Abstract
<p style="margin-bottom: 0in;"><span style="color: #000000;"><span style="font-family: Times New Roman,serif;"><span style="font-size: small;"><span style="color: #231f20;"><em><strong>Introduction: </strong></em></span><span style="color: #231f20;">Large for gestational age at term could be following maternal diabetes and it affects neonatal mortality and morbidity. The aims of this study were to assess, firstly the mid-trimester blood glucose levels and secondly to assess the pregnancy outcomes of the macrosomic babies.</span></span></span></span> <p style="margin-bottom: 0in;"><span style="color: #000000;"><span style="font-family: Times New Roman,serif;"><span style="font-size: small;"><span style="color: #231f20;"><em><strong>Methods: </strong></em></span><span style="color: #231f20;">This was a retrospective descriptive study conducted at labour room C of Castle Street Hospital for Women during 15th May 2012 to 25th October 2012. Pregnancy records, delivery notes and admission notes to the neonatal care units were retrieved in order to find the mid-trimester blood glucose levels, mode of delivery, neonatal morbidity and mortality, stillbirth rate and occurrence of shoulder dystocia.</span></span></span></span> <p style="margin-bottom: 0in;"><span style="color: #000000;"><span style="font-family: Times New Roman,serif;"><span style="font-size: small;"><span style="color: #231f20;"><em><strong>Results: </strong></em></span><span style="color: #231f20;">There were 149 with a BW of </span><span style="color: #231f20;">≥</span><span style="color: #231f20;">3.5kg out of 1363 total deliveries. Rate of macrosomia was 11%. There were 133 women with documented ANBG. Majority (90%) of the women with a BW of </span><span style="color: #231f20;">≥</span><span style="color: #231f20;">3.5Kg were classified as non-diabetes. Out of the mothers who were diagnosed as diabetes (15 cases) in pregnancy, 13 were gestational diabetes (GDM) while two were type 2 diabetes. Majority had a vaginal delivery (n-105, 70.5%). Out of these, six (4%) were instrumental deliveries (4-forcep, 2 vacuum deliveries). There was one stillbirth and zero neonatal deaths reported in this study group. There were three (2%) third degree perineal tears, two following NVD and one following forceps delivery.</span></span></span></span> <p style="margin-bottom: 0in;"><span style="color: #000000;"><span style="font-family: Times New Roman,serif;"><span style="font-size: small;"><span style="color: #231f20;"><em><strong>Conclusions: </strong></em></span><span style="color: #231f20;">Majority of mothers with babies with birthweight >3.5 kg did not have altered blood glucose levels. Further prospective studies are needed to define the association of adverse perinatal outcomes and macrosomia.</span></span></span></span> <p style="margin-bottom: 0in; font-weight: normal;"><span style="color: #000000;"><span style="font-family: Times New Roman,serif;"><span style="font-size: small;">DOI: <a href="http://dx.doi.org/10.4038/sljog.v35i3.6336">http://dx.doi.org/10.4038/sljog.v35i3.6336</a></span></span></span> <p style="margin-bottom: 0in; font-weight: normal;"><em>Sri Lanka Journal of Obstetrics and Gynaecology </em>2013; 35: 84-85 <p style="margin-bottom: 0in; font-weight: normal;">
Highlights
Large for gestational age at term could be following maternal diabetes and it affects neonatal mortality and morbidity
Incidence of shoulder dystocia in all deliveries is approximately 1% but the incidence increases with macrosomia[2]
Delivery notes and admission notes to the neonatal care units were retrieved in order to find the mid-trimester blood glucose levels, mode of delivery, neonatal morbidity and mortality, stillbirth rate and occurrence of shoulder dystocia
Summary
Large for gestational age at term could be following maternal diabetes and it affects neonatal mortality and morbidity. Large birth weight affects neonatal mortality and morbidity[1]. Rates of shoulder dystocia and caesarean birth rise substantially with larger birth weights[2]. The incidence of shoulder dystocia in all deliveries is approximately 1% but the incidence increases with macrosomia (birth weight ≥90th percentile)[2]. Sri Lankan standard for macrosomia at term is 3500g or more[3]. Maternal characteristics such as weight, height, parity and ethnicity need to be adjusted to establish an appropriate standard for normal birth weight for gestation[4]
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