Objectives: To determine the frequency of fetal macrosomia, to specify the epidemiological and clinical profile of the patients, the methods of delivery, to assess the maternal and perinatal prognosis and the factors associated with complications and the route of delivery at the Maternity of the Social Hygiene Institute Hospital of Dakar. Material and Methods: This was a retrospective, descriptive and analytical study concerning macrosomia deliveries carried out at the Maternity Hospital of the Institute of Social Hygiene between January 1, 2019 and December 31, 2022. The parameters studied were epidemiological and clinical data, delivery characteristics and maternal and perinatal complications. Results: During the study period, we recorded 213 macrosomia deliveries out of a total of 7878 deliveries, representing a frequency of 2.7% of deliveries. The average age of the patients was 29 years old with extremes of 18 and 47 years old. The average gestation was 3 with extremes of 1 and 8. The parity was between 1 and 7 with an average of 1.7. Primipara represented 50.3% of the study population. In our series, maternal history was dominated by gestational diabetes (29.7%) and the history of macrosomia delivery concerned 11.7% of the study population. The majority of patients (83.5%) had benefited from at least 4 prenatal consultations (CPN) and pregnancy monitoring was most often provided by a midwife (61.6%). In most patients (63%), the term of pregnancy on admission was between 37 and 40 weeks + 6 days. In our series, the majority of patients (52.1%) were referred. The diagnosis of macrosomia was most often made in the postnatal period (65.3%). The cephalic presentation (93%) was the most frequent. Childbirth was most often performed by a specialist doctor (85%). Caesarean section was the main way of delivery (59.6%) and it was most often planned (37.1%). The indications for caesarean section were dominated by feto-pelvic disproportion by fetal macrosomia (50.4%) followed by moderately narrowed pelvises (13.5%) and scarred uteri (12.6%). In our series, the Apgar score at the first minute was most often greater than 7 (94.4%). We also recorded 2 stillbirths (0.9%) including a fresh stillbirth and a macerated stillbirth. Almost all of the newborns (95.3%) had an Apgar score at the fifth minute greater than or equal to 7. In our series, the weight of the newborns was between 4000 and 5700 grams with an average of 4194 grams. Most newborns (71.3%) had a birth weight between 4000 and 4299 grams. We also recorded 4 newborns
References
[1]
Arbuckle, T.E. and Sherman, G.J. (1989) An Analysis of Birth Weight by Gestational Age in Canada. Canadian Medical Association Journal, 140, 157-60, 165.
[2]
Institute of Medicine (1990) Nutrition During Pregnancy. National Academy Press, 52-56.
[3]
Alberman, E. (1991) Are Our Babies Becoming Bigger? Journal of the Royal Society of Medicine, 84, 257-260. https://doi.org/10.1177/014107689108400505
[4]
Power, C. (1994) National Trends in Birth Weight: Implications for Future Adult Disease. BMJ, 308, 1270-1271. https://doi.org/10.1136/bmj.308.6939.1270
[5]
Skjærven, R., Gjessing, H.K. and Bakketeig, L.S. (2000) Birthweight by Gestational Age in Norway. Acta Obstetricia et Gynecologica Scandinavica, 79, 440-449. https://doi.org/10.1034/j.1600-0412.2000.079006440.x
[6]
Ridha, F., houssem, R., Latifa, M., Ines, M. and Sabra, H. (2017) Facteurs de risque et pronostic materno-fœtal de la macrosomie fœtale: Étude comparative a propos de 820 cas. Pan African Medical Journal, 28, Article 126. https://doi.org/10.11604/pamj.2017.28.126.8508
[7]
Badji, C.A., Moreau, J.C., Ba, M.G., Diallo, D., Diouf, A., Dotou, C., et al. (1999) The Delivery of the Large Child at Dakar University Hospital: Epidemiology and Prognosis. Médecine d’Afrique Noire, 46, 355-358.
[8]
Klebanoff, M.A., Mills, J.L. and Berendes, H.W. (1985) Mother’s Birth Weight as a Predictor of Macrosomia. American Journal of Obstetrics and Gynecology, 153, 253-257. https://doi.org/10.1016/s0002-9378(85)80107-1
[9]
Diouf, A., Diallo, A., Thiam, M., Faye Dieme, M., Sylla, T., Moreau, J., et al. (2013) Prognosis of Macrosomal Delivery in Africa. Case-Control Study in a Dakar Maternity Hospital. Journal of Sago, 14, 1-4.
[10]
Azzam, I. (2015) Macrosomia about 1270 Cases. Doctorate’s Thesis, Medicine Morocco, 153.
[11]
Boulanger, L., Mubiayi, N., Therby, D., Decocq, J. and Delahousse, G. (2003) Fetal Macrosomia: Experience at the Paul Gellé Maternity Hospital. Journal de Gynécologie, Obstétrique et Biologie de la Reproduction, 132, 8-9.
[12]
Chaouki, N. (2011) Epidemiology and Immediate Prognosis of Macrosomia in the Maternity and Neonatology Department of the Abass Ndao Hospital in Dakar. Doctorate’s Thesis, Université Cheikh Anta Diop de Dakar, 139.
[13]
Vivet-Lefébure, A., Roman, H., Robillard, P.-Y., Laffitte, A., Hulsey, T.C., Camp, G., et al. (2007) Obstetrical and Neonatal Consequences of Gestational Diabetes in the Population of Southern Reunion Island. Gynécologie Obstétrique & Fertilité, 35, 530-535. https://doi.org/10.1016/j.gyobfe.2007.04.010
[14]
Bar, J., Dvir, A., Hod, M., Orvieto, R., Merlob, P. and Neri, A. (2001) Brachial Plexus Injury and Obstetrical Risk Factors. International Journal of Gynecology & Obstetrics, 73, 21-25. https://doi.org/10.1016/s0020-7292(00)00385-4
[15]
Carlotti, N., Moquet, P.Y., Foucher, F. and Laurent, M.C. (2000) Gestational Diabetes: Joint Obstetrical and Endocrine Management. Journal de Gynécologie, Obstétrique et Biologie de la Reproduction, 29, 403-405.
[16]
Hiéronimus, S., Cupelli, C., Durand-Réville, M., Bongain, A. and Fénichel, P. (2004) Pregnancy and Type 2 Diabetes: What Is the Fetal Prognosis? Gynécologie Obstétrique & Fertilité, 32, 23-27. https://doi.org/10.1016/j.gyobfe.2003.10.023
[17]
Lepercq, J., Timsit, J. and Hauguel-de Mouzon, S. (2000) Etiopathogenesis of Fetal Macrosomia. Journal de Gynécologie Obstétrique et Biologie de la Reproduction, 29, 6-12.
[18]
Ballard, J.L., Rosenn, B., Khoury, J.C. and Miodovnik, M. (1993) Diabetic Fetal Macrosomia: Significance of Disproportionate Growth. The Journal of Pediatrics, 122, 115-119. https://doi.org/10.1016/s0022-3476(05)83503-6
[19]
Hayriat, A. (2018) What Route of Delivery for Macrosomia at the Centre Hospitalier National of Pikine about 193 Cases. Doctorate’s Thesis, Université Cheikh Anta Diop de Dakar, 57.
[20]
Ndiaye, O., Sylla, A., Cissé, C.T., Guèye, M., Ndabashinzé, P., Ouattara, A., et al. (2005) Influence of Maternal Overweight on Birth Weight in a Population of Full-term Newborns in Senegal. Journal de Pédiatrie et de Puériculture, 18, 33-37. https://doi.org/10.1016/j.jpp.2004.12.002
[21]
Coulibaly, E. (2009) Large Fetal Delivery at Gabriel Touré University Hospital: Risk Factors and Maternal-Fetal Prognosis. Doctorate’s Thesis, University of Bamako, 108.
[22]
Keita, M. (2014) Epidemio-Clinical Study of Fetal Macrosomia at the Maternity Hospital of the Reference Health Center of Commune IV of the Bamako District from January 1, 2010 to December 31, 2013. Doctorate’s Thesis, University of Bamako, 75.
[23]
Meryem, M.F. (2016) Fetal Macrosomia at Term about 340 Cases. Doctorate’s Thesis, University of Fez, 144.
[24]
Zinzindohoua, F. (2013) Delivery of the Large Fetus at the Maternity Issaka Gazoby of Niamey about a Retrospective Study about 161 Cases Collected from January 1 to December 31, 2012. Doctorate’s Thesis, University of Niamey (Niger), 136.
[25]
Pintiaux, A. and Foidart, J.M. (2005) Gestational Diabetes: An Update. Revue Médicale de Liège, 60, 338-343.
[26]
Ouarda, C., Marzouk, A., Ben Youssef, L. and Chelli, M. (1989) Neonatal and Maternal Prognosis of Delivery of a Large Single Fetus at Term (about 497 Cases). Journal de Gynécologie, Obstétrique et Biologie de la Reproduction, 18, 360-366.