Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
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In view of the rising trend in caesarean section rates all over the world and women requesting caesarean section without any medical indication, we conducted a questionnaire survey to assess the opinion of clinicians in the field of obstetrics to assess their views regarding this issue. We found that clinicians agree that the caesarean section rates are increasing and most of them hold the media and women responsible for this rising trend. However, in situations where no definite medical indication was evident, most of the clinicians favoured caesarean section. The findings of this study suggest that there is a need for change in the attitude of clinicians before attempting to educate women regarding the caesarean section for non-medical reasons.
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This study reviews the deliveries of macrosomic babies and their outcomes. A total of 330 macrosomic (birth weight > or =4 kg) cases were studied retrospectively from July 1999 to December 1999 in the Maternity Hospital of Kuala Lumpur. The variables studied included induction of labour, mode of delivery and the incidence of maternal and perinatal complications. ⋯ Two cases of stillbirths were documented but no maternal death occurred during the period of study. Vaginal delivery is the most frequent mode of delivery for a fetus weighing in excess of 4 kg and vaginal delivery should be attempted in the absence of contraindications, because vaginal delivery has less maternal morbidity compared to caesarean delivery. However, shoulder dystocia remains a significant complication of vaginal delivery for macrosomic fetuses.