medical notes

Apr 17th, 2015
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MACROSOMIADefinition: The term macrosomia is used to describe a newborn with anexcessive birth weight. A diagnosis of fetal macrosomia can be made only bymeasuring birth weight after delivery; therefore, the condition isconfirmed only retrospectively, i.e. after delivery of the neonate. Macrosomia refers to growth beyond a specific threshold Macrosomia is generally used to refer to fetuses with anestimated fetal weight greater than or equal to 4000 g. However, some feel that macrosomia should be defined asgreater than 4500 g, greater than 90th percentile, or greaterthan 2 standard deviations above the mean for weight at anyparticular gestational age. The most common thresholds that have been proposed areweight above 4000 g, 4500 g, or 4536 g (ie,10 pounds) A grading system has also been suggested: grade 1 for infants 4000 to 4499 g, grade 2 for 4500 to 4999 g, grade 3 for over 5000 g The American College of Obstetricians and Gynecologistssupports use of the 4500 g threshold for diagnosis ofmacrosomia because morbidity increases sharply beyond thisweight, but acknowledges there is some increased risk ofmorbidity at weights >4000 gEpidemiology The worldwide prevalence of the birth of infants 4000 g isapproximately 9 percent, with wide variations between countries Fetal macrosomia is encountered in up to 10% of deliveries Variation in the percentage of macrosomia in different ethnicgroups has been observed

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