ABSTRACT
Fetal macrosomia is a known intrapartum risk factor for fetal injury and maternal
morbidity. The purpose of this study was to review our experience with macrosomic
fetuses in nondiabetic pregnancies and compare perinatal outcomes between those whose
labor had been spontaneous or induced. Between January 1989 and December 1991, the
186 pregnancies of infants with birthweights greater than 4000 g (4001 to 5131 g)
underwent labor that had been induced (46) or spontaneous (140). Cesarean delivery
was more common after induced than spontaneous labor (11 [23.9%] vs 14 [10.0%]; P < 0.03) regardless of parity or gestational age. Frequencies of shoulder dystocia,
1-minute Apgar scores less than 7, and abnormal umbilical blood gas determinations
were not different between the two groups. We conclude that spontaneous rather than
induced labor is associated with a lower chance of cesarean delivery among those fetuses
with birthweights 4000 g or more.
Keywords
Fetal macrosomia - labor - induction of labor
