Document Detail

Obstetric and neonatal outcome of babies weighing more than 4.5 kg: an analysis by parity.
MedLine Citation:
PMID:  10996687     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To analyse by parity the obstetric and neonatal outcome of babies delivered weighing more than 4.5 kg. METHODS: All deliveries resulting in a baby weighing more than 4.5 kg, in the 5 years from 1991 to 1995, were identified using a computerised database. The following variables confined to singleton, cephalic pregnancies were recorded: mode of delivery, duration of labour, incidence of shoulder dystocia and admission to the neonatal centre. Outcome measures in primigravidae and multigravidae were compared using the Epi Info package (WHO, Version 6.0b January 1997). RESULTS: There were 32,834 deliveries over the study period and 828 (2.5%) weighed more than 4.5 kg. Birthweight more than 4.5 kg occurred in 1.6% (n=198) of primigravidae and 3.1% (n=630) of multigravidae (P<0.05). Primigravidae had a higher risk of prolonged labour (27.7% vs. 4.9%), operative vaginal delivery (32% vs.9%) and emergency caesarean section (24.2% vs. 5.7%) compared to multigravidae. When delivering a macrosomic baby, primigravidae had a higher incidence of prolonged labour (27% vs. 7.9%), operative vaginal delivery (32% vs.25%) and emergency caesarean section (24.2% vs. 5.7%) compared to normal weight babies. The incidence of shoulder dystocia and elective caesarean section were similar in both primigravidae and multigravidae. CONCLUSIONS: Macrosomic infants have an increased incidence of prolonged labour, operative vaginal delivery and emergency caesarean section compared with normal weight babies and these complications are more pronounced in primigravidae compared to multigravidae. Shoulder dystocia occurs with equal frequency in primigravidae and multigravidae. The poor antenatal predictability of macrosomia, the high rate of vaginal delivery and the low incidence of shoulder dystocia would not support the use of elective caesarean section for delivery of the macrosomic infant either in primigravidae or multigravidae.
E V Mocanu; R A Greene; B M Byrne; M J Turner
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of obstetrics, gynecology, and reproductive biology     Volume:  92     ISSN:  0301-2115     ISO Abbreviation:  Eur. J. Obstet. Gynecol. Reprod. Biol.     Publication Date:  2000 Oct 
Date Detail:
Created Date:  2000-11-15     Completed Date:  2000-12-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0375672     Medline TA:  Eur J Obstet Gynecol Reprod Biol     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  229-33     Citation Subset:  IM    
Coombe Women's Hospital, 8, Dublin, Ireland.
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MeSH Terms
Birth Weight*
Cesarean Section
Delivery, Obstetric
Fetal Macrosomia*
Labor, Obstetric
Pregnancy Outcome*
Time Factors

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