A study of 57 629 women with GDM reported that the prevalence of caesarean delivery, macrosomia
, preterm birth and pre-eclampsia was 27.8%, 15.7%, 8.4% and 2.6%, respectively.
Looking at nearby Trusts, St Helens has one of the highest rates of children born with macrosomia
, with 11%.
Most researches focused on identifying risk factors at the first trimester for GDM development, including family predisposition, increased maternal age, cultural background, high Body Mass Index (BMI), elevated C-reactive protein levels and history of fetal macrosomia
.8 Fasting plasma glucose (FPG) is a predictive index for type 2 diabetes.
Insulin is therefore recommended for management of gestational diabetes to prevent babies from development of macrosomia
which may also help in planning vaginal delivery and can reduce cesarean sections rate as well.
There is positive association between gestational weight gain and GDM, macrosomia
, GHTN and pre-eclampsia (Table 3).
Neonatal adverse outcomes included neonatal care unit admission rate, hypoglycemia, hyperbilirubinemia, RDS, macrosomia
, congenital malformations, and neonatal death.
(8) have reported a different de novo HNF4A mutation at the same position (p.C93S, c.278 G>C) leading to a diazoxide responsive hyperinsulinemic hypoglycemia that was diagnosed within the first week of life in a patient born with macrosomia
El normopeso se dio en 47 RN (47/84:56%), seguido del bajo peso (30/84:35,7%), macrosomia
(3/84:3,6%) y muy bajo peso (2/84:2,4%).
Son escasos los reportes de casos de Dumping en la gestacion y hay una tendencia a subestimar la implicacion sobre el bienestar maternofetal, puesto que dan prioridad al riesgo de diabetes gestacional y macrosomia
fetal sobre los efectos indeseables como la hipoglucemia al aumentar los requerimientos metabolicos durante el embarazo.
Though late-gestation fetal growth lowers the risk of perinatal mortality, fetal macrosomia
can cause labor complications that may raise the risk of perinatal death [1, 11].
is a term used to describe an estimated foetal weight or birthweight of more than 4500 g, but a birthweight above 4000 g is also commonly used to define this condition.
Aside from early-onset diabetes, HNF4A mutations have been associated with increased birth weight and macrosomia