Large for dates

Question 1

Risk factors for LGA

Answer 1

DM
Post-term pregnancy
Maternal obesity
Others: previous big baby, male infant, increased maternal height, age,

Question 2

Diagnosis of macrosomia

Answer 2

USS

Question 3

Monitoring macrosomia

Answer 3

Serial USS every 3-4 weeks for high risk women and those with known LGA

Question 4

Management of macrosomia

Answer 4

Induction of labour at 41-2 weeks
Sweep cervix at 41 weeks - then daily CTGs

Elective CS for DM + >4500 and for normal women with estimated >5000g baby

Avoid assisted vaginal delivery

Question 5

Complications of macrosomia

Answer 5

Prolonged labour

Increased foetal morbidity and mortality (shoulder dystocia, brachial plexus palsy, hypoglycaemia, jaundice)

Increased maternal mortality/morbidity - PPH, perineal trauma, puerperal infection