Fetal Macrosomia (≥4500 g): Perinatal Outcome of 231 Cases According to the Mode of Delivery

Nassar, Anwar H.; Usta, Ihab M.; Khalil, Ali; Melhem, Ziad I; Nakad, Toufic I; Musa, Antoine Abu

doi:10.1038/sj.jp.7210877

Cited by 34 publications

(27 citation statements)

References 23 publications

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“…1 Schaefer-Graf et al 13 in their study found that hypoglycaemia was associated with only 1.5% of perinatal birth asphyxia at 5 minutes. The higher number in our study could be because of the small sample size of 106 in comparision to 887 in the study conducted by Schaefer-Graf et al 13 Hypocalcemia was observed in 5 LGA babies in the present study out of which 3 had hypoglycemia (p=.004). Hypocalcemia as such may not cause hypoglycemia but whenever hypoglycemia is documented in LGA baby of non-diabetic mother, the presence of concomitant hypocalcemia should be considered especially when hypocalcaemic symptoms are not relieved by treatment with intravenous dextrose fluid.…”

mentioning

confidence: 36%

“…3,4 LGA babies are at risk of many complications such as difficult delivery, neonatal injuries and metabolic complications like hyperbilirubinemia, hypoglycemia, hypocalcemia, polycythemia etc. 5,6 During intrauterine life, transplacental transport supplies various nutrients including glucose, which is the most important fetal energy substrate to the growing fetus. With the abrupt cessation of maternal supply of glucose immediately after birth, transient hypoglycaemia is common in LGA infants because of the physiologic immaturity of pathways of glucose homeostasis and glucose values reach a nadir at 2-3 hours of life.…”

Section: Introductionmentioning

confidence: 99%

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Incidence and Risk Factors of Hypoglycaemia in Large-For-Gestational Age Newborns of Non-Diabetic Mothers in a Tertiary Care Hospital

Prakash¹

2017

JMSCR

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mentioning

confidence: 36%

Section: Introductionmentioning

confidence: 99%

Incidence and Risk Factors of Hypoglycaemia in Large-For-Gestational Age Newborns of Non-Diabetic Mothers in a Tertiary Care Hospital

Prakash¹

2017

JMSCR

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“…Os vários estudos existentes na literatura não são específicos em seus critérios de inclusão/exclusão [6][7][8] . Entretanto, grande parte deles apontam a forte associação entre a MF e a interrupção da gestação pela via alta 13,18,20,[24][25][26] . Dentre os estudos citados, o percentual de partos cesáreos variou de 27,3%, em casos de fetos com peso igual ou superior a 4.500 g, a 34% para fetos com peso superior a 4.000 g 17,21 .…”

Section: Idade Paridadeunclassified

Fatores maternos e perinatais relacionados à macrossomia fetal

Madi¹,

Rombaldi²,

Filho³

et al. 2006

Rev. Bras. Ginecol. Obstet.

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RESUMOObjetivo: identificar fatores maternos e perinatais relacionados a fetos com peso igual ou maior do que 4.000 g no nascimento. Métodos: estudo de corte transversal, de 411 casos consecutivos de macrossomia fetal, ocorridos no período de março de 1998 a março de 2005. Compararam-se os dados obtidos aos de 7.349 casos de fetos com peso entre 2.500 e 3.999 g ao nascimento, ocorridos no mesmo período. Foram analisadas variáveis maternas (idade, paridade, diabete melito, ocorrência de parto cesáreo, mecônio, desproporção feto-pélvica, principais indicações das cesáreas) e perinatais (ocorrência de tocotraumatismo, índice de Apgar inferior a sete no 1º e 5º minuto, natimortalidade, neomortalidade precoce, necessidade de internação na Unidade de Tratamento Intensivo Neonatal). As avaliações estatísticas foram realizadas com o teste não paramétrico do χ 2 com a correção de Yates e com o teste t de Student. Adotou-se o nível de significância de p<0,05. Resultados: as diferenças entre os grupos foram consideradas estatisticamente significantes ao se analisarem a idade materna (p<0,05), paridade (p<0,05) e índice de Apgar menor que 7 no 1º minuto (p<0,05; OR=1,8; IC 95%: 1,4-2,5) e 5º minuto (p<0,05; OR=2,3; IC 95%: 1,3-4,1), diabete melito materno (p<0,05; OR=4,2; IC 95%: 2,7-6,4), ocorrência de mecônio (p<0,05; OR=1,3; IC 95%: 1,0-1,7), necessidade de cuidados intensivos neonatais (p<0,05; OR=2,0; IC 95%: 1,5-2,7), neomortalidade precoce (p<0,05; OR=2,7; IC 95%: 1,0-6,7), parto cesáreo (p<0,05; OR=2,03; IC 95%: 1,6-2,5) e desproporção fetopélvica (p<0,05; OR=2,8; IC 95%: 1,6-4,8), mas não quanto ao tocotraumatismo e à natimortalidade. No grupo de fetos macrossômicos, as principais indicações de operação cesariana foram a iteratividade (11,9%) e a desproporção fetopélvica (8,6%). No grupo controle as principais indicações foram a iteratividade (8,3%) e o sofrimento fetal agudo (3,9%). Conclusão: a despeito das limitações características de uma avaliação retrospectiva, o estudo demonstra quais complicações tendem a se associar ao excessivo tamanho fetal, podendo ser de utilidade no manejo obstétrico de pacientes com suspeita de crescimento fetal excessivo. A macrossomia fetal permanece sendo problema obstétrico de difícil solução, associado a importantes conseqüências maternas e perinatais, haja vista as significantes taxas de morbiletalidade observadas em países desenvolvidos e em desenvolvimento. PALAVRAS-CHAVE: Macrossomia fetal; Morbidade materna; Morbidade fetal; Peso fetalABSTRACT Purpose: to identify maternal and perinatal factors related to neonates with birthweight ≥4,000 g. Methods: cross-section cohort study with 411 consecutive cases of fetal macrosomia (FM) which occurred from March 1998 to March 2005. Data were compared to 7,349 cases of fetal birthweight ≥2,500 and <3,999 g which occurred in the same period. Maternal variables (maternal age, parity, diabetes, previous cesarean section, meconium-stained amniotic fluid, cephalopelvic disproportion, main cesarean section indications) and perinatal variabl...

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“…Increased risks of maternal obstetrical complications and longer labor periods especially in primigravid women have been reported in mothers of macrosomic babies [5]. Consequently, fetal macrosomia is a risk factor for fetal injury and maternal morbidity in type I, type II, and gestational diabetic pregnancies [1,4,[6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Role of lipids and fatty acids in macrosomic offspring of diabetic pregnancy

Khan

2007

Cell Biochem Biophys

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Diabetic pregnancy frequently results in macrosomia or fetal obesity. It seems that the anomalies in carbohydrate and lipid metabolism in macrosomic infants of diabetic mothers are due to maternal hyperglycemia, which leads to fetal hyperinsulinemia. We have developed a rat model of macrosomic offspring and assessed the onset of obesity in these animals. The macrosomic offspring born to diabetic mothers are prone to the development of glucose intolerance and obesity as a function of age. It seems that in utero programming during diabetic pregnancy creates a "metabolic memory" which is responsible for the development of obesity in macrosomic offspring. We have demonstrated that the metabolism of lipids, and altered anti-oxidant status and immune system are implicated in the etiopathology of obesity in these animals. We have reported beneficial effects of n-3 polyunsaturated fatty acids (PUFAs) in obese animals, born to diabetic dams.

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Fetal Macrosomia (≥4500 g): Perinatal Outcome of 231 Cases According to the Mode of Delivery

Abstract: Vaginal delivery is achievable in 88.9% of pregnancies with infants >or = 4500 g allowed to labor, at the expense of a 7.7% risk of perinatal trauma.

Cited by 34 publications

References 23 publications

Incidence and Risk Factors of Hypoglycaemia in Large-For-Gestational Age Newborns of Non-Diabetic Mothers in a Tertiary Care Hospital

Incidence and Risk Factors of Hypoglycaemia in Large-For-Gestational Age Newborns of Non-Diabetic Mothers in a Tertiary Care Hospital

Fatores maternos e perinatais relacionados à macrossomia fetal

Role of lipids and fatty acids in macrosomic offspring of diabetic pregnancy

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