[Neonatal and maternal prognosis in the delivery of a single large fetus at term. Apropos of 497 cases].

We have studied 497 deliveries of large fetuses over a period of two years from 1/1/86 to 31/12/87 in the Maternity Unit of Aziza Othmana. We understand by the term "large fetus" the delivery of a baby weighing 4 kg or more. From this study it appears that: the overall incidence is 6.8% of the deliveries; fetal macrosomia occurs much more frequently in multiparous women who are older; 18.4% of these had large babies previously; diabetes occurred in only 11% of the population studied. We study in this article the complications due to fetal macrosomia during pregnancy, labour and following the delivery. We unfortunately have to report: at fetal level: the mortality is 1.2% and the morbidity is 3.6%; at maternal level: the mortality is nil, the morbidity is 4.6%. Several factors affecting the prognosis were analysed in order to look at the subject from the aetiological and prophylactic points of view (these were the method of delivery, the obstetrical factor, the maternal factors, the factors linked to labour, the factors linked to the pregnancy and other factors).