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macrosomia fetal complications, macrosomia fetal can cause what disease

macrosomia fetal complications, macrosomia fetal can cause what disease

Complications of fetal macrosomia

Common complications: uterine rupture postpartum hemorrhage neonatal asphyxia meconium aspiration syndrome scalp hematoma neonatal hypoglycemia

1. The incidence of shoulder dystocia increases in patients with vaginal delivery of macrosomia, especially diabetic macrosomia. The incidence of shoulder dystocia was 15% in neonates with birth weight > 4500g in non-diabetic pregnancy. The incidence of shoulder dystocia is about 7% in those with birth weight above 4000g and below 4500g. The incidence of shoulder dystocia is less than 1% in those with birth weight【小于】4000g. However, in gestational diabetes mellitus patients, the incidence of shoulder dystocia in the three groups was 50%, 14% and 1.2%, respectively. If shoulder dystocia is not handled properly or delayed, serious complications and even life-threatening may occur, such as neonatal asphyxia, meconium aspiration syndrome and various birth injuries. Head injuries may include scalp hematoma, intracranial hemorrhage, facial paralysis, brachial plexus injury, clavicle fracture, humeral fracture, etc., and even phrenic nerve injury.

2. Cephalopelvic dissymmetry Due to the large fetal head of macrosomia, the pelvis of pregnant women is relatively narrow, and the incidence of cephalopelvic dissymmetry increases. In the fetal head biparietal diameter is larger, until the fetal head does not enter the basin after labor: the performance is prolonged in the first stage of labor: if the fetal head is shelved above the pelvic entrance plane, it is called riding sign positive. The second stage of labor is prolonged: if the biparietal diameter is relatively smaller than the thoracoabdominal diameter, the descent of fetal head is blocked. Secondary uterine atony is easily caused by prolonged labor; At the same time, the uterine volume of macrosomia is large, the tension of uterine muscle fibers is high, and excessive traction of muscle fibers is prone to primary uterine atony; Uterine atony, in turn, leads to prolonged labor, abnormal fetal position, soft birth canal laceration, postpartum uterine atony, postpartum hemorrhage and other complications. Due to the increase of dystocia rate, the incidence of cesarean section and vaginal operation (forceps and aspirators) increases. If it is not handled in time in backward areas, uterine rupture can occur; In cities, the cesarean section rate of macrosomia can be increased due to the prevention of dystocia.

3. Neonatal diseases are prone to neonatal respiratory distress syndrome because high concentration of insulin can reduce the concentration of glycerol 3-phosphate and dioxyacetone, thus inhibiting the synthesis of phospholipids. Because of the long-term hyperglycemia environment, the pancreatic secretion function of the fetus of gestational diabetes mellitus or pregnant women with diabetes mellitus is hyperfunction. If the energy is not replenished in time after delivery, the newborn is prone to hypoglycemia, which may endanger the life of the newborn or cause irreversible brain injury. In addition, the incidence of hypocalcemia, hyperbilirubinemia and polycythemia increases in macrosomia.

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