Maternal Outcome Of Macrosomia

Introduction The perinatal morbidity and mortality have known to occur more frequently following delivery of macrosomic babies.Prenatal diagnosis of suspected macrosomia has proven difficult and is often inaccurate.The mode of delivery of macrosomia for favorable obstetric outcome is still debatable.Therefore,the aim of this study was to analyse the obstetric outcome of macrosomic baby via vaginal delivery versus assisted delivery.Method and Materials A descriptive observational study was conducted at KIST Medical College Teaching Hospital,Lalitpur Nepal on live term macrosomic babies.The hospital record of mother was reviewed for maternal demographic profile,medical condition of the mother,mode of delivery and complication.Similarly,macrosomic babies were reviewed for gestational age at delivery,birth weight,gender,Apgar score and neonatal complications.The mother having perineal tear,postpartum hemorrhage,shoulder dystocia,wound infection and puerperal pyrexia were considered as complicated.The macrosomic babies,needing admission into the neonatal care unit due to any morbidity,were considered as complicated.All the mother and their babies were followed up till discharge or demise.Obstetric outcome of vaginal delivery versus assisted delivery was analyzed.Result The prevalence of macrosomia was 11.7 % out of which 52% of babies were delivered by assisted delivery whereas 48% of babies were delivered by normal delivery.Seven percentages of macrosomic mothers had associated medical co-morbidities.There was only one case of maternal diabetes mellitus associated with macrosomia.The mean birth weight was3650 grams and 12.3% of the babies weighed 4000 grams or more.Twenty-three percentage of mother had complications,which included perineal tear,postpartum hemorrhage and puerperal pyrexia.Similarly,20% of macrosomic babies had complications,which mostly included neonatal sepsis,significant hyperbilirubinemia,transient tachypnea of newborn and perinatal asphyxia.Ninety-six percentage of maternal complications were seen in mothers who delivered by normal delivery and only six percentage of maternal complications were seen in mothers who delivered by assisted delivery which was statistically significant(p-value-<0.01).Also,72% of neonatal complications were seen in babies delivered by assisted delivery and 28% of neonatal complications were seen in babies delivered by normal delivery which was statistically significant(p-value-<0.01).However,there was not any maternal or neonatal mortality.Conclusion In resource limited setting like Nepal where prenatal diagnosis of macrosomic babies is difficult,increased rates of hospital delivery is reasonable to improve obstetric outcome associated with macrosomia.