Retrospective Study on the Large for Gestational Age cases from SSBH, Brunei

Abstract

Introduction: Large-for-gestational-age babies are at high risk for short-term outcomes such as shoulder dystocia, neonatal hypoglycaemia and birth trauma. Macrosomic babies are defined as those with birth weights of >4,000 g, irrespective of gestational age, sex, or country/region-specific differences in mean birth weight and maternal body weight. In the recent past, the rate of large-for-gestational-age [LGA] babies, has increased all over the world. Purpose This study is aimed to investigate the prevalence of macrosomia/LGA in Suri Seri Begawan Hospital (SSBH) and to determine the maternal and fetal outcomes. Methodology: The selected universe for the study is at Suri Seri Begawan Hospital, for the time duration of 2 consecutive years (2018-19). The secondary data is used to calculate a prevalence. Result: The prevalence of 1.9% was found in this study (all >4 kg) and 75% of male babies were born as macrosomia/LGA. 19% of the participants delivered big babies before, and 27% were diabetic in this current pregnancy. 63.6% were delivered by spontaneous vaginal delivery, and there was 1 shoulder dystocia with a 4.1 kg weighed baby. One LSCS wound infection and one vaginal haematoma occurred in this study, although only 21% of babies were admitted to the neonatal unit. Conclusion: The current study draws its conclusion based on the findings that macrosomia/LGAs in SSBH are not as high as like China. Expectant management was practiced in most of the cases and outcome wise is acceptable ensuring our management protocol was safe. Large-for-gestational-age babies are at high risk for shoulder dystocia with brachial plexus injury, which is of great concern for all obstetricians. The management of macrosomia/LGA pregnancy should be individualized by taking into account all maternal and foetal factors as well as all available diagnostic tools. Obstetricians should be vigilant and careful with proper clinical judgement and early recognition of possible complications.