Fetal macrosomia

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Treatments and drugs

By Mayo Clinic staff

If your health care provider suspects fetal macrosomia, a vaginal delivery isn't necessarily out of the question. However, you'll need to give birth in a hospital — in case forceps or a vacuum device are needed during delivery or a C-section becomes necessary.

Inducing labor — stimulating uterine contractions before labor begins on its own — isn't generally recommended. Research suggests that labor induction doesn't reduce the risk of complications related to fetal macrosomia and might increase the need for a C-section.

In some cases, your health care provider might recommend a C-section. For example:

  • You have diabetes. If you had diabetes before pregnancy or you develop gestational diabetes and your health care provider estimates that your baby weighs 9 pounds, 15 ounces (4,500 grams) or more, a C-section might be the safest way to deliver your baby.
  • Your baby weighs 11 pounds or more and you don't have a history of maternal diabetes. If you don't have pre-gestational or gestational diabetes and your health care provider estimates that your baby weighs 11 pounds (5,000 grams) or more, a C-section might be recommended.
  • You delivered a baby whose shoulder got stuck behind your pelvic bone (shoulder dystocia). If you've delivered one baby with shoulder dystocia, you're at increased risk of the problem occurring again. A C-section might be recommended to avoid the risks associated with shoulder dystocia, such as a fractured collarbone.

If your health care provider recommends an elective C-section, be sure to discuss the risks and benefits. If your health care provider recommends a C-section before week 39 of pregnancy, he or she will test a sample of amniotic fluid — which surrounds and protects your baby during pregnancy — to determine whether your baby's lungs are mature enough for birth (maturity amniocentesis).

After your baby is born, he or she will likely be examined for signs of birth injuries, abnormally low blood sugar (hypoglycemia) and a blood disorder that affects the red blood cell count (polycythemia). He or she might need special care in the hospital's neonatal intensive care unit. Keep in mind that your baby might be at risk of childhood obesity and insulin resistance and should be monitored for these conditions during future checkups.

Also, if you haven't previously been diagnosed with diabetes, after childbirth your health care provider will test you for the condition. During future pregnancies, you'll be closely monitored for signs and symptoms of gestational diabetes — a type of diabetes that develops during pregnancy.

Coping and support Tests and diagnosis
References
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  18. Wegner EK, et al. Operative vaginal delivery. http://www.uptodate.com/index. Accessed March 21, 2012.
  19. McCulloch DK, et al. Prediction and prevention of type 2 diabetes. http://www.uptodate.com/index. Accessed March 21, 2012.
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DS01202 May 24, 2012

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