Factors Allowing Delivery of Macrosomia by Vagina Route in N’Djamena Mother and Child University Hospital, Chad

Abstract

Background: Macrosomia is defined as a fetus weight ≥ 4000g or above 10° percentile. It represents a public health problem related to the occurrence of maternal and fetal morbidity and mortality. Objective:  Analyzed factors allowing the delivery of macrosomia by vagina route. Patients and Methods: This was a descriptive-analytical study covering a period of 11 month from January 1st 2024 to November 30th 2024 performed in the maternity of N’djamena Mother and Child University Hospital (NMCUH) about factors allowing delivery of macrosomia by vagina route. All patients consent that delivered macrosomia in NMCUH were included Studied variables were: clinical and prognostic. We used the p-value statistical test to compare the data (significative when ≤ 5%). Results: During the study period, we recorded 81 cases of macrosomia among 3,654 deliveries giving a frequency of 2.2%. Patients with a history of previous macrosomia delivery accounted for 53.1% (p=0.002). Fetus with cephalic presentation predominated with 96.3% (p=0.003), and the pelvis was normal in the majority of cases (80.2%) (p=0.001). The majority of parturient had given birth vaginally (64.2%). Newborns weighted between 4,000-4,500g accounted 75.3% and the Apgar score was 7/10 in 79%. Multiparity was significantly associated with vaginal delivery (p=0.009). Conclusion: Delivery of fetal macrosomia is frequent in our context. Multiparity, normal maternal pelvis and fetus with cephalic presentation are factors with a good prognosis for vaginal delivery.