Labor and delivery in a pregnancy involving fetal macrosomia

The alleged connection between fetal magalosomia and the increased risk of maternal and perinatal morbidity justifies the lively discussion that has developed about the management problems caused by a big unborn child. The aim of this study is to offer a contribution to the definition of the more or less peculiar problems associated with labour and delivery in a pregnant women with a megalosomic fetus. The study was retrospectively carried out on a sample of 45 women who, during the period 1190-1993, delivered a fetus weighing at least 4 kg. This sample was statistically compared with a numerically identical standard sample, selected at random. The main characteristics of labour and delivery were examined in the two groups under study. The most considerable differences observed concern the length of the labour, greater in the sample than in the standard group, and the frequency of dystocic events, similarly more considerable in the pregnant women with a megalosomic fetus. Maternal and perinatal outcomes, in spite of the small number of cesarean sections performed, were anyway very good in both the examined groups. In our experience, the risks associated with fetal megalosomia were rather limited, but this is not a reason to minimize beyond measure the problem we are talking about.