Risk in the Vaginal Delivery of the Large Fetus

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Abstract
The problem of the excessively weighted fetus was studied. For this purpose, over a period of 2 yr, each delivery with fetal weight of 4500 g or more was included in the study. The history and examination findings of the present pregnancy were reviewed following delivery. The postpartum outcome and later complications in both mothers and infants were investigated prospectively. A total of 82 deliveries of large babies were included in the study and the outcome was compared with that of parallel deliveries of babies within the normal weight range (2500-4000 g). Factors frequently associated with excessive fetal weight were identified. A relatively high perinatal mortality and morbidity relating to vaginal delivery were observed among the large infants. In all those cases who developed delay in the 2nd stage of labor, Caesarean section was proposed when macrosomia was clinically suspected and confirmed by ultrasonic assessment. Elective Caesarean section should be considered before labor, when macrosomia is associated with hyperglycemia or other pathology.

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