The excessively large fetus. A study of 261 cases

Abstract

From January 1964 to October 1972, 261 infants of 4,500 g or over were born in 140,157 deliveries, an incidence of 1.86%. About 67% of the excessively large infants occurred in mothers 31 or more yr old, of whom 5% were primigravidas. Nearly 15% of these infants were born from diabetic mothers and the coincidence of toxemia of pregnancy was recorded at 20%. Male infants predominate among excessively large babies, up to 63.2%. About 63% of the cases were delivered spontaneously. Operative vaginal deliveries had to be done in about 20%. The rest were delivered abdominally. There was no maternal mortality in the 261 cases and maternal morbidity was not excessive. The common fetal morbidities were brachial plexus injury, fracture of the humerus and clavicle, hypoglycemia and cerebral hemorrhage. The uncorrected fetal mortality rate was 11.5%, caused by diabetes in antepartum, dystocia for intrapartum and cerebral hemorrhage for neonatal deaths, respectively. Early recognition of excessively large fetus and more radical intervention are the keys to obtain the best result.