Epidemiolpgie de la macrosomie

ABSTRACT

The purpose of this work is to study the epidemiological profile of macrosomia in the Moroccan context stressing on the aetiological factors. Material and methods: We studied pregnancy and delivery of 2160 macrosomal cases during a period of four years [1994-1997]. We adopted the correlation coefficient for the statistical study. The macrosomal frequency was 7,5%. Specially in young parturient women aged 20-30 years, multipara, fatty, tall, diabetic, having had previous antecedents of a macrosomian newborn and having a fundal level more than 35 cm. Delivery was normal in 90,7%, assisted by ventouse in 32% and forceps in 3% of cases. The caesarean section was practised in 9,3% of cases. The neonatal morbidity in the for of distress was [6%], paralysis of brachial plexus in [2,1%], fracture of the clavicle or humerus [0,3%] and one case suffered from facial paralysis. Maternal morbidity was mainly dominated by post-partum hemorrhage [1,9%], infections and uterine rupture [0,8%]. The foetal macrosomia raises many problems the best way to confirm its diagnosis is by using the echography although it has a high error margin. The question here is starting at what weight should the prophylactic caesarean section be done systematically