Management of large-for-gestational-age pregnancy in non-diabetic women
Article first published online: 24 JAN 2011
2010 Royal College of Obstetricians and Gynaecologists
The Obstetrician & Gynaecologist
Volume 12, Issue 4, pages 250–256, October 2010
How to Cite
Aye, S. S., Miller, V., Saxena, S. and Farhan, D. M. (2010), Management of large-for-gestational-age pregnancy in non-diabetic women. The Obstetrician & Gynaecologist, 12: 250–256. doi: 10.1576/toag.18.104.22.168617
- Issue published online: 24 JAN 2011
- Article first published online: 24 JAN 2011
- birth weight;
- estimated fetal weight;
- induction of labour;
- shoulder dystocia
- •Over the last two to three decades there has been a 15–25% increase in many countries in the number of women giving birth to large infants.
- •Rates of shoulder dystocia and caesarean birth rise substantially at 4000 g and again at 4500 g.
- •There is an increase in maternal and neonatal morbidity associated with fetal macrosomia.
- •Serial measurement of fundal height adjusted for maternal physiological variables substantially improves antenatal detection.
- •Sonographic assessment of fetal weight is frequently inaccurate.
- •Induction of labour for suspected macrosomia in non-diabetic women has not been shown to reduce the risk of caesarean section, instrumental delivery or perinatal morbidity.
- •To identify the risks associated with fetal macrosomia and to be aware of the long-term implications.
- •To understand the limitations of predictive tools.
- •To be able to take an informed approach to managing the macrosomic fetus.
- •To what extent should the fear of medico-legal action influence obstetricians' management of suspected fetal macrosomia?
- •What advice should clinicians give women regarding modes of delivery?
Please cite this article as: Aye SS, Miller V, Saxena S, Farhan M. Management of large-for-gestational-age pregnancy in non-diabetic women. The Obstetrician & Gynaecologist 2010;12:250–256.