IMPROVEMENT OF MANAGEMENT OF CHILDBIRTH WITH MACROSOMIA
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Abstract
Orenburg State Medical University, Orenburg, Russia
The aim of the research – to study the features of the clinical course of childbirth with macrosomia and improve the management.
Material and methods. It was prospective cohort study. In this study 500 pregnant women were analyzed who delivered term, singleton, live born infants for 2015-2020 years. The study population was divided into 2 groups according to the estimated fetal weight (with fetal weight 3000-3995 g, 4000 g and more). Complication rates were compared between study and control groups taking into account operative childbirth, complications of pregnancy and childbirth, obstetric injuries and perinatal outcomes.
Results. In the case of macrosomia the greatest risk among complications in vaginal delivery is secondary uterine inertiа, shoulder dystocia and postpartum hemorrhage. Induction of labor in macrosomia significantly reduced the incidence of complications in labor. Induction of labor performed at 39-40 weeks of gestation leads to a decrease in emergency caesarean section. Induction of labor at this gestational age reduces the incidence of hypoglycemia in newborns, transfer to the intensive care unit, caesarean section.
Conclusion. In the cases of macrosomia without pre-existing and manifest forms of diabetes mellitus, labor induction at a gestational age of 39-40 weeks is the most favorable method of delivery.
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