Likelihood of vaginal delivery in pregnancies complicated by macrosomia

Elly M Xenakis, J. Piper, O. Langer

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To determine the labor characteristics, and likelihood of vaginal delivery in pregnancies complicated by macrosomia. STUDY DESIGN: Consecutive, nondiabetic pregnancies resulting in the delivery of a macrosomic fetus (≥4000 g) were compared to consecutive term non-macrosomic deliveries. Labor characteristics, labor abnormalities and mode of delivery were compared overall, and stratified by type of labor. RESULTS: Cesarean Section Rates (p < 0.05 vs control) No oxylocin Augmented Induced Overall Macro 3.6% (4/110) 23.4% (26/111) 44% (26/59) 20% (56/280) Control 1.7% (19/1137) 12.4% (93/749) 16.2% (58/359) 7.6% (170/2245) Overall, labor abnormalities were more frequent in Macrosomic than Control [15.9% vs 4.7%, O.K. 3.9 (2.6-5.7)]. In the subset of women undergoing induction of labor, the Macrosomic group had higher rates of both arrest of dilation (25.4% vs 6.4%, O.R. 4.7 (2.1-10.3)1 and arrest of descent [8.5% vs 1.1%, O.R. 8.2 (1.8-38)] than the Controls. The Macrosomic cases requiring augmentation also had a higher rate of arrest of descent than Controls [9% vs 2.4%, O.R. 4.98 (2.3-10.9)]. CONCLUSION: Spontaneous labor results in vaginal delivery in the vast majority of macrosomic pregnancies even if augmentation is required. Labor induction, however, has an extremely high risk of failure in the face of macrosomia. Any oxytocin requirement is associated with a greater increase in cesarean section rate for macrosomic than for non-macrosomic pregnancies.

Original languageEnglish (US)
JournalActa Diabetologica Latina
Volume176
Issue number1 PART II
StatePublished - 1997

Fingerprint

Induced Labor
Pregnancy
Cesarean Section
Oxytocin
Dilatation
Fetus

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Likelihood of vaginal delivery in pregnancies complicated by macrosomia. / Xenakis, Elly M; Piper, J.; Langer, O.

In: Acta Diabetologica Latina, Vol. 176, No. 1 PART II, 1997.

Research output: Contribution to journalArticle

@article{6d4fa065e07447bbac5414e348b5932e,
title = "Likelihood of vaginal delivery in pregnancies complicated by macrosomia",
abstract = "OBJECTIVE: To determine the labor characteristics, and likelihood of vaginal delivery in pregnancies complicated by macrosomia. STUDY DESIGN: Consecutive, nondiabetic pregnancies resulting in the delivery of a macrosomic fetus (≥4000 g) were compared to consecutive term non-macrosomic deliveries. Labor characteristics, labor abnormalities and mode of delivery were compared overall, and stratified by type of labor. RESULTS: Cesarean Section Rates (p < 0.05 vs control) No oxylocin Augmented Induced Overall Macro 3.6{\%} (4/110) 23.4{\%} (26/111) 44{\%} (26/59) 20{\%} (56/280) Control 1.7{\%} (19/1137) 12.4{\%} (93/749) 16.2{\%} (58/359) 7.6{\%} (170/2245) Overall, labor abnormalities were more frequent in Macrosomic than Control [15.9{\%} vs 4.7{\%}, O.K. 3.9 (2.6-5.7)]. In the subset of women undergoing induction of labor, the Macrosomic group had higher rates of both arrest of dilation (25.4{\%} vs 6.4{\%}, O.R. 4.7 (2.1-10.3)1 and arrest of descent [8.5{\%} vs 1.1{\%}, O.R. 8.2 (1.8-38)] than the Controls. The Macrosomic cases requiring augmentation also had a higher rate of arrest of descent than Controls [9{\%} vs 2.4{\%}, O.R. 4.98 (2.3-10.9)]. CONCLUSION: Spontaneous labor results in vaginal delivery in the vast majority of macrosomic pregnancies even if augmentation is required. Labor induction, however, has an extremely high risk of failure in the face of macrosomia. Any oxytocin requirement is associated with a greater increase in cesarean section rate for macrosomic than for non-macrosomic pregnancies.",
author = "Xenakis, {Elly M} and J. Piper and O. Langer",
year = "1997",
language = "English (US)",
volume = "176",
journal = "Acta Diabetologica",
issn = "0940-5429",
publisher = "Springer-Verlag Italia",
number = "1 PART II",

}

TY - JOUR

T1 - Likelihood of vaginal delivery in pregnancies complicated by macrosomia

AU - Xenakis, Elly M

AU - Piper, J.

AU - Langer, O.

PY - 1997

Y1 - 1997

N2 - OBJECTIVE: To determine the labor characteristics, and likelihood of vaginal delivery in pregnancies complicated by macrosomia. STUDY DESIGN: Consecutive, nondiabetic pregnancies resulting in the delivery of a macrosomic fetus (≥4000 g) were compared to consecutive term non-macrosomic deliveries. Labor characteristics, labor abnormalities and mode of delivery were compared overall, and stratified by type of labor. RESULTS: Cesarean Section Rates (p < 0.05 vs control) No oxylocin Augmented Induced Overall Macro 3.6% (4/110) 23.4% (26/111) 44% (26/59) 20% (56/280) Control 1.7% (19/1137) 12.4% (93/749) 16.2% (58/359) 7.6% (170/2245) Overall, labor abnormalities were more frequent in Macrosomic than Control [15.9% vs 4.7%, O.K. 3.9 (2.6-5.7)]. In the subset of women undergoing induction of labor, the Macrosomic group had higher rates of both arrest of dilation (25.4% vs 6.4%, O.R. 4.7 (2.1-10.3)1 and arrest of descent [8.5% vs 1.1%, O.R. 8.2 (1.8-38)] than the Controls. The Macrosomic cases requiring augmentation also had a higher rate of arrest of descent than Controls [9% vs 2.4%, O.R. 4.98 (2.3-10.9)]. CONCLUSION: Spontaneous labor results in vaginal delivery in the vast majority of macrosomic pregnancies even if augmentation is required. Labor induction, however, has an extremely high risk of failure in the face of macrosomia. Any oxytocin requirement is associated with a greater increase in cesarean section rate for macrosomic than for non-macrosomic pregnancies.

AB - OBJECTIVE: To determine the labor characteristics, and likelihood of vaginal delivery in pregnancies complicated by macrosomia. STUDY DESIGN: Consecutive, nondiabetic pregnancies resulting in the delivery of a macrosomic fetus (≥4000 g) were compared to consecutive term non-macrosomic deliveries. Labor characteristics, labor abnormalities and mode of delivery were compared overall, and stratified by type of labor. RESULTS: Cesarean Section Rates (p < 0.05 vs control) No oxylocin Augmented Induced Overall Macro 3.6% (4/110) 23.4% (26/111) 44% (26/59) 20% (56/280) Control 1.7% (19/1137) 12.4% (93/749) 16.2% (58/359) 7.6% (170/2245) Overall, labor abnormalities were more frequent in Macrosomic than Control [15.9% vs 4.7%, O.K. 3.9 (2.6-5.7)]. In the subset of women undergoing induction of labor, the Macrosomic group had higher rates of both arrest of dilation (25.4% vs 6.4%, O.R. 4.7 (2.1-10.3)1 and arrest of descent [8.5% vs 1.1%, O.R. 8.2 (1.8-38)] than the Controls. The Macrosomic cases requiring augmentation also had a higher rate of arrest of descent than Controls [9% vs 2.4%, O.R. 4.98 (2.3-10.9)]. CONCLUSION: Spontaneous labor results in vaginal delivery in the vast majority of macrosomic pregnancies even if augmentation is required. Labor induction, however, has an extremely high risk of failure in the face of macrosomia. Any oxytocin requirement is associated with a greater increase in cesarean section rate for macrosomic than for non-macrosomic pregnancies.

UR - http://www.scopus.com/inward/record.url?scp=33748619750&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33748619750&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:33748619750

VL - 176

JO - Acta Diabetologica

JF - Acta Diabetologica

SN - 0940-5429

IS - 1 PART II

ER -