[Macrosomia. Diagnosis, delivery and complications].

More than 15% of all newborn babies in 1989 in Denmark had a birthweight exceeding 4.000 g, and the incidence is increasing. Risk factors are described in the article. Diagnosing macrosomia before birth is quite difficult, whether using abdominal palpation, ultrasound or measurement of symphysis-fundus height. The foetal weight is often underestimated. Induction of labour due to suspicion of macrosomia is generally not recommended. Macrosomic infants delivered by caesarean section have significantly fewer birth injuries, but the Apgar score is not affected, remaining low. Macrosomia is associated with birth trauma. The severity of the injuries increases with increasing birth weight. More maternal complications are seen as well. Prenatal diagnosis is important. When a macrosomic infant is suspected, ultrasound measurement is recommended after the 38th week. The obstetrician must be trained in the management of shoulder dystocia and should be ready to perform caesarean section. When a birth weight exceeding 5.000 g/5.500 g is suspected, elective caesarean section is recommended.