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as part of the lecture series for ob/gyn residents at Christiana Hospital in Newark Delaware this is a summary of the ACOG practice bulletin on macrosomia for November 2016 two terms are often used to refer to excessive field growth the first is large for gestational age where LGA its a relative term and includes fetuses with an estimated weight greater than the 90th percentile for a given gestational age the second term is an absolute term meaning a specific weight cutoff irrespective of the gestational age however theres no agreement about what that cutoff is with some using 4000 grams and some using 4,500 grams while the practice Bolton includes a table of percentiles at a particular gestational age in the third trimester one figure is worth remembering for context the 90th percentile at 40 weeks is about four thousand grams whats clinically important about macrosomia is whether a fetal weight is associated with the adverse outcomes for the purpose of clarity that practice Bolto