Macrosomia

Question 1

What are the risk factors for macrosomia?

Answer 1

Diabetes (all types, including gestational)
Abnormal 1-hour glucose screen with a normal 3-hour glucose tolerance test
Previous birth of an infant > 4000g
Maternal pre-pregnant obesity
Excessive prenatal weight gain
Prolonged pregnancy
Male fetus
High paternal birth weight

Question 2

How might macrosomia present? (specific subjective and objective findings)

Answer 2

Fundal height growth pattern > 3 cm more than expected for gestation
Woman’s perception

Question 3

What are the differential diagnoses for those subjective and objective findings?

Question 4

What are the diagnostic criteria for macrosomia?

Answer 4

U/S
Leopold maneuvers

Question 5

What are the components of a management plan for a client with macrosomia?

Answer 5

Elective cesarean birth:
- estimated fetal weight of at least 5000g in women without diabetes
-At least 4,500 in women with diabetes

Question 6

When and how does a WHNP involve other members of the health care team for a client with macrosomia?