Foetal macrosomia: a case report
Journal Title: Medpulse International Journal of Dentistry - Year 2014, Vol 1, Issue 3
Abstract
Introduction: Foetal macrosomia is defined conventionally as newborn weight exceeding 4000gm. various maternal and foetal factors predispose to foetal macrosomia. The incidence of foetal macrosomia is increasing and has highlighted the management dilemma of vaginal delivery or caesarean delivery to selected for suspected foetal macrosomia. Case Report: A 25 yr old fourth gravida with 39 weeks gestation, booked in our ANC clinic, with first trimester BMI 34kg/m2 and normal glucose tolerance tests, presented in labour. Her antenatal USG done in 38th week predicted the weight of the baby to be 3770kg, clinically foetal macrosomia was expected and all preparations to tackle the complications, her labour progressed without any arrest. During delivery, there was shoulder dystocia which was immediately tackled by expert obstetrician. Baby weighed 4.74 kg and had reduced movement in right upper limb movement which was regained in 24hours and discharged immediately. Discussion: It is possible to avoid unnecessary caesarean section in mothers with macrosomic babies if they are diagnosed well in advance of labour by clinical and ultrasonographic methods and thus being prepared for all possible complications during labour. This will help reduce caesarean section complication like Post-partum haemorrhage and obesity related post-operative complications thus reducing maternal morbidity. Ecker et al concluded that an excessive number of unnecessary caesarean deliveries would be needed to prevent a single brachial plexus injury in infants born to women without diabetes. Conclusion: Majority of macrosomic infants can be delivered vaginally if diagnosed and anticipatory measures to tackle possible complications are taken early, this will reduce the maternal morbidity due to unnecessary caesarean sections to a great extent. Planned caesarean delivery on the basis of suspected macrosomia to prevent brachial plexopathy is not a reasonable strategy in general population.
Authors and Affiliations
A. G. Kirane, N. B. Gaikwad, P. E. Bhingare, V. D. Mule
Keywords
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