{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T06:14:14Z","timestamp":1773900854672,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,2,17]],"date-time":"2015-02-17T00:00:00Z","timestamp":1424131200000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Management of extremely large birthweight infants presents challenges during the period of labour and delivery. We sought to examine outcomes in infants with extreme macrosomia (birthweight\u00a0&gt;\u00a05000\u00a0g), at an institution where the management of labour is standardised.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>This is a retrospective analysis of prospectively gathered data on all infants with a birthweight &gt;5000\u00a0g delivered at a tertiary level institution from 2008 to 2012. Details of labour characteristics and outcomes were examined; these were compared according to parity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the study period, there were 46\u00a0128 deliveries at the hospital and 182 infants with a birthweight &gt;5000\u00a0g, giving an incidence of 0.4%. The majority of women (133\/182) were multiparous. Among nulliparas, 47% (23\/49) had a vaginal delivery, while 53% (26\/49) had a caesarean delivery. 86% (97\/113) of multiparas had a vaginal delivery, and 14% (16\/113) had a caesarean delivery. 43% (69\/162) required induction of labour. This was more common in nulliparous compared with multiparous women (58% [29\/49] vs 30% [40\/133], <jats:italic>P<\/jats:italic>\u00a0=\u00a00.005, <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a03.4, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a01.7\u20136.6). A total of 30% (49\/162) of women had their labour accelerated with oxytocin. There were higher rates of oxytocin use in nulliparas than in multiparas (55% [27\/49] vs 16.5% [22\/133], <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001, <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a06.2, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a03\u201312.8). Seventeen of the 120 infants delivered vaginally had a shoulder dystocia (14.2%), with three suffering an Erbs palsy, all of which had resolved before 6\u00a0months of age. One baby had a clavicular fracture.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Extreme macrosomia affects 0.4% of pregnancies in contemporary practice. Multiparas have a low rate of caesarean section. Infants delivered vaginally are at increased risk of shoulder dystocia and associated complications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.12285","type":"journal-article","created":{"date-parts":[[2015,2,17]],"date-time":"2015-02-17T13:38:42Z","timestamp":1424180322000},"page":"42-46","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Extreme macrosomia \u2013 Obstetric outcomes and complications in birthweights &gt;5000\u00a0g"],"prefix":"10.1111","volume":"55","author":[{"given":"Mark P.","family":"Hehir","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology National Maternity Hospital Holles St. Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann F.","family":"Mchugh","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology National Maternity Hospital Holles St. Dublin 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