Volume 04 Issue 02-2024
82
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
04
ISSUE
02
P
AGES
:
82-86
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
One of the significant medical and social problems is pregnancy and childbirth in the presence of a large fetus.
Macrosomia in most literature is defined as birth weight >4000 g and occurs in 10% of pregnancies. This condition is
associated with risks for both the mother and the fetus: the frequen-cy of cesarean section, trauma to the birth canal,
shoulder dystocia and perinatal asphyxia increas-es.
KEYWORDS
Large fetus, macrosomia, birth, pregnancy, childbirth complications.
INTRODUCTION
One of the significant medical and social problems is
pregnancy and childbirth in the presence of a large
fetus. Macrosomia in most literature is defined as birth
weight >4000 g and oc-curs in 10% of pregnancies [1, 11,
15]. This condition is associated with risks for both the
mother and the fetus: the frequency of cesarean
section, trauma to the birth canal, shoulder dystocia
and perinatal asphyxia increases. The American
Association of Obstetricians and Gynecologists (ACOG)
defines macrosomia as a birth weight > 4500 g, since
the incidence of postpartum com-plications increases
significantly after this value [2, 13, 17]. Children
Research Article
FETAL MACROSOMIA. OBSTETRIC AND PERINATAL OUTCOMES
Submission Date:
February 13, 2024,
Accepted Date:
February 18, 2024,
Published Date:
February 23, 2024
Crossref doi:
https://doi.org/10.37547/ijmscr/Volume04Issue02-12
Zakirova Nodira Islamovna
Samarkand State Medical University, Uzbekistan
Abdullaeva Nigora Erkinovna
Samarkand State Medical University, Uzbekistan
Xaydarova Diyora Sukhrobovna
Samarkand State Medical University, Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 04 Issue 02-2024
83
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
04
ISSUE
02
P
AGES
:
82-86
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
weighing more than 4000 g are more often born to
multiparous women in the presence of obesity and
diabetes mellitus [7, 12, 14]. Birth weight depends on
many
factors:
genetic,
environmental
and
constitutional, metabolic disorders, gender, ethnicity;
currently there are normative values even for specific
ethnic groups.
Women with a predominantly sedentary lifestyle and
reduced physical activity in the third trimester of
pregnancy have a high risk of developing fetal
macrosomia. The problem of a large fetus deserves the
close attention of doctors of various specialties -
obstetricians, neonatolo-gists, neurologists, since
pregnancy and childbirth with a large fetus are often
complicated. Perina-tal morbidity and mortality in fetal
macrosomia are 5
–
10 times higher than in children born
with normal div weight [4, 17, 19].
Most authors note that with fetal macrosomia,
complications begin to develop even during
pregnancy. According to a number of authors [3,5],
among complications of the gestational period in
patients with fetal macrosomia, gestosis, anemia, and
early toxicosis are detected significantly more often
than in the population; polyhydramnios.
Gestational diabetes mellitus is a known clinical risk
factor for the development of fetal macrosomia and
accounts for 90% of all types of diabetes observed in
pregnancy. In women with GDM, fetal macrosomia is
the main complication, which often, together with
others, serves as an indication for a planned CS in order
to reduce potential perinatal complications.
Childbirth with a fetal weight of 4000 g or more often
occurs with complications: primary and secondary
weakness of labor, untimely rupture of amniotic fluid is
observed; pelvic-cephalic disproportion of fetal origin
occurs 5 times more often than with normal fetal sizes;
shoulder dys-tocia occurs significantly more often
during the pushing period. Therefore, when a large
fetus is diagnosed, the number of planned cesarean
sections and operative vaginal births increases [8,
9,10]. With fetal macrosomia, the risk of amniotic fluid
aspiration syndrome, birth trauma in mother and child
increases significantly, and a higher incidence of
asphyxia at birth is recorded [6, 16]. In the afterbirth
and early postpartum periods, due to overstretching of
the uterus due to a large fetus, hypotonic bleeding
occurs more often [20, 21].
Having analyzed perinatal outcomes, we revealed a
high incidence of hemorrhage in the adrenal gland of
newborns weighing 4500 or more after natural birth.
The same authors noted high risks of clavicle fractures,
low assessment of the newborn's condition on the
Apgar scale at 5 minutes, and birth in a state of
hypoglycemia in case of fetal macrosomia. The
consequences of chronic suffering of a large fetus in
the antenatal period lead to a disruption of adaptation
process-es, a decrease in resistance to the action of
Volume 04 Issue 02-2024
84
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
04
ISSUE
02
P
AGES
:
82-86
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
unfavorable environmental factors, and deviations in
physical, somatic and neuropsychic development in the
postnatal period of ontogenesis. It is known that
macrosomia in girls at birth during puberty is
manifested by advanced physical devel-opment with a
relative delay in sexual development; menstrual
function
is
characterized
by
hy-permenstrual
syndrome and irregular menstrual cycle (17.8%), high
frequency of dysmenorrhea (54.4%) and uterine
bleeding during puberty (35.7%); dyshormonal changes
in the mammary glands (67%) and hyperandrogenism
syndrome (58.1%); echographic signs of peripheral type
of polycystic ovaries and persistent retention
formations of the ovaries.
Modern methods for predicting fetal macrosomia have
their advantages and disadvantages. Identification of
risk factors and the use of clinical methods for
assessing estimated fetal weight are accessible, non-
invasive and easy to use, but have low predictive value.
The error in ultrasound assessment of fetal weight in
macrosomia reaches 29% with a high rate of false-
positive results [18,22]. Magnetic resonance fetometry
is highly accurate and informative, non-invasive, allows
you to obtain sections in any plane without projection
magnification, study the anatomical struc-ture and
dimensions of the small pelvis, and also perform
fetometry. However, MRI is an expen-sive study, which
requires the development of clear indications for its
implementation.
Thus, the relevance of timely diagnosis of fetal
macrosomia, which influences the choice of optimal
delivery tactics, is beyond doubt. The ideal model for
preventing possible perinatal com-plications is to
eliminate the causes of fetal macrosomia.
Considering the relevance of the problem of predicting
macrosomia in modern obstetrics, the lack of effective
methods for assessing the estimated fetal weight, the
high level of obstetric and perina-tal complications
caused primarily by fetal-pelvic disproportion during
childbirth, further research in this direction is necessary
The above suggests that fetal macrosomia is one of the
pressing problems of modern obstetrics, caused by a
high percentage of complicated pregnancy and
childbirth, leading to serious medical, social and
economic consequences. An ideal model for
prevention the formation of fetal macro-somia is to
eliminate the causes of its occurrence. Currently, there
is no clear understanding of the causes and processes
leading to fetal macrosomia.
REFERENCES
1.
Abdullaeva N. Zakirova F. Telmanova J. The
consequences of polyhydramnios for mother
and fetus. International Journal of Medical
Sciences And Clinical Research. 2023;3(4):125-
128.
2.
Bailey C., Kalu E. Fetal macrosomia in
nondiabetic mothers: antenatal diagnosis and
Volume 04 Issue 02-2024
85
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
04
ISSUE
02
P
AGES
:
82-86
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
de-livery out come. Journal of Obstetrics and
Gynaecology, 2009, vol. 29, pp. 206-208.
3.
Biratu A.K., Wakgari N., Jikamo B. (2018)
Magnitude of fetal macrosomia and its
associat-ed factors at public health institutions
of Hawassa city, southern Ethiopia. BMC Res
Notes, no 11 (1), pp. 888
–
6.
4.
Darendeliler F. et al. Adiponectin is an indicator
of insulin resistance in non-obese prepu-bertal
children born large for gestational age (LGA)
and is affected by birth weight. Clini-cal
Endocrinology, 2009, vol. 70, pp. 710-716.
5.
Jolly M.C., Sebire N.J., Harris J.P., Regan L.,
Robinson S. (2003) Risk Factors for macro-
somia and its clinical consequences: A study of
350,311 pregnancies. Eur J Obstet Gynecol
Reprod Biol., no 111 (1), pp. 9
–
14.
6.
Macrosomia: ACOG Practive Bullentin, Number
216. Obstet. Gynecol. 2022; 135(1): e18-e35
7.
Zakirova N. Zakirova F. Abdullayeva N. Features
of pregnancy management and birth out-
comes in women with fetal macrosomiya with
active and expectant tactics. Journal of re-
productive health and uro- nephrology
research. 2022; 3(4):77-79.
8.
Zakirova Nodira Islamovna, Zakirova Fotima
Islamovna, Abdullaeva Nigora Erkinovna, Risk
factors for maternal mortality, Journal of
reproductive health and uro-nephrology re-
search 2023, vol 4, issue 3, pp 86-89
9.
Zakirova N. Abdullayeva N
. Women’s health
-
national health// Tibbiyotda yangi kun// 4(54).
2023. P.569-572
10.
Salihu H. M. et al. The impact of obesity on
maternal morbidity and feto-infant outcomes
among
macrosomic
infants.Journal
of
Maternal-Fetal and Neo natal Medicine, 2011,
vol. 24, no. 9, pp. 1088-1094.
11.
Zakirova, N., & Abdullaeva, N. (2024).
Macrosomia: modern aspects of the problem.
В in
-ternational bulletin of medical sciences
and clinical research (Т. 4, Выпуск 2, сс. 115–
118).
12.
Zakirova, F., Telmanova, J., & Abdullaeva, N.
(2024). Choosing a method of abdominal
delivery in women with a scar on the uterus. В
international bulletin of medical sciences and
clinical research (Т. 4, Выпуск 2, сс. 119–
122).
13.
Yuldasheva I. Farangiz, Samiyeva U. Gulnoza,
Zakirova I. Nodira. Treatment of vaginal
dysbiotic disorders in pregnant women before
childbirth // Journal of Biomedicine and
Practice. 2023, vol. 8, issue 1, pp. 17-22
14.
Ляличкина Н.А., Макарова Т.В., Салямова
Л.Ш. Макросомия плода. Акушерские и
перинатальные исходы
// Современные
проблемы науки и образо вания. –
2016.
–
№
3.
15.
Мыльникова
Ю.В.,
Протопопова
Н.В.
/Крупный
плод.
Современная
тактика
Volume 04 Issue 02-2024
86
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
04
ISSUE
02
P
AGES
:
82-86
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ведения беременности и родов// Вестник
Бурятского Госуниверситета –
2009-
№ 12
-
С.
174-178
16.
Закирова Н.И., Закирова Ф.И., Абдуллаева
Н.Э.// Акушерские и перинатальные аспекты
крупного
плода//
Достижения
фундаментальной, прикладной медицины и
фармации. 2023. С.232
-233
17.
Закирова Ф.И., Закирова Н.И., Абдуллаева
Н.Э. Последствия многоводия для
матери и
плода// Проблемы биологии и медицины.
-
2023. №3.1. Том. 145.
-
С. 109 111.
18.
Эшкабилов Т.Ж., Абдуллаев Б.С., Закирова
Н.И., Элтазарова Г.Ш., Атакулов Б.М.,
Жуманов
3.Э.
Анализ
перинатальной
смертности в о самаркандской области
республики Узбекистан // Журнал Здоровье,
демография,
экология
финно
-
угорских
народов//–
2014-
№ 3. С.57
-58
19.
Закирова Н.И., Закирова Ф.И., Абдуллаева
Н.Э.// Макросомия плода: современное
состояние
проблемы/
Современные
подходы
к
стандартизации
оказания
медицинской
помощи
в
акушерско
-
гинекологической практике/23.02.2022/ С.
144-146
20.
Закирова Н.И., Закирова Ф.И., Абдуллаева
Н.Э.//
Women's
health
and
modern
contraceptive technology after childbirth//
Вестник фундаментальной и клинической
медицины—
2022,
—
№3 (3) —Р 82
-83.
21.
Закирова Ф. Закирова Н. Абдуллаева Н.
Особенности ведения беременности, исход
родов
у
женщин
с
ожирением
и
макросомией.
Современная
медицина:
традиции и инновации. 2022; 1: 142
-144.
22.
Умедова, С.Э. Исходы беременности и родов
при макросомии плода / С.Э. Умедова, М.З.
Равшанова, А.А. Холбоев // Молодой ученый.
–
2011.
–
№ 3. –
Т.2. –
С. 172
-173.
