POSTMATURITY AND FETAL MACROSOMIA IN JOS, NIGERIA

Abstract

Background: One of the risk factors of post term pregnancy is fetal macrosomia. The excessively large infant presents a recurring and potentially serious obstetric problem. Methods:This was a retrospective study of all consecutive births in the maternity unit, Jos University Teaching Hospital, Jos, Nigeria, between January 1998 and December 2001. The case records of all mothers of babies born with weight of 4000g and above were retrieved and data collated and analyzed for total deliveries, maternal and fetal characteristics, complications and outcome of pregnancy. Results:Macrosomic infants (4000g and above) were 286 cases representing 2.9% of all deliveries. Ten (3.5%) of the infants with macrosomia were preterm, 90.9% were term, and 5.6% were post-term. The mean age and parity of the mothers with pregnancies at term was 29.2 years, and 3.2 respectively. The post term mothers had a mean age and parity of 32.7 years and 3.8 respectively. Maternal morbidity included increased caesarean delivery, and vaginal trauma (episiotomies, tears and bruises) in both groups. Caesarean section was the mode of delivery in 31.3% of post term and 27.6% term infants, while the indication for caesarean section was cephalopelvic disproportion in 80% and 87.3% for post term and term infants respectively. Fetal complications were birth asphyxia and stillbirth. There were no gross fetal abnormalities recorded in the series. Still birth rate was 8.1% and 12.5% in term and post term infants respectively. Conclusion: Post term pregnancies account for macrosomic babies in our facility, posing an increased risk to the mother and fetus. Early diagnosis, intrapartum fetal monitoring and recourse to operative delivery may improve the fetal outcome of these infants. A correction to this article has been issued in Annals of African Medicine, Vol. 4, No. 3, 2005, pp. 141. Please see the full text HTML document for further details