Osaikhuwuomwan James, Osemwenkha Abieyuwa, Orukpe Godwin
Department of Obstetrics and Gynaecology, College of Medical Sciences, University of Benin, Nigeria.
Ethiop J Health Sci. 2016 Jan;26(1):31-6. doi: 10.4314/ejhs.v26i1.7.
Macrosomic fetuses are high risk with their delivery process being associated with potential risk to both mother and baby The aim of this study is to determine the incidence of macrosomic births and the associated maternal characteristics and to ascertain the fetal outcome.
It was a retrospective survey of maternal characteristics and pregnancy outcome of macrosomic births. Comparison was made with the next selected normal birth weight delivery during the study period.
There were 8607 deliveries during the period (3 years) reviewed. Of this, 306 were macrosomic deliveries, a frequency of 3.6%. The mean weight for macrosomic babies was 4.23kg (range 4.01 - 5.62kg). There was a higher mean maternal weight and gestational age of mothers with macrosomic deliveries compared to mothers in the control group, (85.87 ± 19.39kg vs 74.92 ± 19.11kg P<0.01; and 41.51±1.46 vs 39.02±1.29, P<0.001). Caesarean delivery was significantly associated with macrosomic births compared to controls, p<0.0001, odds ratio 3.977. Also, asphyxia and shoulder dystocia occurred more in macrosomic babies, 10.4% vs 2.9% and 2.28% vs 0.65%, P<0.001. The majority of the asphyxiated babies amongst macroomic births were following vagina delivery compared to caesarean delivery, (65.6% vs 34.4%) p= 0.001. There were 3 cases of still birth in the macrosomic deliveries, but no maternal deaths were encountered.
Macrosomic births could be tragic. Although delivery outcome seems better with a caesarean section, good fetal outcome can only be assured on the premise of astute labour and delivery management.
巨大胎儿风险较高，其分娩过程对母婴均有潜在风险。本研究旨在确定巨大儿出生的发生率、相关母体特征，并确定胎儿结局。
这是一项对巨大儿出生的母体特征和妊娠结局的回顾性调查。与研究期间接下来选定的正常出生体重分娩进行比较。
在回顾的期间（3年）内共有8607例分娩。其中，306例为巨大儿分娩，发生率为3.6%。巨大儿的平均体重为4.23千克（范围4.01 - 5.62千克）。与对照组母亲相比，巨大儿分娩母亲的平均体重和孕周更高，（85.87±19.39千克对74.92±19.11千克，P<0.01；41.51±1.46对39.02±1.29，P<0.001）。与对照组相比，剖宫产与巨大儿出生显著相关，p<0.0001，比值比为3.977。此外，巨大儿发生窒息和肩难产的情况更多，分别为10.4%对2.9%和2.28%对0.65%，P<0.001。在巨大儿出生中，大多数窒息婴儿是经阴道分娩而非剖宫产，（65.6%对34.4%）p = 0.001。巨大儿分娩中有3例死产，但未出现孕产妇死亡。
巨大儿出生可能是悲剧性的。虽然剖宫产的分娩结局似乎更好，但只有在精明的产程和分娩管理的前提下，才能确保良好的胎儿结局。
