Hello and welcome to the zero to finals podcast.

My name is Tom and in this episode I'm going to be talking to you about large for gestational age.

And you can find written notes on this topic at zero to finals.com slash LGA or in the antinatal care section of the zero to finals obstetrics and

gynecology book. So let's get straight into it. Babies are defined as being large for gestational age,

also known as macrosomia, when the weight of the newborn is more than 4.5 kilograms at birth.

During pregnancy, an estimated fetal weight above the 90th centile is considered large for gestational age.

Let's talk about the causes of macrosomia, or large for gestational age.

These causes include constitutional, meaning in keeping with the family and the mother's size,

maternal diabetes, previous macrosomia in a previous pregnancy,

maternal obesity or rapid weight gain in the mother,

being overdue for dates, and male babies, which can be bigger.

Let's talk about the risks associated with macrosomia.

The risks to the mother include shoulder

dystosia during the birth, failure to progress in labour, perineal tears, and instrumental

delivery or caesarean section, postpartum hemorrhage or bleeding afterbirth, and uterine rupture, which is rare.

The risks to the baby include a birth injury, for example, an herbs palsy, clavicular fracture,

fetal distress and hypoxia in the fetus, neonatal hypoglycemia where the blood sugar

level drops after birth, obesity in childhood and later life, and type 2 diabetes in adulthood.

A top tip for you, if you only remember two things about macrosomia,

remember that it's caused by gestational diabetes,

and there is a significant risk of shoulder dystasia during birth.

Finally, let's talk about management.

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