FETO-MATERNAL OUTCOME OF PREGNANCIES COMPLICATED WITH FETAL MACROSOMIA AT THE UNIVERSITY OF ABUJA TEACHING HOSPITAL: A 3-YEAR REVIEW

Dr. Mba G. O. and Dr. Abdullahi I. H.*

ABSTRACT

Background: Fetal macrosomia has remained a considerable challenge in current obstetric practice due mainly to fetal and maternal complications associated with this condition. Aim: The aim of this study is to determine the incidence of fetal macrosomia and feto-maternal outcome in University of Abuja Teaching Hospital. Materials and method: This was a 3-year retrospective study of pregnant women with fetal macrosomia (defined as a baby weighing 4kg or above) managed in this hospital from 1st January 2012 to 31st December 2014. Data was collected from labour ward, maternity ward and theatre registers; and patients’ folders from the medical records and analyzed using descriptive statistics. Results: There were a total of 341 macrosomic babies delivered within the study period and a total of 5097 deliveries, giving an incidence of 6.7%, however, only 332 had adequate and complete information and were analyzed giving a retrieval rate of 97.4%. Booked cases were 244(73.5%) while the unbooked were 98(26.5%) of the parturients. Age range of 31-35 had a total of 119(35.9%) of the babies which was the highest among others. Caeserean delivery accounted for 174(52.4%), spontaneous vaginal delivery and exploratory laparotomy due to ruptured uterus constituted 157(47.3%) and 1(0.3%) respectively. Out of the 174(52.4%) that had caesarean section, 146(83.9%) were emergency while 28(16.1%) were elective. The commonest maternal complication was genital laceration which accounted for 37(11.1%) and the least was shoulder dystocia and accounted for 4(1.2%) of the cases. Primary post-partum haemorhage occurred in 21(6.3%) of the cases and 1(0.3%) of maternal mortality as a result of primary postpartum haemorrhage was found. One parturient had subtotal hysterectomy due to uncontrollable postpartum haemorrhage. A total of 139(41.9%) of the babies were delivered by women of Ibo tribe and far higher than found among other tribes. Of the total number of babies, 216(65.1%) were male while 116(34.9%) were females. Babies with severe birth asphyxia amounted to 1.9% and stillbirth accounted for 23(6.9%) of the babies. No incidence of fractures, Erb’s or Klumpke’s palsy was recorded. Conclusion: Fetal macrosomia is more frequent among multiparas who are between 31-35 years. The common complications include cephalopelvic disproportion, higher frequency of caesarean section, perineal laceration, postpartum haemorrhage, birth asphyxia and stillbirth Though the study showed minimal fetal morbidity; fetal mortality was still high.

Keywords: Fetal macrosomia, big baby, feto-maternal outcome, maternal morbidity, perinatal outcome.