what is macrosomia course hero

What is macrosomia and how is it treated?

Macrosomia is a term that describes a baby who is born much larger than average for their gestational age, which is the number of weeks in the uterus.

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How common is it to have a baby with macrosomia?

About 9 percent of all babies are born with macrosomia. Causes of this condition include: You’re more likely to have a baby with macrosomia if you: The main symptom of macrosomia is a birth weight of more than 8 pounds, 13 ounces — regardless of whether the baby was born early, on time, or late.

What is macrosomia?

Overview. The term "fetal macrosomia" is used to describe a newborn who's much larger than average. A baby who is diagnosed as having fetal macrosomia weighs more than 8 pounds, 13 ounces (4,000 grams), regardless of his or her gestational age. About 9% of babies worldwide weigh more than 8 pounds, 13 ounces.

What causes macrosomia?

Fetal macrosomia is most commonly caused by a mother with uncontrolled diabetes — pregestational or gestational. Higher amounts of sugar in the mother's system pass through the placenta and converts into fat, leading to a larger baby.

What is the difference between LGA and macrosomia?

LGA refers to neonatal birth weight larger than the 90th percentile for a given gestational age. In contrast to LGA, fetal macrosomia is defined as an absolute birth weight above a specified threshold regardless of gestational age.

What is the pathogenesis of macrosomia?

The pathophysiology of macrosomia is related to the associated maternal or fetal condition that accounts for its development. In general, poorly controlled diabetes, maternal obesity, and excessive maternal weight gain are all associated with macrosomia and have intermittent periods of hyperglycemia in common.

How is macrosomia diagnosed?

Fetal macrosomia can't be diagnosed until after the baby is born and weighed. However, if you have risk factors for fetal macrosomia, your health care provider will likely use tests to monitor your baby's health and development while you're pregnant, such as: Ultrasound.

How does obesity cause macrosomia?

Maternal pre-pregnancy obesity may contribute to macrosomia due to increased insulin resistance, which leads to enhanced hepatic glucose production and cause high fetal glucose and insulin concentrations (30).

What is the difference between macrosomia and large for gestational age?

Whereas large for gestational age relates to a baby's size before birth, macrosomia is usually used to describe babies following birth who are larger than the 90th or 95th percentile on an infant growth chart or who weigh 4kg or more at birth.

How common is macrosomia?

But some grow much larger. In fact, there's a technical term for babies weighing more than 8 pounds 13 ounces when they're born. Called macrosomia, it affects around 8 percent of infants. Most macrosomic babies are born perfectly healthy without complications.

How do you manage macrosomia?

Interventions for Suspected Macrosomia Management strategies for suspected fetal macrosomia include elective cesarean section and early induction of labor.

Why is there macrosomia in GDM?

In GDM, a higher amount of blood glucose passes through the placenta into the fetal circulation. As a result, extra glucose in the fetus is stored as body fat causing macrosomia, which is also called 'large for gestational age'.

What is macrosomia in gestational diabetes?

About 15-45% of babies born to diabetic mothers can have macrosomia, which is a 3-fold higher rate when compared to normoglycemic controls. Macrosomia is typically defined as a birth weight above the 90th percentile for gestational age or >4,000 g.

Is macrosomia an indication for induction?

Suspected fetal macrosomia is not an indication for induction of labor, because induction does not improve maternal or fetal outcomes. Labor and vaginal delivery are not contraindicated for women with estimated fetal weights up to 5,000 g in the absence of maternal diabetes.

What is the 90th percentile of macrosomia?

Babies with macrosomia are in the 90th percentile or higher in weight for their gestational age if born at term. Macrosomia can cause a difficult delivery, and increase the risks for a cesarean delivery (C-section) and injury to the baby during birth. Babies born with macrosomia are also more likely to have health problems such as obesity ...

Why do babies have macrosomia?

Causes of this condition include: diabetes in the mother. obesity in the mother. genetics. a medical condition in the baby. You’re more likely to have a baby with macrosomia if you: have diabetes before you get pregnant, or develop it during your pregnancy ( gestational diabetes) start out your pregnancy obese.

How much does a baby weigh in macrosomia?

Babies with macrosomia weigh over 8 pounds, 13 ounces.

Can macrosomia cause a baby to get stuck in the birth canal?

Macrosomia can cause these problems during delivery: the baby’s shoulder may get stuck in the birth canal. the baby’s clavicle or another bone gets fractured. labor takes longer than normal. forceps or vacuum delivery is needed. cesarean delivery is needed. the baby doesn’t get enough oxygen.

How to prevent macrosomia?

Controlling your blood sugar level is the best way to prevent complications, including fetal macrosomia. Be active. Follow your health care provider's recommendations for physical activity. By Mayo Clinic Staff.

Why is macrosomia more likely to occur during pregnancy?

Fetal macrosomia is more likely to be a result of maternal diabetes, obesity or weight gain during pregnancy than other causes. If these risk factors aren't present and fetal macrosomia is suspected, it's possible that your baby might have a rare medical condition that affects fetal growth.

How much weight is fetal macrosomia?

Risks associated with fetal macrosomia increase greatly when birth weight is more than 9 pounds, 15 ounces (4,500 grams). Fetal macrosomia may complicate vaginal delivery and can put the baby at risk of injury during birth. Fetal macrosomia also puts the baby at increased risk of health problems after birth.

What are the complications of fetal macrosomia?

Possible complications of fetal macrosomia for your baby might include: Lower than normal blood sugar level. A baby diagnosed with fetal macrosomia is more likely to be born with a blood sugar level that's lower than normal. Childhood obesity.

Can you control fetal macrosomia?

Many factors might increase the risk of fetal macrosomia — some you can control, but others you can't. For example: Maternal diabetes. Fetal macrosomia is more likely if you had diabetes before pregnancy (pre-gestational diabetes) or if you develop diabetes during pregnancy (gestational diabetes).

What is the definition of macrosomia?

Development of macrosomia (traditionally defined as birth weight >4000 g or above the 90th percentile for gestational age) is the quintessential fulfillment of the Pedersen hypothesis and a frequent complication of pregnancies complicat ed by DM and GDM. Increased adiposity is the primary component of the macrosomia. Infants of diabetic mothers may have up to twice the body-fat content of infants of normal mothers. Increased fat content was reported in infants of mothers with GDM, even with total body weight identical to that of controls, 63 and data from the HAPO Study 5 showed that the risk for high infant percent body fat increased in association with higher maternal glucose concentration across the entire range of subdiabetic glucose levels. Adiposity tends to be prominent in the shoulder region, enhancing risks for cesarean delivery, shoulder dystocia, and birth trauma. 64 Skin-fold measurements may be used to document adiposity at birth and reflect maternal metabolic regulation. 65 However, skin-fold measurements are difficult to standardize and are seldom used in routine clinical assessment. 65

What are the adverse effects of macrosomia?

Macrosomia is associated with several adverse outcomes, including elevated rates of operative and cesarean deliveries, birth trauma, shoulder dystocia, and stillbirth. Macrosomia rates may reduce with optimal glycemic control from 30% to 50% to as low as 0%–22%, depending on glucose levels.

What percentage of diabetics have macrosomia?

Macrosomia is defined variously as birthweight above the 90th percentile for gestational age or birthweight greater than 4000 g; it occurs in 15% to 45% of diabetic pregnancies. Excessive fetal size contributes to a greater frequency of intrapartum injury (shoulder dystocia, brachial plexus palsy, and asphyxia).

What are the risk factors for macrosomia?

1. Maternal obesity, defined as a prepregnancy body mass index greater than 30, and excessive gestational weight gain are two important risk factors for macrosomia given the high prevalence of both in the United States. 3–5. 2.

Does macrosomia increase the risk of Caesarean section?

Fetal macrosomia is found to increase the risk of Caesarean section as well as instrumental assisted vaginal delivery, especially in cases of primigravida. However, there is a wide variation in the reported overall rates of such delivery methods in fetal macrosomia. 93.

Does CS decrease shoulder dystocia?

Limited evidence exists to suggest that elective CS in women with diabetes with an EFW greater than 4250 g may decrease the incidence of shoulder dystocia. In women without diabetes, it seems intuitive that there is some weight beyond which CS is indicated, but there is no good evidence for what that cutoff should be.

Is macrosomia a clinical diagnosis?

1. Macrosomia is difficult to diagnose. Clinical diagnosis is probably as accurate as ultrasound; ultrasound has a high negative predictive value, and thus may be most helpful in ruling out macrosomia. Studies are lacking that address how best to learn (or teach) the clinical estimation of fetal weight.

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When did Course Hero launch?

On April 17, 2012, Course Hero launched 22 free online courses in three "learning paths": Entrepreneurship, Business, and Web Programming. These courses use aggregated educational content from the web and consistently test students until they master their subject.