Kliniğimizde 2006 - 2008 yılları arasında olan; 4000gram ve üzeri doğumların gebelik özellikleri,maternal, fetal, neonatal komplikasyonları vedoğum şekli açısından analizi /
Yazar: MEHMET GÜL
Danışman: DR. ERBİL ÇAKAR
Sağlık Bakanlığı / ​Zeynep Kamil Kadın ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi / Kadın Hastalıkları ve Doğum Ana Bilim Dalı
Derece: Tıpta Uzmanlık, 2010
Konu: Kadın Hastalıkları ve Doğum = Obstetrics and Gynecology

Özet:
OBSTETRİC CHARACTERİSTİCS AND CONSEQUENCES OF THE PREGNANCİES  WİTH MACROSOMİA
Zeynep Kamil Women's and Children's Disease Training and Research Hospital

Summary 
Objective: To evaluate the relationship complications of the pregnancy, maternal, fetal, neonatal and mode of delivery between  in infants with birth weight 4000 g  and above, and infants with birht weigt between 2500 and 3999 g.
 Materials and Methods: The birth records between 2006 and 2008 in Obstetry Clinic of Zeynep Kamil Women and Children Diseases Education and Research Hospital, were rewieved retrospectively. Study group were occured from 2133 cases with bith weight 4000 g and above, for the control group, 300 cases with birth weight between 2500-3999 g were randomly selected. Pregnancies under 37 weeks gestation, multiple pregnancy and  the cases with IUGR were not included to control group.
Results: Macrosomia (≥ 4kg) was found as 5,15 %.  > 35 years, multiparity, history of macrosomic birth, male gender, anemia, polyhydramnios, postterm  pregnancy rate, mean gestational age, mother's and baby's hospital stay  were higher in macrosomic  group. Diabet rates were not significantly different between the two groups. Ultrasound to predict the weight of big babies, compared to normal birth weight infants were less successful. Big baby / cpd, was determined as the primary risk factor and an indication for primary cesarean section. In  the cases with oxytocin infusion and in macrosomic  group  the duration of  labour was longer and caeserean section rate was higher viewed. Shoulder dystocia was more prevalent in macrosomic infants  and cases with diabetes, uterine atony was only in macrosomic infants. Fetal trauma, in the cases with shoulder dystocia and   who delivered vaginally were more prevalent. Hypoglycemia, were higher in the study group. Hypoglycemia was observed to be higher in larger babies. The rate of perinatal mortality in the study  group was  0.51%, in the control group was not observed.
 Conclusion: In macrosomic groups  who estimated fetal weight less successful with ultrasound, the cesarean section were in very high rates, and in cases delivered vaginally of this group  shoulder dystocia and fetal trauma more frequently observed. 
Key words: macrosomia, estimated fetal weight, shoulder dystocia, fetal trauma

Abstract:
OBSTETRİC CHARACTERİSTİCS AND CONSEQUENCES OF THE PREGNANCİES  WİTH MACROSOMİA
Zeynep Kamil Women's and Children's Disease Training and Research Hospital

Summary 
Objective: To evaluate the relationship complications of the pregnancy, maternal, fetal, neonatal and mode of delivery between  in infants with birth weight 4000 g  and above, and infants with birht weigt between 2500 and 3999 g.
 Materials and Methods: The birth records between 2006 and 2008 in Obstetry Clinic of Zeynep Kamil Women and Children Diseases Education and Research Hospital, were rewieved retrospectively. Study group were occured from 2133 cases with bith weight 4000 g and above, for the control group, 300 cases with birth weight between 2500-3999 g were randomly selected. Pregnancies under 37 weeks gestation, multiple pregnancy and  the cases with IUGR were not included to control group.
Results: Macrosomia (≥ 4kg) was found as 5,15 %.  > 35 years, multiparity, history of macrosomic birth, male gender, anemia, polyhydramnios, postterm  pregnancy rate, mean gestational age, mother's and baby's hospital stay  were higher in macrosomic  group. Diabet rates were not significantly different between the two groups. Ultrasound to predict the weight of big babies, compared to normal birth weight infants were less successful. Big baby / cpd, was determined as the primary risk factor and an indication for primary cesarean section. In  the cases with oxytocin infusion and in macrosomic  group  the duration of  labour was longer and caeserean section rate was higher viewed. Shoulder dystocia was more prevalent in macrosomic infants  and cases with diabetes, uterine atony was only in macrosomic infants. Fetal trauma, in the cases with shoulder dystocia and   who delivered vaginally were more prevalent. Hypoglycemia, were higher in the study group. Hypoglycemia was observed to be higher in larger babies. The rate of perinatal mortality in the study  group was  0.51%, in the control group was not observed.
 Conclusion: In macrosomic groups  who estimated fetal weight less successful with ultrasound, the cesarean section were in very high rates, and in cases delivered vaginally of this group  shoulder dystocia and fetal trauma more frequently observed. 
Key words: macrosomia, estimated fetal weight, shoulder dystocia, fetal trauma