Showing 3 results for Macrosomia
Zafarghandi N, Zafarghandi A.sh, Hadavand Sh, Zayeri F, Hamzeloo L,
Volume 64, Issue 7 (8-2006)
Abstract
Background: To identify the risk factors of fourth-degree laceration during vaginal delivery.
Methods: This is a retrospective, case control study. We reviewed 131802 records of vaginal deliveries within 14 years period from 1990 to 2004 in two obstetric center. Cases were 93 vaginal deliveries with fourth-degree laceration and 7 cases were delivered at home, control subjects were 200 vaginal deliveries without third- or fourth-degree lacerations and were identified with the use of random selection. We studied the effects of: maternal age, nationality, parity, gestational age, hour of delivery, birth attendants, episiotomy use and duration of second stage of labor, use of oxytocin, use of forceps or vaccum, Infant birth weight, presentation and postion of fetus, previous severe perineal injury, maternal medical illness and place of delivery.
Results: We found 93 cases (%0.07) of documented fourth-degree laceration in 131802 deliveries
Conclusion: This study identified several factors associated with fourth-degree laceration. Median episiotomy should be avoided. Nulliparity, fetal macrosomia and OP position are significant risk factors that require caution by birth attendants during delivery
Ghanbari Z, Emamzdeh A, Bagheri M,
Volume 66, Issue 6 (9-2008)
Abstract
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Background: Macrosomia is a term applied to newborns with a birth weight of >4000g.
This condition leads to several maternal and fetal complications including
maternal traumas as well as newborn injury. This study was designed to evaluate
the risk factors of macrosomia among Iranian women.
Methods: This cross-sectional study performed between July 2001
and July 2002, included 2000
term deliveries involving newborns with birth weights of >2500g.
The records of 77 mothers of live born
infants weighing >4000g
were compared to those of the control group (231
women). Stillborn and neonates who were <2500g
were excluded from the study.
Results: Among the 2000 deliveries performed
in Imam Hospital, 77(3.8%)
of the newborns weighed >4000g and 12(0.6%)
weighed >4500g. The mean age of the
mothers, maternal BMI, history of diabetes
mellitus, multiparity, fetal sex and underling maternal disease were found to
be associated with increase risk of fetal macrosomia. There was no significant
relationship between prolonged gestation, weight gain more than 16kg
during pregnancy and past history of macrosomic delivery and macrosomia.
Conclusions: It is possible to prevent macrosomia by weight and diabetes control before the decision
to become pregnant. To prevent pregnancy among multipara mothers aged >35
years old, highly protective contraceptive methods should be used. Furthermore,
if a mother is diagnosed with a macrosomic fetus by sonography or other imaging
methods, more care should be taken during the delivery to decrease the risk of
fetal injury, such as asphyxia and brachial plexus palsy.
Rahimi Sharbaf F, Mosavy Fakhr Z, Davari Tanha F,
Volume 66, Issue 9 (12-2008)
Abstract
Background: Maternal zinc deficiency during pregnancy has been related to adverse
pregnancy outcomes. Most studies in which pregnant women have been supplemented
with zinc to examine its effects on the outcome of the pregnancy have been carried out
in industrialized countries and the results have been inconclusive. It has been shown
that women with gestational diabetes (GDM) have lower serum zinc levels than healthy
pregnant women, and higher rates of macrosomia. Zinc is required for normal glucose
metabolism, and strengthens the insulin-induced transportation of glucose into cells by
its effect on the insulin signaling pathway. The purpose of this study was to assess the
serum zinc levels of GDM patients and evaluate the effect of zinc supplementation.
Methods: In the first stage of this prospective controlled study, we enrolled 70 women
who were 24-28 weeks pregnant at the Prenatal Care Center of Mirza Kochak Khan
Hospital, Tehran, Iran. The serum zinc level of each subject was determined. In the
second stage, among these 70 subjects, the diabetics receiving insulin were divided into
two groups, only one of which received a zinc supplement and the other group was the
control group. Birth weight of neonates and insulin dosages were recorded.
Results: The mean serum zinc level in the GDM group was lower than that of the
control group (94.83 vs. 103.49mg/dl, respectively) and the mean birth weight of
neonates from the GDM women who received the zinc supplement was lower than that
of the control group (3849g vs. 4136g). The rate of macrosomia was lower in the zinc
supplemented group (20% vs. 53%). The mean of increase of insulin after receiving the
zinc supplement was lower (8.4u vs. 13.53).
Conclusion: Maternal insulin resistance is associated with the accumulation of
maternal fat tissue during early stages of pregnancy and greater fetoplacental nutrient
availability in later stages, when 70% of fetal growth occurs, resulting in macrosomia.
In our study, zinc supplementation is associated with a reduction in the rate of fetal
macrosomia among pregnant women with GDM.
