Flashcards in LGA Deck (4)
EFW > 90th centile
Birth weight > 4kg or >4.5kg
Risks of LGA
- Stillbirth, particularly if EFW>5kg
- Congenital abnormalities
- Neonatal: Hypoglycaemia, admission to SCBU/NICU, respiratory problems, polycythaemia
- Later in life- obesity, metabolic syndrome, cardiac remodeling, impaired glucose tolerance
- labour dystocia
- EMCS for obstructed labour
- Instrumental delivery
- Shoulder dystocia
- Perineal trauma (including OASIS)
Results of 2016 cochrane review for IOL near or at term for macrosomia.
Review of 4 trials found-
- Intervention = IOL 37-40 wks in babies with suspected macrosomia
- IOL group: reduction in incidence of shoulder dystocia, birth weight and #clavicle but 1 study found increase in 3/4th degree perineal tears.
- No difference in CS rate, brachial plexus injury rate or instrumental delivery rate.