ABSTRACT
The birth weight is one of the important factors affecting the perinatal morbidity and mortality. Fetal macrosomia is associated with increased risks of cesarean section and trauma. To determine prevalence and outcome of the macrosomic infants, this case-control, prospective study is performed in the two university hospitals in Tehran during a 36- month period between 2002 through 2004. 1000 neonates with birth weight of at least 4000g [<90[th] centile] constituted the case group. Another 2000 Cases amongst the newborns delivered in the same period between 2500 and 3999g [10[th]-90[th] centile] formed the control group. A total of 17236 deliveries occurred during the study period. The prevalence of macrosomic deliveries was 5.8 and prevalence of the deliveries [>4500g or heavier] was 0.84%. The mean birth weight of study group was 4254 +/- 215 and 3245 +/- 310g of control group [P<0.001].While the cesarean section rate was 35.2% for study group and it was 18.5% for the control group [P<0.001] in the study group. 16 cases of clavicular fracture [1.6%], 13 cases of brachial plexus palsy [1.3%], [P<0.00l]. No perinatal mortality was recorded in two groups. There were 12 cases [1.2%] of asphyxia related to delivery in the study group [P<0.01]. The rate of maternal complication, were significantly higher in the study group [p<0.01]. The macrosomic infants are in increased risk for birth trauma and asphyxia. The risk of birth trauma for the infants weighing 4500g or more is even greater. The majority of factors which lead to the delivery of macrosomic infants are preventable
ABSTRACT
A variable hematological value without clinical sign of sepsis or hematological disorder is often observed in newborns. The purpose of this study was to investigate hematological measurements in umbilical cord vein of newborns delivered spontaneously or by cesarean section. We studied 150 pregnant women who delivered term normal infants. The patients were divided into two groups according to the route of delivery: vaginal [n=75] and cesarean section [n=75]. Immediately after delivery, umbilical cord blood samples were collected. Any possible relationship between mode of delivery, gestational age, gravidity, parity, sex, weight of the new born infant, and the duration of different phase of labor with the hematological parameters was investigated. We observed a significant increase in all hematologic parameters including hemoglobin and hematocrit levels and WBC, platelet and RBC counts in newborns delivered spontaneously [p<0.001]. The lymphocyte counts were similar in two groups. Male infants and newborns with higher gestational age showed a higher hemoglobin and hematocrit levels. Increased parity and gravidity correlated with a decrease in all hematological values of umbilical vein blood except of lymphocyte count [p<0.001]. Prolonged duration of first and second stage was associated with higher mean leukocyte, neutrophil, platelet, hemoglobin and hematocrit values. The mode of delivery, gestational age, parity, gravidity, sex and weight of newborn, and the duration of first and second stage of labor can influence on hematological parameters of umbilical cord blood