Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.
Fetal macrosomia and management of delivery
During the period 1988-1966,737 pregnancies , in which the infant birth weight was ≥4000 grams were studied. During the sameperiod there were 11,631 newborns, and 6.3% of them were infants with a birth weight ≥4000 grams. Normal vaginal delivery occurred in 583 cases (79.1%), vacuum extraction in 24 cases (3.3%) and caesarean section in 130 cases (17.6%). Regarding the caesarean sections, 38 (29.2%) of them were elective and 92 (70.8%) were done in different periods of thelabour. ln these macrosomic babies perinatal death never occurred, but different pathological neonatal oucomes were observed and themajority of these weap clavicle abruptions (39 cases: 5.3%). Matemal movbidity observed in the 607 (82.4%) cases with vaginal delivery is characterized by:60 cases (9.8%) of vaginal andperineal tears,4 cases (0.6%) of cervical tears, and 2 cases (0.3%) of pubic symphysis traumatic diastasis. Shoulder dystocia is the most likely outcome in fetal macrosomic delivery, for this reason we considered the diagnostic and the-rapeutic management of this obstetrical complication. Because the nomal outcome of neonatal births actually encourages the preference for normal vaginaldelivery, we concluded that mothers with macrosomic fetuses can safely be managed expectantly unless there is a high matemal and fetal risk.