Fetal macrosomia is a medical term used to describe a newborn with an excessive birth weight, typically defined as a baby weighing more than 8 pounds, 13 ounces, regardless of gestational age. In more severe cases, macrosomia is defined as a birth weight exceeding 9 pounds, 15 ounces. This condition poses significant challenges during childbirth and can increase the risk of a range of birth injuries for both the infant and the mother.
Causes and Risk Factors of Fetal Macrosomia
Fetal macrosomia can result from various maternal and fetal factors, including:
- Maternal diabetes: Both gestational diabetes and pre-existing diabetes are among the most common causes of macrosomia. Excess glucose in the mother’s bloodstream crosses the placenta and triggers increased insulin production in the fetus, leading to excessive growth.
- Obesity: Pregnant individuals who are overweight or obese are more likely to deliver babies with macrosomia due to altered metabolic and hormonal regulation.
- Excessive weight gain during pregnancy: Gaining more weight than recommended during pregnancy can contribute to higher birth weight.
- Post-term pregnancy: Babies born after 40 weeks of gestation have more time to grow and are at higher risk of having macrosomia.
- Genetic factors: Family history and genetic predisposition can influence fetal size. Tall or large-framed parents may naturally have larger babies.
Potential Birth Injuries Caused by Fetal Macrosomia
The size of an infant with macrosomia can complicate the birthing process, particularly in vaginal deliveries, increasing the risk of both maternal and neonatal injuries. Below are some common birth injuries associated with fetal macrosomia:
Shoulder Dystocia
One of the most significant risks during the delivery of a baby with macrosomia is shoulder dystocia, a condition in which the baby’s shoulders become lodged behind the mother’s pelvic bone after the head has been delivered. This is a medical emergency that requires immediate intervention. Shoulder dystocia can cause:
- Brachial plexus injury: Damage to the network of nerves that control movement and sensation in the arms and hands. This can result in weakness, loss of movement or brachial plexus palsy (Erb’s palsy).
- Clavicle or humerus fractures: The use of physical manipulation by the doctor to dislodge the shoulders can lead to broken bones.
- Asphyxia or brain injury: If the baby is stuck for too long, it may be deprived of oxygen, leading to hypoxic-ischemic encephalopathy (HIE) or permanent brain damage.
Birth Asphyxia
Infants with macrosomia may be more difficult to deliver, and prolonged or obstructed labor can lead to reduced oxygen supply during birth. This can cause a range of complications, from temporary respiratory distress to permanent neurological damage.
Cephalohematoma and Caput Succedaneum
Larger infants often experience trauma to the head during delivery. Cephalohematoma (bleeding under the skull bone) and caput succedaneum (swelling of the scalp) are more common due to pressure during passage through the birth canal or from the use of instruments like forceps or vacuum extractors.
Respiratory Issues
Infants with macrosomia are at increased risk for transient tachypnea of the newborn and other breathing difficulties, especially if delivered via cesarean section (C-section) or before their lungs are fully mature.
Diagnosis and Monitoring
Early diagnosis of fetal macrosomia is critical to managing potential risks. Diagnosis may involve:
- Ultrasound: Used to estimate fetal weight, though it has a margin of error.
- Fundal height measurement: An unusually large measurement may prompt further investigation.
- Maternal history and risk assessment: Knowing the mother’s weight gain, diabetes status and previous deliveries helps identify at-risk pregnancies.
Preventing or managing fetal macrosomia involves proactive prenatal care. For example, strict blood glucose control in diabetic pregnancies can reduce the risk of macrosomia and associated complications. Monitoring and maintaining appropriate weight gain during pregnancy helps minimize excessive fetal growth.
When macrosomia is suspected, healthcare providers may recommend a C-section, especially if the estimated fetal weight exceeds 4,500 grams in diabetic mothers or 5,000 grams in non-diabetic mothers.
Contacting an Experienced Lawyer
The experienced York personal injury attorneys at the Law Offices of Kenneth A. Wilhelm can help you better understand your legal rights and options, and also fight hard to recover just compensation for you. One of our clients secured a $2,850,000 verdict in an Erb’s palsy (brachial plexus palsy) case that was reduced by the appeals court to $1,846,000 because the verdict was so large. This was the highest amount upheld by the appellate (appeals)courts for many, many years. In addition we recovered $1,400,000 for a newborn who lost motion in the arm during birth due to doctors applying incorrect force on the baby’s head. Also, one of our clients obtained a verdict for $43,940,000 and another of our clients got a verdict for $23,500,000, both in medical malpractice cases.
We have seen cases where New York City Health and Hospital Corporation facilities deliver babies who are born with brachial plexus palsy (Erb’s palsy) stemming from negligence (carelessness), and/or medical malpractice in the labor and delivery etc. of the children. The following list identifies some of these hospitals (operated by New York City Health and Hospitals Corporation):
- Jacobi Hospital aka Bronx Municipal 1400 Pelham Parkway South Bronx, New York 10461 718-918-5000
- Lincoln Hospital 234 East 149th Street Bronx, New York 10451 718-579-5000
- North Central Bronx Hospital 3424 Kossuth Avenue Bronx, New York 10467 718-519-5000
- Coney Island Hospital 2601 Ocean Parkway Brooklyn, New York 11235 718-616-3000
- Kings County Hospital 451 Clarkson Avenue Brooklyn, New York 11203 718-245-3131
- Woodhull Hospital 760 Broadway Brooklyn, New York 11206 718-963-8000
- Bellevue Hospital 462 First Avenue New York, New York 10016 212-562-5555
- Harlem Hospital 506 Lenox Avenue New York, New York 10037 212-939-1000
- Metropolitan Hospital 1901 First Avenue New York, New York 10029 212-423-6262
- Elmhurst Hospital 79-01 Broadway Elmhurst, New York 11373 718-334-4000
- Queens Hospital Center 82-68 164th Street Jamaica, New York 11432 718-883-3000
Please contact us TOLL FREE 24 hours a day, 7 days a week at 1-800-WORK-4-YOU (1-800-967-5496). WE CAN EVEN COME TO YOU. There is no attorneys’ fee unless we recover money for you. We can also help with personal injury, lead poisoning and medical malpractice cases including, brachial plexus palsy (Erb’s palsy) and cerebral palsy cases in New York, New Jersey, Connecticut, Pennsylvania, or Florida. If you have been seriously injured in any of the 50 U.S. states, please call us and we will try to help you with your case.
Other TOLL FREE phone numbers for us are:
1-800-RADIO-LAW, 1-888-WYPADEK, OR 1-800-LAS-LEYES
Please visit us at: www.WORK4YOULAW.com