Risk of adverse maternal outcome following macrosomic birth in Nigeria

Objective: To determine the risk of adverse maternal outcome associated with obstetric intervention in la-bour. Methods:All cases of macrosomic births conducted at the University of Calabar Teaching Hospital, Calabar, be-tween January 1st 1994 and December 31 st 2000 were reviewed. Measure of treatment/intervention effect was calculated as relative risk for adverse maternal outcome, using spontaneous vaginal births as control, Results: Frequency of mode of delivery was as follow: vaginal births, 139 (60.7%), instrumental vaginal deliveries, 16(7% ); and abdominal deliveries, 74(32.3%). Obstetric intervention occurred in 90 (39.3%) cases. Sixty- four (28%) cases did not book for antenatal care, with 42 cases (18.3%) requiring obstetric intervention. About one in every two parturients (1: 2.1) in this study, requiring obstetric intervention at delivery had been interfered with at unorthodox health facilities. Relative risks for post-partum haemorrhage, wound sepsis and paralytic ileus were significantly high in parturients with abdominal delivery; while in parturients with instrumental vaginal delivery relative risks were significantly high for puerperal sepsis, paralytic ileus and obstetric palsy. There were no maternal deaths. Conclusion: Obstetric intervention in parturients with macro-somic births was high due to labour complications; and was associated with significant risk for adverse maternal outcome, especially in parturients with unskilled interference.