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Chapter-17 Challenges in the Management of Macrosomia in Diabetic Pregnancy

BOOK TITLE: Clinical Guidelines for Management of Diabetes in Pregnancy

Author
1. Saxena Pikee
2. Singh Abha
3. Soni Raksha
ISBN
9789352703951
DOI
10.5005/jp/books/18049_18
Edition
1/e
Publishing Year
2018
Pages
7
Author Affiliations
1. Lady Hardinge Medical College, New Delhi, India, Lady Hardinge Medical College and SSK Hospital New Delhi, India, Reproductive Biomedicine National Institute of Health and Family Welfare, New Delhi, Lady Hardinge Medical College and Suchitra Kripalani Hospital New Delhi, Lady Hardinge Medical College and Smt Sucheta Kriplani Hospital, New Delhi, India
2. Lady Hardinge Medical College and SSK Hospital, New Delhi, India, Lady Hardinge Medical College and SSK Hospital, New Delhi, JNM Medical College Raipur, Chhattisgarh, India, Lady Hardinge Medical College and Associated Smt. SK Hospital, New Delhi, India, Raipur Medical College, Raipur, Raipur Medical College, Raipur, Chhattisgarh, India, Pt Jawahar Lal Nehru Memorial Medical College, Raipur, Chhattisgarh, India, Lady Hardinge Medical College and Smt Sucheta Kriplani Hospital, New Delhi, India
3. Lady Hardinge Medical College and Smt Sucheta Kriplani Hospital, New Delhi, India
Chapter keywords
Macrosomia, diabetic pregnancy, gestational diabetes mellitus, GDM, hyperglycemia, ultrasonography, infection, postpartum hemorrhage

Abstract

The aim of this chapter is to focus on the management of macrosomia in diabetic pregnancy. The American College of Obstetricians and Gynecologists (ACOG) defined macrosomia as birth-weight over 4,500 g irrespective of gestational age or greater than the 90th percentile for gestational age after correcting for neonatal sex and ethnicity. Macrosomia affects 3–15% of all pregnancies. This chapter covers the risk factors, pathophysiology, diagnosis, complications, and clinical management of the fetus with macrosomia. Fetal macrosomia is associated with a number of maternal and perinatal complications. Maternal complications include infection, postpartum hemorrhage, prolonged labor, high-degree perineal tears, cesarean delivery, anesthetic accidents, and thromboembolic events.

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