Obstetric Performance of Mothers with Fetal Macrosomia in Bida, North Central Nigeria.

Abstract

Fetal macrosomia remains an important determinant of perinatal outcome and a contributor to neonatal morbidity and mortality due to its possible attendant complications. The aim of the study was to determine the maternal characteristics, as well as neonatal and maternal outcome following delivery of macrosomic babies. A descriptive study of deliveries that resulted in the delivery of macrosomic babies at the Federal Medical Centre, Bida, Nigeria was conducted over a five year period. The list of eligible parturient was compiled from the delivery registers, the case files were retrieved and relevant information extracted. Statistical analysis was with SPSS version 20.0 and p<0.05 was significant. Out of 8141 deliveries, macrosomia occurred in 500 (6.1%); among the 480 cases analyzed, 345(71.9%) mothers of macrosomic babies were <35 years of age, the mean maternal weight at term was 89.42kg±2.50 while 297(61.9%) mothers had previous delivery of macrosomic babies. Also, 337(70.2%) women had vaginal delivery while maternal risk factors for fetal macrosomia were not statistically significant relative to the mode of delivery (p0.857). Maternal complications included perineal lacerations [90(18.8%)] and primary postpartum haemorrhage [82(17.1%)]. Maternal booking status (p0.001), male fetal gender (p0.001) and birth weight less than 4500g (p0.002) were significant predictors of vaginal delivery while maternal complications were significantly higher following vaginal delivery (p0.001). Low APGAR scores were higher following vaginal deliveries (p0.732); the perinatal mortality rate was 31/1,000 live birth (15/480) but there was no maternal death. This study revealed a high incidence of fetal macrosomia and vaginal delivery was associated with a high maternal and perinatal morbidity.

Key words: Obstetric Performance; Pregnancy outcome; Fetal macrosomia; Mode of Delivery.