Influence of Foetal Macrosomia on the Neonatal and Maternal Birth Outcome
| Autor: | Alexander Weichert, Wolfgang Henrich, Tamara Margit Jutta Pahlitzsch, L. Hanne |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Pregnancy Obstetrics business.industry Incidence (epidemiology) Birth weight fetale Makrosomie Obstetrics and Gynecology Gestationsdiabetes Perinatal outcome Original Article/Originalarbeit foetal macrosomia medicine.disease Obesity Gestational diabetes Foetal macrosomia Shoulder dystocia Schulterdystokie Maternity and Midwifery medicine GebFra Science shoulder dystocia gestational diabetes business |
| Zdroj: | Geburtshilfe und Frauenheilkunde |
| ISSN: | 1438-8804 0016-5751 |
| Popis: | Introduction Foetal macrosomia is associated with various obstetrical complications and is a common reason for inductions and primary or secondary Caesarean sections. The objective of this study is the generation of descriptive data on the mode of delivery and on maternal and foetal complications in the case of foetal macrosomia. The causes and consequences of foetal macrosomia as well as the rate of shoulder dystocia are examined in relation to the severity of the macrosomia. Patients The study investigated all singleton births ≥ 37 + 0 weeks of pregnancy with a birth weight ≥ 4000 g at the Charité University Medicine Berlin (Campus Mitte 2001 – 2017, Campus Virchow Klinikum 2014 – 2017). Results 2277 consecutive newborns (birth weight 4000 – 4499 g [88%], 4500 – 4999 g [11%], ≥ 5000 g [1%]) were included. Maternal obesity and gestational diabetes were more common in the case of newborns weighing ≥ 4500 g than newborns weighing 4000 – 4499 g (p = 0.001 and p Conclusion An increased birth weight is associated with an increased maternal risk and an increased rate of primary and secondary sections as well as shoulder dystocia; no differences in the perinatal outcome between newborns with a birth weight of 4000 – 4499 g and ≥ 4500 g were seen. In our collective, a comparably low incidence of shoulder dystocia was seen. In the literature, the frequency is indicated with a large range (1.9 – 10% at 4000 – 4499 g, 2.5 – 20% at 4500 – 5000 g and 10 – 20% at ≥ 5000 g). One possible cause for the low rate could be the equally low prevalence of gestational diabetes in our collective. A risk stratification of the pregnant women (e.g. avoidance of vacuum extraction, taking gestational diabetes into account during delivery planning) is crucial. If macrosomia is presumed, it is recommended that delivery take place at a perinatal centre in the presence of a specialist physician, due to the increased incidence of foetal and maternal complications. |
| Databáze: | OpenAIRE |
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