MULTIGRAVIDA DENGAN MAKROSOMIA DAN INTRA UTERINE FETAL DEATH: SUATU STUDI KASUS DI RS ABDUL MOELOEK BANDAR LAMPUNG

Abstract

Background: Macrosomia is the term for newborn with birthweight greater than 4000 grams or are in the 90th percentile for the infant’s gestational age. Macrosomia increases the risk of injury to the mother and fetus during labor. Macrosomia can be prevented or early detected by controlling risk factors. Ilustration case: In this case, macrosomia has caused complication that is intrauterine fetal death. The patient was diagnosed with a G3P1A1, 37-week pregnant in the first phase of the active phase with 3 hours of premature rupture of membranes (outside), a single fetus die, head presentation with macrosomic suspect. Management: Trial of labor performed on patient. The trial of labor failed and the patients can be diagnose with cephalopelvic disproportion, so the patient was treated with caesarean section. Physical Examination: Born baby boy in a dead condition, weight 5400 grams, body length 62 cm with grade I maceration. During surgery, a brownish and thick green amniotic color was obtained which indicates a chronic hypoxic process in the fetus that causes fetal death in this case. The risk factor found on a patient is a history of a previous large baby birth (4100 grams). Antenatal visits are rarely done so that weight during pregnancy is not monitored. Discussion: This case report shows that macrosomia can increase the risk of complications for the mother and baby, especially during labor. Complications can be reduced by preventing and early diagnosing macrosomia by controlling risk factors. Controlling of risk factors can be done with routine antenatal visits.