Fetal macrosomia and<unk>  often do not present with noticeable patient symptoms. Important signs include<unk>  fundal height (uterus size) and excessive amniotic fluid (polyhydramnios). Fundal height can be measured from the top of the uterus to the pubic bone and indicates that the newborn is likely<unk>  in volume. Excessive amniotic fluid indicates that the fetus’ urine output is<unk> r than expected, indicating a<unk> r baby than normal; some symptoms of excessive amniotic fluid include *shortness of breath *swelling of lower extremities & abdominal wall *uterine discomfort or contractions *fetal malposition, such as breech presentation. Complications<unk>  or macrosomic births can lead to complications for both the mother and the infant. Infant complications Common risks in<unk>  babies include shoulder dystocia, hypoglycemia, brachial plexus injuries, metatarsus adductus, hip subluxation and talipes calcaneovalgus, due to intrauterine deformation. Shoulder dystocia occurs when the infant's shoulder becomes impacted on the mother's pubic symphysis during birth. Newborns with shoulder dystocia are at risk of temporary or permanent nerve damage to the baby's arm, or other injuries such as fracture. Both increased birth weight and diabetes in the<unk>  parent are independent risk factors seen to increase risk of shoulder dystocia. In non-diabetic women, shoulder dystocia happens 0.65% of the time in babies that weigh less than , 6.7% of the time in babies that weigh to , and 14.5% of the time in babies that weigh more than . In diabetic women, shoulder dystocia happens 2.2% of the time in babies that weigh less than 8 pounds 13 ounces (4,000 g), 13.9% of the time in babies that weigh 8 pounds 13 ounces (4,000 g) to 9 pounds 15 ounces (4,500 g), and 52.5% of the time in babies that weigh more than 9 pounds 15 ounces (4,500 g). Although<unk> r babies are at higher risk for shoulder dystocia, most cases of shoulder dystocia happen in smaller babies because there are many more small and normal-size babies being born than<unk>  babies.<unk>  babies are at higher risk of hypoglycemia in the neonatal period, independent of whether the mother has diabetes. Hypoglycemia, as well as hyperbilirubinemia and polycythemia, occur as a result of hyperinsulinemia in the fetus. High birth weight may also impact the baby in the long term as studies have shown associations with increased risk of overweight, obesity, and type 2 diabetes mellitus. Studies have shown that the long-term overweight risk is doubled when the birth weight is greater than 4,000 g. The risk of type 2 diabetes mellitus as an adult is 19% higher babies weighing more than 4,500 g at birth compared to those with birth weights between 4,000 g and 4,500 g. Pregnant mother complications Complications of the pregnant mother include: emergency cesarean section, postpartum hemorrhage, and obstetric anal sphincter injury. Compared to pregnancies without macrosomia, pregnant women giving birth to newborns weighing between 4,000 grams and 4,500 grams are at two times greater risk of complications, and those giving birth to infants over 4,500 grams are at three times greater risk.Schematic representation of macrosomia/LGA risk factors and related complications.
Large for gestational age
Small for gestational age
Low Birth Weight
Breech birth
Vanishing twin
Low birth weight
Fetal hydantoin syndrome
Neonatal hypocalcemia