Skip to main content

Fetal Macrosomia

  • Chapter
Cesarean Section

Part of the book series: Clinical Perspectives in Obstetrics and Gynecology ((CPOG))

  • 133 Accesses

Abstract

Macrosomia, arbitrarily defined as a birthweight of more than 4000 g at term, complicates about 10% and 25% of term and postterm pregnancies, respectively.1–4 It remains an important cause of perinatal morbidity and mortality and maternal morbidity, which arise mainly from birth injury and asphyxia and increased rate of cesarean section, respectively.5 In addition to the significant immediate complications, the long-term impact of less severe perinatal asphyxia on the mental development of the affected children is unknown. The major obstacle in reducing the perinatal morbidity and mortality associated with fetal macrosomia has been the inability to predict with certainly which fetuses will sustain birth injury before delivery.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Arias F. Predictability of complications associated with prolongation of pregnancy. Obstet Gynecol 1987;70:101.

    PubMed  CAS  Google Scholar 

  2. Boyd ME, Usher RH, McLean FH. Fetal macrosomia: prediction, risks, proposed management. Obstet Gynecol 1983;61:715.

    PubMed  CAS  Google Scholar 

  3. Golditch IM, Kirkman K. The large fetus. Management and outcome. Obstet Gynecol 1978;52:26.

    PubMed  CAS  Google Scholar 

  4. Chervenak JL, Divon MY, Hirsch J, et al. Macrosomia in the postdate pregnancy: Isroutine ultrasonographic screening indicated? Am J Obstet Gynecol 1989;161:753.

    PubMed  CAS  Google Scholar 

  5. Spellacy WN, Miller S, Winegar A, et al. Macrosomia-maternal characteristics and infant complications. Obstet Gynecol 1985;66:158.

    PubMed  CAS  Google Scholar 

  6. Klebanoff MA, Mills JL, Berendes HW. Mother’s birth weight as a predictor of macrosomia. Am J Obstet Gynecol 1985;153:253.

    PubMed  CAS  Google Scholar 

  7. Morgan MA, Thurnau GR. Efficacy o the fetal-pelvic index for delivery of neonates weighing 4000 grams or greater: a preliminary report. Am J Obstet Gynecol 1988;158:1133.

    PubMed  CAS  Google Scholar 

  8. Larsen CE, Serdula MK, Sullivan KM. Macrosomia: Influence of maternal overweight among a low-income population. Am J Obstet Gynecol 1990;162:490.

    PubMed  CAS  Google Scholar 

  9. Coustan DR, Imarah J. Prophylactic insulin treatment of gestational diabetes reduces the incidence of macrosomia, operative delivery, and birth trauma. Am J Obstet Gynecol 1984;150:836.

    PubMed  CAS  Google Scholar 

  10. Goldberg JD, Franklin B, Lasser D, et al. Gestational diabetes: impact of home glucosemonitoring on neonatal birth weight. Am J Obstet Gynecol 1986;154:546.

    PubMed  CAS  Google Scholar 

  11. Lin C-C, River J, River P, et al. Good diabetic control early in pregnancy and favorable fetal outcome. Obstet Gynecol 1986;67:51.

    PubMed  CAS  Google Scholar 

  12. Morris MA, Grandis AS, Litton JC. Glycosy-lated hemoglobin concentration in early gestation associated with neonatal outcome. Am J Obstet Gynecol 1985;153:651.

    PubMed  CAS  Google Scholar 

  13. Willman SP, Leveno KJ, Guzick DS, et al. Glucose threshold for macrosomia in preg-nancy complicated by diabetes. Am J Obstet Gynecol 1986;154:470.

    PubMed  CAS  Google Scholar 

  14. Combs CA, Gunderson E, Kitzmiller JL, et al. Relationship of fetal macrosomia to maternal postprandial glucose control during pregnancy. Diabetes Care 1992;15:1251.

    Article  PubMed  CAS  Google Scholar 

  15. Langer 0, Brustman L, Anyaegbunam A, et al. The significance of one abnormal glucose tolerance test value on adverse outcome in pregnancy. Am J Obstet Gynecol 1987;157:758.

    PubMed  Google Scholar 

  16. Lindsay MK, Graves W, Klein L. The relationship of one abnormal glucose tolerance test value and pregnancy complications. Obstet Gynecol 1989;73:103.

    PubMed  CAS  Google Scholar 

  17. Tallarigo L, Giampietro O, Penno G, et al. Relation of glucose tolerance to complications of pregnancy in nondiabetic women. N Engl J Med 1986;315:989.

    Article  PubMed  CAS  Google Scholar 

  18. Pederson J, Bojsen-Moller B, Paulson H. Blood sugar in newborn infants of diabetic mothers. Acta Endocrinol 1954;15:33.

    Google Scholar 

  19. Sosenko IR, Kitzmiller JL, Loo SW, et al. The infant of the diabetic mother. N Engl J Med 1979;301:859.

    Article  PubMed  CAS  Google Scholar 

  20. Susa JB, McCormick KL, Widness JA, et al. Chronic hyperinsulinemia in the fetal rhesus monkey. Diabetes 1979;28:1058.

    PubMed  CAS  Google Scholar 

  21. Widness JA, Schwartz HC, Thompson D, et al. Glycohemoglobin (HbAlc): a predictor of birth weight in infants of diabetic mothers. J Pediatr 1978;92:8.

    Article  PubMed  CAS  Google Scholar 

  22. Yatscoff RW, Mehta A, Dean H. Cord blood glycosylated (glycated) hemoglobin: correlation with maternal glycosylated (glycated) hemoglobin and birth weight. Am J Obstet Gynecol 1985;152:861.

    PubMed  CAS  Google Scholar 

  23. Menon RK, Cohen RM, Sperling MA, et al. Transplacental passage of insulin in pregnant women with insulin-dependent diabetes mellitus. N Engl J Med 1990;323:309.

    Article  PubMed  CAS  Google Scholar 

  24. Edwards LE, Dickes WF, Alton IR, et al. Pregnancy in the massively obese. Course, outcome, and obesity prognosis of the infant. Am J Obstet Gynecol 1978;131:479.

    PubMed  CAS  Google Scholar 

  25. Gross T, Sokol RJ, King K. Obesity in pregnancy. Risks and outcome. Obstet Gynecolv 1980,56:4.

    Google Scholar 

  26. Philipson EH, Kaihan SC, Edelbert SC, et al. Maternal obesity as a risk factor in gestational diabetes. Am J Perinatol 1985;2:4.

    Article  Google Scholar 

  27. Wolfe HM, Zador IE, Gross TL, et al. The clinical utility of maternal body mass index in pregnancy. Am J Obstet Gynecol 1991;164:1306.

    PubMed  CAS  Google Scholar 

  28. Kirz DS, Dorchester W, Freeman RK. Advanced maternal age. The mature gravida. Am J Obstet Gynecol 1985;152:7.

    PubMed  CAS  Google Scholar 

  29. Elliott JP, Garite TJ, Freeman RK, et al. Ultrasonic prediction of fetal macrosomia in diabetic patients. Obstet Gynecol 1982;60:159.

    PubMed  CAS  Google Scholar 

  30. Tamura RK, Sabbagha RE, Depp R, et al. Diabetic macrosomia—accuracy of third trimester ultrasound. Obstet Gynecol 1986;67:828.

    Article  PubMed  CAS  Google Scholar 

  31. Keller JD, Metzger BE, Dooley SL, et al. Infants of diabetic mothers with accelerated fetal growth by ultrasonography: are they all alike? Am J Obstet Gynecol 1990,163:893.

    PubMed  CAS  Google Scholar 

  32. Landon MB, Mintz MC, Gabbe SG. Sonographic evaluation of fetal abdominal growth: Predictor of large-for-gestational-age infantin pregnancies complicated by diabetes mellitus. Am J Obstet Gynecol 1989;160: 33.

    Google Scholar 

  33. Shepard MJ, Richards VA, Berkowitz RL, et al. An evaluation of two equations for predicting fetal weight by ultrasound. Am J Obstet Gynecol 1982;142:47.

    PubMed  CAS  Google Scholar 

  34. Hadlock FB, Harrist RB, Sharman RS, et al. Estimation of fetal weight with the use of head, body, and femur measurements-a prospective study. Am J Obstet Gynecol 1985;151:333.

    PubMed  CAS  Google Scholar 

  35. Hirata GI, Medearis AL, Horenstein J, et al. Ultrasonographic estimation of fetal weight in the clinically macrosomic fetus. Am J Obstet Gynecol 1990;162:238.

    PubMed  CAS  Google Scholar 

  36. Miller JM, Haywood LB, Oscar FK, et al. Ultrasonographic identification of the macrosomic fetus. Am J Obstet Gynecol 1988;158:1110.

    Google Scholar 

  37. Bernstein IM, Catalano PM. Influence of fetal fat on the ultrasound estimation of fetal weight in diabetic mothers. Obstet Gynecol 1992;79:561.

    PubMed  CAS  Google Scholar 

  38. Farmer RM, Medearis AL, Hirata GI, et al. The use of a neural network for the ultraso-nographic estimation of fetal weight inthe macrosomic fetus. Am J Obstet Gynecol 1992;166:1467.

    PubMed  CAS  Google Scholar 

  39. Oppenheim WL, Davis A, Growdon WA, et al. Clavicle fractures in the newborn. Clin Orthop Relat Res 1990;250:176.

    PubMed  Google Scholar 

  40. Turner MJ, Rasmussen MJ, Turner JE, et al. The influence of birth weight on labor in nulliparas. Obstet Gynecol 1990;76:159.

    PubMed  CAS  Google Scholar 

  41. Amico JA, Seitch J, Robinson AG. Studies of oxytocin in plasma of women during hypocontractile labor. J Clin Endocrinol & Metab 1984;58:274.

    Article  CAS  Google Scholar 

  42. Seitchik J, Castillo M. Oxytocin augmentation of dysfunctional labor. I. Clinical data. Am J Obstet Gynecol 1982;144:899.

    PubMed  CAS  Google Scholar 

  43. Baxi LV, Pétrie RH, Caritis SN. Induction of labor with low-dose prostaglandin F2a and oxytocin. Am J Obstet Gynecol 1980;136:28.

    PubMed  CAS  Google Scholar 

  44. Seitchik J, Castillo M. Oxytocin augmentation of dysfunctional labor. III. Multiparous patients. Am J Obstet Gynecol 1983;145:777.

    PubMed  CAS  Google Scholar 

  45. Blakemore KJ, Qin NG, Pétrie RH, et al. A prospective comparison of hourly and quarter-hourly oxytocin dose increase intervals for the induction of labor at term. Obstet Gynecol 1990;75:757–761.

    PubMed  CAS  Google Scholar 

  46. Mercer B, Pilgrim P, Sibai B. Labor induction with continuous low-dose oxytocin infusion: a randomized trial. Obstet Gynecol 1991;77:659–663.

    PubMed  CAS  Google Scholar 

  47. Acker DB, Benjamin PS, Friedman EA. Risk factors for shoulder dystocia. Obstet Gynecol 1985;66:762.

    PubMed  CAS  Google Scholar 

  48. Acker DB, Gregory KD, Sachs BP, et al. Risk factors for Erb-Duchenne palsy. Obstet Gynecol 1988;71:389.

    PubMed  CAS  Google Scholar 

  49. Gordon M, Rich H, Deutschberger J, et al. The immediate and long-term outcome of obstetric birth trauma. I. Brachial plexus paralysis. Am J Obstet Gynecol 1973;117:1.

    Google Scholar 

  50. Rubin A. Management of shoulder dystocia. JAMA 1964;189:11.

    Google Scholar 

  51. McFarland LV, Raskin M, Daling JR, et al. Erb/Duchenne’s palsy: a consequence of fetal macrosomia and method of delivery. Obstet Gynecol 1986;68:784.

    PubMed  CAS  Google Scholar 

  52. Gross SJ, Shime J, Farine D. Shoulder dystocia: predictors and outcome. A five-year review. Am J Obstet Gynecol 1987;156:334.

    PubMed  CAS  Google Scholar 

  53. Modanlou HD, Komatsu G, Dorchester W, et al. Large-for-gestational-age neonates: anthropometric reasons for shoulder dystocia. Obstet Gynecol 1982;60:417.

    PubMed  CAS  Google Scholar 

  54. Winn HN, Grasso J, Holcomb W, et al. The potential of fetal chest circumference in the prenatal diagnosis of shoulder dystocia. Proceedings of the 9th Annual Society of Perinatal Obstetricians Meeting, New Orleans, 1989.

    Google Scholar 

  55. Benedetti TJ, Gabbe SG. Shoulder dystocia: a complication of fetal macrosomia and prolonged second stage of labor with midpelvic delivery. Obstet Gynecol 1978;52:526.

    PubMed  CAS  Google Scholar 

  56. Hopwood HG. Shoulder dystocia: fifteen years’ experience in a community hospital. Am J Obstet Gynecol 1982;144:162.

    PubMed  Google Scholar 

  57. Smeltzer JS. Prevention and management of shoulder dystocia. Clin Obstet Gynecol 1986;29:2.

    Article  Google Scholar 

  58. Woods CE. A principle of physics as applicable to shoulder delivery. Am J Obstet Gynecol 1943;45:796.

    Google Scholar 

  59. Gonik B, Stringer CA, Held B. An alternate maneuver for management of shoulder dystocia. Am J Obstet Gynecol 1983;145:7.

    Google Scholar 

  60. Sandberg ED. The Zavanelli maneuver: a potentially revolutionary method for the resolution of shoulder dystocia. Am J Obstet Gynecol 1985;152:479.

    PubMed  CAS  Google Scholar 

  61. Delpapa EH, Mueller-Heubach E. Pregnancy outcome following ultrasound diagnosis of macrosomia. Obstet Gynecol 1991; 78:340.

    PubMed  CAS  Google Scholar 

  62. Flamm BL, Goings JR. Vaginal birth aftercesarean section: is suspected fetal macrosomia a contraindication? Obstet Gynecol 1989;74:694.

    PubMed  CAS  Google Scholar 

  63. Langer O, Berkus MD, Huff RW, et al. Shoulder dystocia: Should the fetus weighing>4000 grams be delivered by cesarean section? Am J Obstet Gynecol 1991;165:831.

    PubMed  CAS  Google Scholar 

  64. American College of Obstetricians and Gynecologists. Management of the breech presentation. ACOG Technical Bulletin No. 95. Washington, DC: American College of Obstetricians and Gynecologists, 1986.

    Google Scholar 

  65. Marchick R. Antepartum external cephalic version with tocolysis: a study of term singleton breech presentations. Am J Obstet Gynecol 1988;158:1339.

    PubMed  CAS  Google Scholar 

  66. Morrison JC, Myatt RE, Martin JN, et al. External cephalic version of the breech presentation under tocolysis. Am J Obstet Gynecol 1986;154:900.

    PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1995 Springer-Verlag New York, Inc.

About this chapter

Cite this chapter

Winn, H.N., Hobbins, J.C. (1995). Fetal Macrosomia. In: Flamm, B.L., Quilligan, E.J. (eds) Cesarean Section. Clinical Perspectives in Obstetrics and Gynecology. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-2482-2_8

Download citation

  • DOI: https://doi.org/10.1007/978-1-4612-2482-2_8

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-7556-5

  • Online ISBN: 978-1-4612-2482-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics