Clinical Survey of Fetal Macrosomia / 대한산부인과학회잡지

ABSTRACT

OBJECTIVE: Under the definition of macrosomia where the birth weight of the fetus being 4,000 grams or more, we analyzed and studied the obstetrical problems, complications of both mother and the fetus and the predisposing factors of macrosomia in this report. METHODS: A study was done on 231 cases of macrosomia infants weighing 4,000 grams or more out of 5220 full-term delivered cases in Dongguk University, Kyung-ju hospital from January, 1998 to December, 2002. RESULTS: The frequency of macrosomia ranged from 4.18% in 4,000 g or more to 0.42% in 4,500 g or more. In macrosomia frequency correlations to parity showed 41.13% (95 cases) in primiparous women, 58.87% (134 cases) in multiparous women. According to the type of delivery, normal vaginal delivery has proven to be the most, consuming 52.38% (121 cases), where Cesarean section was 47.61% (110 cases). Indications for Cesarean section ranged from cephalopelvic disproportion (27.3%) to previous Cesarean section (25.4%), in the order of frequency. Maternal complications due to delivery showed highest incidence in postpartum hemorrhage (13.63%), followed by birth canal laceration (12.12%). As of fetal complications, 3 cases (2.72%) of cephalhematoma existed, and 1 brachial plexus palsy and clavicle fracture were reported and 1 case of fetal death was reported. CONCLUSION: It would be appropriate to have definite diagnostic schemes and adequate choice of delivery method for macrosomia. Therefore, the complications of macrosomia could be decreased by a well-trained delivery coming in forehand.