HipertrofiÄno nedonoÅ¡?e

Abstract

Hypertrophy or excessive fetal growth denotes infant with birth weight greater than ninety percentile for gestational age or term newborns with birth weight greater than 4000 grams. In the overall perinatal population hypertrophic newborns accounts for about 10%, while the incidence of hypertrophic premature infants is 1.09%.The etiology of newbors hypertrophyis multifactorial. Risk factors are genetic predisposition, maternal age over30 years, male gender, diabetes of mothers, infants with Beckwith-Wiedemann syndrome, fetal erythroblastosis, transposition of the great arteries and others. During vaginal delivery of hypertrophic newborns there is a greater risk for complications for the mother and the newborn like shoulder dystocia in the birth canal and brachial plexus injury and increased risk of bleeding after childbirth and disruption of soft parts of maternity channel.Perinatal morbidity ofhypertrophic newborns is twice higher compared toeutrophic newborns mostly because birth trauma or hypoglycemia which usually occurs 1-2 hours after birth due to fetal hyperinsulinemia present.In the hypertrophicinfantsperinatal asphyxia, caesarean section, meconium aspiration, hypocalcemia,hyperbilirubinemia, respiratory distress syndrome, dystocia shoulder are more common. The negative consequences of increased fetal growth are not limited only to the perinatal period. Compared with normal birth weight infants, hypertrophic newborns have increasedrisk of obesity, coronary heart disease, hypertension and diabetes mellitus type 2 in adolescence and adulthood.The aim is to highlight the importance of a multidisciplinary approach of gynecologist, anesthetist and neonatologist in providing of hypertrophy newborns in rder to reduce the morbidity and mortality of mothers and newborns.