Macrosomia means a newborn that is larger than average. There may be nothing wrong with the baby and the baby may be totally healthy but a large size may present birth complications in delivery. Vaginal delivery with a very large baby may cause traumatic birth injuries. Instead, a larger baby may have to be delivered through a c-section.
One of the problems with macrosomia is that doctors may make the wrong decision in trying to deliver the baby. Doctors may try to force a vaginal labor, causing injury to the mother and baby. Doctors may also delay the decision to perform an emergency c-section, resulting in oxygen deprivation that can lead to brain injury. When a doctor makes a mistake during delivery, it can cause permanent damage to the baby.
Larger Than Average Babies
Babies can range in size greatly during pregnancy. However, most babies grow to an average range before delivery. When a baby is too small, they may have developmental problems because their brains and organs are not developed enough to thrive outside the womb. On the other end, babies who grow too large in the womb may cause delivery complications.
According to Guinness World Records, the largest baby born on record was 22 pounds and 28 inches in length, born in 1846. However, the average weight of babies born in the U.S. is about 7.5 pounds and 20 inches in length. The “normal” range of birth weight is between 5.5 pounds and 10 pounds. The average length is between 18 inches and 22 inches.
Macrosomia refers to fetal growth beyond a certain weight. A baby that weighs more than 8 pounds, 13 ounces is considered to have macrosomia, no matter what their gestational age. According to the Mayo Clinic, about 9% of babies worldwide would qualify as having macrosomia.
Babies who are born of a high birth weight are often referred to as “large for gestational age” or LGA. Babies who are LGA are defined as those above the 90th percentile for their gestational age and gender. By definition, 10% of all babies are large for their gestational age.
Is Macrosomia a Birth Defect?
Macrosomia is not usual. A large baby may have no problems developmentally or physically and there is nothing that sets them apart other than their larger than average size. The most common problem with macrosomia just has to do with the physical part of a vaginal delivery. However, some very large babies may have other diseases or conditions that cause them to grow very large.
There are some genetic disorders that are associated with macrosomia. Genetic disorders of overgrowth may include:
- Beckwith–Wiedemann syndrome
- Sotos syndrome
- Perlman syndrome
- Simpson-Golabi-Behmel syndrome
Some of these overgrowth disorders have other complications, which may include abnormal facial features and developmental delay. Sotos syndrome is also known as cerebral gigantism and overgrowth may continue into childhood. Beckwith-Wiedemann syndrome is one of the more common overgrowth syndromes, which can also involve abdominal wall defects, developmental delay, enlarged organs, cleft palate, and hypoglycemia.
Macrosomia alone does not indicate a birth defect but some birth disorders can be characterized by macrosomia. Some genetic disorders can be identified through genetic testing during pregnancy.
Cephalopelvic disproportion occurs when the baby is too big for the mother’s pelvis. This can involve a baby with macrosomia or a baby without macrosomia if a mother has a small pelvis. A small or abnormally shaped pelvis may be too small to deliver a baby of “normal” size and cesarean section delivery may be the safest option for the mother and baby.
Complications of Macrosomia
When the baby is too large to fit through the mother’s birth canal, it can cause birth complications. Macrosomia may cause the baby to be too large to fit through the canal or the large size of the baby could also increase the risk of other complications, including abnormal presentation, shoulder dystocia, and traumatic birth injuries. Even if the baby can physically fit through the birth canal, macrosomia may delay delivery, putting the baby at risk of oxygen deprivation injuries.
Labor can be difficult even with a normal baby. In a baby with macrosomia, labor can be more difficult. The baby may not physically be able to fit through the mother’s birth canal. A larger baby may also cause labor to take longer, put the mother at greater risk of bleeding injuries, and put the baby at greater risk of traumatic injuries.
During labor and childbirth, the child may be especially sensitive to changes in oxygen levels as the baby transitions from getting oxygen through the womb to breathing outside air. Lack of oxygen during labor or after birth can cause damage to the brain. Macrosomia may delay labor and increase the time that the baby is unable to breathe outside air.
Traumatic Birth Injuries
Neonatal injuries can occur in a difficult birth. The baby’s brain, spinal cord, and bones can be very sensitive to pressure, causing physical injuries which could have permanent effects. Traumatic birth injuries include:
- Erb’s palsy or shoulder dystocia
- Intracranial hemorrhage
- Facial paralysis
- Bone fractures
- Spinal birth injury
- Caput Succedaneum
- Subconjunctival hemorrhage
Intracranial and subarachnoid hemorrhages are brain bleeds which can be caused by some sort of trauma to the head. Improper delivery technique or delivery using forceps or a vacuum device can also cause bleeding in the head.
Shoulder dystocia is a birth injury that occurs when one or both of the baby’s shoulders become obstructed by the mother’s pelvic bone, preventing the baby from passing below. If doctors fail to promptly alleviate symptoms of shoulder dystocia and to act quickly to relieve the stress on the baby, the baby could suffer serious and permanent damages.
Cerebral palsy is a general term for many types of conditions that affect motor skills and movement control. The condition is normally the result of damaged or incorrectly developed nerves. Cerebral palsy has a number of possible causes, including improper assistance given when a mother is experiencing a challenging or prolonged labor.
Cesarean Section Delivery with Macrosomia
A cesarean section delivery, or C-section, is a way of delivering a baby through an incision of the mother’s abdomen and uterus. C-sections are a vital emergency option for mothers and their babies who face serious birth complications. If the baby is too big for vaginal birth, a C-section birth may be the only way to deliver the child. A cesarean section can be planned before labor or delivery may require an emergency c-section. C-section delivery may be a good option for infants with suspected macrosomia as a way to prevent birth trauma.
Filing a Medical Malpractice Claim After a Birth Injury
If your child was larger than average or had macrosomia, leading to a difficult delivery, it may have caused traumatic injury or oxygen-deprivation injuries to the child. Traumatic birth injuries may have been the result of negligent medical care from your doctor. If your doctor failed to provide the standard of care necessary to keep your baby safe and healthy, the doctor may be liable for damages in a medical malpractice lawsuit.
Philadelphia, Baltimore, and DC Birth Injury Lawyers
The birth injury lawyers at Gilman & Bedigian strive to represent victims of birth injuries throughout the U.S. They even won a record-breaking $55 million verdict in Maryland for a birth injury victim against Johns Hopkins Hospital in Baltimore. Contact the lawyers at Gilman & Bedigian online to get started on your case.