Excessive birth weight and the risks-Macrosomia

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Macrosomia is described as an excessive intrauterine growth above a specific threshold regardless of gestational age (GA). Put in another way, macrosomia is a term for explaining baby whose birth weight is between 4000 to 4500g or a birth weight above the 90th percentile, corrected for gestational age and sex. The World Health Organization (WHO) and the American College of Obstetricians and Gynecologists state that new birth weighing above eight pounds, thirteen ounces (4,000 g) are considered to be macrosomic.

Pregnant women with a bigger baby are susceptible to risk of complications during delivery. Diabetes and baby with over 5000g however increase the risk of complications which call for close and proper antenatal monitoring by the doctor and usually require induction or cesarean section for delivery.



The main cause of macrosomic is genetically related, other factors include diabetes, high blood pressure, post term pregnancy, gender of the baby with the male being prone to macrosomia, gaining additional weight in the pregnancy and history of big baby. It must however be clearly stated here that in spite of having any of the above factors, normal baby may still be given birth to while some who have big baby may not have any of the above mentioned factors.



The diagnosis of the condition is only possible after the birth of the baby because the prenatal assessments and the ultrasound examinations are unrealiable and imprecise in most cases. In cases where the doctor suspects macrosomia on the basis of prenatal findings, no treatment is usually required except the need to have dietary adjustments in diabetic pregnant women.

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Risks and possible complications

Macrosomia has been found responsible for fetal and maternal morbidity and mortality; however, other serious complications associated with this condition are uncommon. Broken collarbone, shoulder dystocia, perineum tears and possibly infections are some of the complications associated with macrosomia. Shoulder dystocia can also occur in infants of normal birth weight. Ceserean section offers can avert some of these complications.



Generally, no treatment is required for a baby with macrosomia. However, there is need to reduce both the blood sugar levels and blood pressure as a safety net for the mother. Adequate rest and relaxation after delivery are vital part of post-partum treatment and recovery.
Infections that may arise must be treated with antibiotics.
Ceserean section is another treatment option depending on the estimated wight of the baby or the presence of diabetes. The American College of Obstetricians and Gynecologists guidelines state that a cesarean delivery may be considered when the weight of the fetus is more than eleven pounds in a mother without diabetes and more than nine pounds, four ounces in a mother with diabetes.

Close and proper monitoring is required in managing macrosomic condition as the condition in most cases is not life-threatening for either the mother or thebaby.

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