TITLE:
Delivery of the Macrosome Fetus at the Institute of Social Hygiene Hospital in Dakar
AUTHORS:
Fatou Samb, Mouhamadou Mansour Niang, Awa Chekh Thiécouba Gueye, Younoussa Keita, Cheikh Tidiane Cisse
KEYWORDS:
Fetal Macrosomia, Diabetes, Cesarean Section, Maternal-Fetal, IHS Prognosis
JOURNAL NAME:
Advances in Reproductive Sciences,
Vol.14 No.1,
February
5,
2026
ABSTRACT: Objectives: To determine the frequency of fetal macrosomia, to specify the epidemiological and clinical profile of the patients, the methods of delivery, to assess the maternal and perinatal prognosis and the factors associated with complications and the route of delivery at the Maternity of the Social Hygiene Institute Hospital of Dakar. Material and Methods: This was a retrospective, descriptive and analytical study concerning macrosomia deliveries carried out at the Maternity Hospital of the Institute of Social Hygiene between January 1, 2019 and December 31, 2022. The parameters studied were epidemiological and clinical data, delivery characteristics and maternal and perinatal complications. Results: During the study period, we recorded 213 macrosomia deliveries out of a total of 7878 deliveries, representing a frequency of 2.7% of deliveries. The average age of the patients was 29 years old with extremes of 18 and 47 years old. The average gestation was 3 with extremes of 1 and 8. The parity was between 1 and 7 with an average of 1.7. Primipara represented 50.3% of the study population. In our series, maternal history was dominated by gestational diabetes (29.7%) and the history of macrosomia delivery concerned 11.7% of the study population. The majority of patients (83.5%) had benefited from at least 4 prenatal consultations (CPN) and pregnancy monitoring was most often provided by a midwife (61.6%). In most patients (63%), the term of pregnancy on admission was between 37 and 40 weeks + 6 days. In our series, the majority of patients (52.1%) were referred. The diagnosis of macrosomia was most often made in the postnatal period (65.3%). The cephalic presentation (93%) was the most frequent. Childbirth was most often performed by a specialist doctor (85%). Caesarean section was the main way of delivery (59.6%) and it was most often planned (37.1%). The indications for caesarean section were dominated by feto-pelvic disproportion by fetal macrosomia (50.4%) followed by moderately narrowed pelvises (13.5%) and scarred uteri (12.6%). In our series, the Apgar score at the first minute was most often greater than 7 (94.4%). We also recorded 2 stillbirths (0.9%) including a fresh stillbirth and a macerated stillbirth. Almost all of the newborns (95.3%) had an Apgar score at the fifth minute greater than or equal to 7. In our series, the weight of the newborns was between 4000 and 5700 grams with an average of 4194 grams. Most newborns (71.3%) had a birth weight between 4000 and 4299 grams. We also recorded 4 newborns (1.9%) weighing more than or equal to 5000 grams. Live births were 211 (99%) and most newborns (63.9%) had no complications. Fifty of them were resuscitated at birth (23.5%) and we recorded 10 cases of neonatal asphyxia (4.7%) and 2 perinatal deaths, i.e., a perinatal mortality of 9.4 per 1000 live births. Perinatal complications were more frequent in cases of maternal pathology (p = 0.0001), overterm (p = 0.0003), caesarean section (p = 0.0002), and when the diagnosis of macrosomia was retrospective (p = 0.00006). We recorded 15 perineal tears (7.2%), one case of postpartum hemorrhage (0.4%) and one uterine rupture (0.4%). Maternal complications were more frequent in patients who came to consult on their own (p = 0.42), pauciparous women (p = 0.11), and when the birth weight was greater than or equal to 5000 grams (p = 0.13). We have not recorded any maternal deaths. Conclusion: The frequency of fetal macrosomia is increasing more and more in our practice and the main risk factor is gestational diabetes. A good follow-up of the pregnancy and monitoring of the work allowed us to record low rates of maternal and perinatal complications.