[Birth of a large fetus: epidemiologic aspects and analysis of factors of a case in an southern urban public health facility (Abidjan)].
OBJECTIVE
to highlight the factors which influence the childbirth of the large foetus in order to propose adequate conduits.


METHODS
it acted of a study case--witness who had been held on May 1, 2003 to April 31, 2004. We had included 108 cases of childbirth large foetus and 229 cases of childbirth of foetus of standard weight. The appreciation of the factors which influence the childbirth in these two groups was made thanks to the statistical analysis of the Chi 2 test; it had been considered to be significant with the threshold 5%.


RESULTS
the parturients who were confined of the large foetus were referred than those of the group of the witnesses (p = 0,0421). The high way was observed in the event of large foetus (p = 0,0091). When the childbirth of the macrosomes was done by low way, one had noted more dystocie shoulders (0,0091) and more episiotomy (0,00479). The Caesarean for large foetus was carried out when the parturients were allowed in room of work in phase of latency of work (p = 0,028). Among the cesarized parturients, there were more first calf cows (p = 0,00532), young people and parturients whose size was between 150 and 170 cm (p = 0,00069) in the group of study.


CONCLUSIONS
the childbirth of the large foetus is childbirth at the risk both for the mother the foetus. However it is necessary to be patient in front of an excessive uterine height evoking a large foetus. The indication of Caesarean should be posed only in primiparous, young parturients or teenagers, first calf cows of which size lower than 170 cm.
Doumbia
Y
Y
Service de Gynécologie obstétrique et d'Andrologie, Centre Hospitalier Universitaire de Bouaké. doumbiay@hotmail.com
Kouakou
K P
KP
Djanhan
Y
Y
Konan
J
J
Kouadio
E
E
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002585:Cesarean Section; D004420:Dystocia; D004841:Episiotomy; D005260:Female; D005320:Fetal Macrosomia / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D008875:Middle Aged; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012307:Risk Factors; D055815:Young Adult