CAN MACROSOMIC FETUSES BE DELIVERED AT 38 WEEKS OF GESTATION?


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BULUT A. N., CEYHAN V., DEMİR M. B., AK M., AYDIN E., DOLANBAY M.

Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, vol.23, no.3, pp.422-428, 2021 (Peer-Reviewed Journal) identifier

Abstract

Objective: Numerous articles have been written on macrosomic fetuses, including the American College of Obstetricians and Gynecologists practice bulletin. However, there is no clear consensus about the time of birth. The aim of this study was to compare the maternal and fetal outcomes of women giving birth at 38+0-38+6 weeks and those with deliveries at ≥39 weeks in pregnancies complicated by fetal macrosomia, and to determine the effect on morbidity and mortality of delivery in the 38th gestational week.Material and Methods: Data of women and their infants born in Kayseri Training and Research Hospital between 01 May 2018 and 31 March 2020 were analyzed retrospectively. The patients included were those with a singleton pregnancy delivered at ≥38 weeks with a birthweight of ≥4000 gr. Demographic data and medical history and birth outcomes of the patients were recorded from the hospital data system. Multiple pregnancies, those with fetal anomalies and births <38 weeks were excluded from the study. The patients were separated into two groups as those who gave birth at 38+0-38+6 gestational weeks (Group 1) and those who gave birth at ≥39 weeks (Group 2).Results: Maternal and/or fetal trauma was found to be statistically significantly higher in nulliparous women with vaginal delivery ≥39 weeks compared to those with vaginal delivery at 38+0-38+6 weeks (p=0.017). No significant difference was observed between the groups in respect of fetal morbidity and mortality.Conclusion: When fetal macrosomia is determined antenatally, rates of fetal and/or maternal trauma can be reduced with delivery planned for the 38th week without increasing fetal morbidity and mortality.