The modern view on the problem of fetal macrosomia

Abstract

Abstract In recent decades, there has been a trend towards an increase in number of newborns with signs of macrosomia. Purpose of the study: to study features of thecourse pregnancy, parturition and the postpartum period associated with fetal macrosomia and to carry out an analysis of perinatal outcomes. Materials and methods of research. A retrospective analysis of 100 histories of patient deliveries giving birth to children weighing 4000.0 g and more during the 3-year study period from 2014 to 2016 at the Kyiv City Maternity Hospital №3, Ukraine. Results of the study. The work demonstrates increasing frequency of parturition with fetal macrosomia over the study period, from 9% of the total number of births in 2014 to 13% in 2016. The main complications of pregnancy were threatened abortion (57%), preeclampsia of varying severity (25%). During delivery, the prevalence of such complications as premature amniotic fluid discharge (26%), failure of progress (12%) and two-fold increase in trauma of soft tissues of birth canals was established. Fetal macrosomia leads to an increase in the frequency of using surgical interventions during delivery, as well as 10 times increase in the percentage of births by caesarean section. Conclusions. Our study showed that fetal macrosomia increases the frequency of complications of pregnancy and parturition. Early evaluation of the estimated fetal weight, individual approach to pregnancy and parturition;proper obstetric, gynecological and somatic anamnesis;and timely anesthesia and controlling of labor in women with fetal macrosomia all can reduce complications of labor and improve perinatal outcomes.