatli, Nabeul, Tunisie.
Chiha
Narjes
N
Bouden
Sahbi
S
Ounaïssa
Faïez
F
Falfoul
Abdelaziz
A
D001724:Birth Weight; D036861:Delivery, Obstetric / Q000379:methods; D005320:Fetal Macrosomia / Q000175:diagnosis; D006801:Humans; D007231:Infant, Newborn; D012189:Retrospective Studies