Fetal Macrosomia and Medical Malpractice

February 11, 2021 | Attorney, Matthew Dolman
Fetal Macrosomia and Medical Malpractice

Fetal Macrosomia Can Cause Serious Birth Complications

Not all birth defects and birth complications are the fault of a doctor or nurse; some issues just happen naturally, or as a result of genetics or a mother's choices during pregnancy. However, even if the cause of a birth defect is not a healthcare professional's fault, the failure to diagnose the problem very much falls within the context of Fetal Macrosomia and medical negligence. When a woman is pregnant, she and her family expect doctors to monitor their progress and warn them of any potential or existing complications. When a doctor fails to do so, the results can be troublesome. Fetal macrosomia often falls into this latter situation, with misdiagnosis creating significant problems for mother and child.

Fetal Macrosomia Definition

According to Mayo Clinic, the term "fetal macrosomia" describes a newborn baby that is significantly larger than average infants. In order to be diagnosed with fetal macrosomia, a baby must have a birth weight of more than 8 pounds 13 ounces, regardless of the fetus's gestational age. About 9% of babies born worldwide fit into this diagnosis. beautiful pregnant woman practicing yoga on a meadow

What Is Fetal Macrosomia?

Quite simply, fetal macrosomia occurs when a baby is larger than the average baby during gestation. To most, a large baby is a sign of health. However, when a baby is too large, serious complications can result. According to Mayo Clinic's definition above, babies are considered to have fetal macrosomia when they weigh above 8 pounds 13 ounces; or when their weight is determined to be 90% or more of the average weight for babies at the same gestational age. For example, if a baby weighs 9.5 pounds at a time when a baby should weigh 5 pounds, they would be considered to have fetal macrosomia. This range of weight or percentage of weight is not universally determined, nor do all doctors use it as an absolute marker of concern. Doctors who understand their patient's unique issues may become concerned when a baby reaches any size that may cause complications for the mother and/or child. Often, doctors become concerned around eight to nine pounds.

How common is fetal macrosomia?

From 2007 to 2011, researchers studied 201,102 pregnant women to understand fetal macrosomia. The study, which was published by the US National Library of Medicine, found that out of 20,000 live-birth deliveries, 1800 infants had a birth weight of about 8 pounds 13 ounces and above; this equates to about 9% of the large sample size. Of the same women, 1520, or about 7.6%, had babies that weighed between 8 pounds 13 ounces and 9 pounds 14 ounces. Further, 1.2% had birth weights between 9 pounds 14 ounces and 11 pounds. Only 0.2% had babies that weighed over 11 pounds. Other studies have found that fetal macrosomia occurs in just a little over 10% of women, making it safe to say that the occurrence of this birth complication occurs to about 1 in 10 babies. Knowing how often babies are macrosomic, makes understanding the common issue even more important. Since there is a good chance that a baby could be dangerously above average in weight, one would assume that doctors understand the condition, and how to deal with it, very well. However, that is not always the case.

Symptoms of Fetal Macrosomia

The symptoms of fetal macrosomia are often difficult to recognize, however, this is not an excuse for doctors to fail to recognize the potentially serious complication. Medical technology has come a long way, and there are some common symptoms, and tests, that can recognize fetal macrosomia. Two of the most common symptoms of fetal macrosomia are: 1. Fundal Height Is Larger than Average The fundal height is measured on the pregnant mother from the top of the uterus to the pubic bone. This measurement is taken while visiting an OBGYN and assists a healthcare provider in determining the size of the fetus. This measurement becomes an accurate predictor of fetal size starting at about 20 weeks. The measurement estimates a baby's size, growth rate, and position during the later stages of pregnancy. As a general rule, the fundal height, when measured in centimeters, should roughly equal the number of weeks the woman is pregnant. For example, a woman with a fundal height of 24 centimeters should be about 24 weeks pregnant, give or take a week. If the fundal height is much larger than average, it's a good indicator that the baby may be suffering from fetal macrosomia. 2. Excessive Amount of Amniotic Fluid Amniotic fluid is the protective liquid that surrounds a baby in the womb during pregnancy. An excess of amniotic fluid, known as polyhydramnios, is another common symptom of fetal macrosomia. Although there are other reasons that this symptom is an accurate predictor, the most common has to do with a baby's urine. Amniotic fluid increases with the production of urine from the baby. Therefore, a larger than the average baby will produce more urine than the average baby, increasing the amniotic fluid. Likewise, other fetal issues that increase a baby's size can contribute to an increase in the baby's urine output.

Fetal Macrosomia Causes

According to the American College of Obstetricians and Gynecologists, or ACOG, causes for fetal macrosomia include:
  • preexisting diabetes
  • a history of macrosomia
  • a mother's pre-pregnancy weight
  • a large increase in maternal weight gain during pregnancy
  • multiparity
  • a male fetus
  • a gestational period longer than 40 weeks
  • the mother's weight and height at birth
  • a mother younger than 17 years old
The most serious of these causes is pregestational diabetes and gestational diabetes, which have a high association with fetal macrosomia. Studies show that women with untreated diabetes have an increased risk of delivering a baby that weighs more than 9 pounds 14 ounces. If gestational diabetes is ignored, the baby's risk of fetal macrosomia could be as high as 20%.

Fetal Macrosomia Risks and Complications

Women who have babies suffering from fetal macrosomia have an increased risk of needing to deliver their baby by cesarean section (C-section). This is, of course, because the mother cannot deliver the larger baby vaginally. C-sections are not always dangerous, however, the need to perform a c-section as an emergency procedure—when a doctor fails to diagnose macrosomia earlier—increases the chances of something going wrong. Women with babies who have fetal macrosomia are twice as likely to need this emergency procedure. Another risk of delivering a baby with fetal macrosomia is a condition called shoulder dystocia; this complication occurs in about 1.4 percent of all vaginal deliveries. Most doctors consider shoulder dystocia to be the most serious complication associated with fetal macrosomia. As the name implies, shoulder dystocia involves the shoulders of the baby obstructing its delivery. This condition can cause serious health risks to a baby and even death. Babies who are macrosomic, because of their larger size, have trouble making their way through the birth canal and out the vagina. When the birth is delayed and obstructed by the baby's large size, they are at risk of suffocating, known as birth asphyxia. Births involving fetal macrosomia are also at risk of birth defects and injuries, like a fractured clavicle or damage to the nerves of the brachial plexus. In fact, these injuries are the most common fetal injuries associated with macrosomia.

Fetal Macrosomia as Medical Malpractice

Very rarely does a doctor's actions cause fetal macrosomia, however, we hire doctors to observe and warn us about possible or existing complications, especially during something like pregnancy. When a doctor fails to diagnose a fetus with macrosomia, or when a surgeon doesn't make the right call when delivering a baby with fetal macrosomia, they may be liable for the damages that occur. Doctors, quite simply, are responsible for the health of a mother and unborn baby when working in the natal unit. A failure to perform this job correctly is a liability that falls on them, as a practitioner, and on the hospital that employs them. Doctors have the tools and skills to diagnose this common, yet manageable condition. When they are negligent in doing so—or negligent in the emergency surgery needed after a failed diagnosis—they deserve to be held responsible by the grieving family.

Hire an Experienced Florida Birth Injury Attorney

If you believe your child was macrosomic and wasn't properly diagnosed, or if your child was diagnosed as macrosomic but a failure to act by the doctor caused birthing complications and injury, contact the experienced birth injury attorneys at Dolman Law Group Accident Injury Lawyers, PA. Of course, no amount of compensation can make right the injuries or unfortunate death of your child, but it can help you and your families deal with the vast medical expenses and suffering that you have endured. We believe that families should not have to suffer from the trauma of a birth defect and suffer from the mounting medical bills and financial damages that follow. Our Florida birth injury lawyers are dedicated to helping people affected by medical negligence recover for their losses. To schedule a free consultation with one of our attorneys, call the Dolman Law Group Accident Injury Lawyers, PA today at (727) 451-6900. If you would prefer to reach us via email, please fill out our online contact form available on the right side of this page. Dolman Law Group Accident Injury Lawyers, PA 800 North Belcher Road Clearwater, FL 33765 (727) 451-6900 https://www.dolmanlaw.com/legal-services/birth-injury-attorneys/


Matthew Dolman

Personal Injury Lawyer

This article was written and reviewed by Matthew Dolman. Matt has been a practicing civil trial, personal injury, products liability, and mass tort lawyer since 2004. He has successfully fought for more than 11,000 injured clients and acted as lead counsel in more than 1,000 lawsuits. Always on the cutting edge of personal injury law, Matt is actively engaged in complex legal matters, including Suboxone, AFFF, and Ozempic lawsuits.  Matt is a lifetime member of the Million Dollar Advocates Forum and Multi-Million Dollar Advocates Forum for resolving individual cases in excess of $1 million and $2 million, respectively. He has also been selected by his colleagues as a Florida Superlawyer and as a member of Florida’s Legal Elite on multiple occasions. Further, Matt has been quoted in the media numerous times and is a sought-after speaker on a variety of legal issues and topics.

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