[Pregnancy and fetal autcomes in macrosomic delivery about 400 cases]

ABSTRACT

Fetal macrosomy represents a materno-fetal high-risk pathology in front of which obstetricians face diagnostic, therapeutic and prognostic problems. We report a retrospective analytical study of 400 deliveries of macrosomes brought together in the gynaecology and obstetrics C departement of the maternity center of Tunis over a period of 4 years from 1997 till 2001. The aim of our study is to stress on the materno-fetal risk factors of macrosomy. The frequency the macrosomy was of 7, 11%. The average maternal age was of 30, 9 years. Pathologies associated with pregnancy were dominated by gestational diabetes in 19% of cases and by toxemia in 17% of cases. The antecedents of big baby were noted in 23% of cases. Screening of macrosomy was based on excessive uterine height [>35 cm] found in 43 % of cases and near term ultrasounds, which suspected macrosomy in 21, 8% of the cases. Delivery was made naturally in 68 % of the cases, with instrumental help in 5, 25% of cases and by cesarian section in 32% of cases. The mean weight of macrosomes was of 4233g. Maternal complications were dominated by delivery hemorrage in 2% of cases and obstetrical trauma in 2, 75% of the cases. Fetal complications were dominated by shoulder dystocia in 2, 25% of the cases, respiratory distress 2, 75% of cases and hypoglycemia in 2% of the cases