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What does a large fetus mean during pregnancy. Preparation for independent childbirth

There is an opinion that women with a large belly necessarily bear a large baby. However, this is not the case, because the size of the abdomen depends not only on the size of the fetus. This factor can be affected by obesity, polyhydramnios during pregnancy. Very rarely, a neoplasm that appears in the pelvic area, as well as the abdominal cavity during pregnancy, also increases the size of the tummy. The success of childbirth depends on how accurately the weight of the baby is determined. How do obstetricians determine a large fetus during pregnancy?

Main Factors

One of the sources for determining the size of a large fetus during pregnancy is ultrasound. However, with the help of modern equipment, the weight of the child is determined rather conditionally. But discrepancies even in 500 g in childbirth can have a significant impact on their process. The accuracy of ultrasound directly depends on the device, monitor resolutions, the professionalism of the doctor and many other factors.

For a pregnant woman in a antenatal clinic, first of all, the size of the pelvis is measured with a tazometer. In addition, during the bearing of the child, the circumference of the abdomen and the height of the fundus of the uterus are measured. Subsequently, just these parameters help to calculate the estimated weight of the crumbs using the formula. The most popular formula, however, is not very accurate: the height of the uterine fundus in centimeters is multiplied by the circumference of the abdomen, also in centimeters. However, this formula does not take into account the thickness of the subcutaneous fat layer when calculating. Therefore, using one formula to calculate the approximate weight of a child is not professional. A good doctor uses several formulas to achieve greater accuracy.

Of course, how accurate the weight of the unborn child can be said only when he is born. Although approximate information on how much the baby weighs is mandatory and important, therefore you need to make guesses about a large fetus.

large fruit

Each woman understands the "large fruit" in her own way. If the child is located in the head presentation, the size of the mother's pelvis is normal, then the fetus is considered large from 4 kg. If a woman has a narrow pelvis and/or a breech presentation of a baby, a “relatively” large fetus is considered a baby weighing 3.5 kg. What does "large" or "relatively large fruit" mean? And the fact that the passage of a child with such a weight through the birth canal can cause some complications after childbirth, both in the mother and in the baby.

Complications with a large fetus

As a rule, if a woman carries a large fetus during pregnancy, there will be a post-term pregnancy. The fetus seems to be already formed, but the cervix is not ready for childbirth. This may be due to a mismatch between the pelvis and the fetus.

Actually this is a very dangerous thing. After all, it is sometimes very problematic to diagnose. It seems that the size of the pelvis in a pregnant woman is normal, but the weight of the child absolutely does not correspond to them, and this complicates the successful completion of childbirth.

The "hidden" discrepancy manifests itself with a normal external size of the pelvis, but narrow internal parameters. Usually the consequence of such a discrepancy is a weakened labor activity. At the same time, contractions are not effective, the uterine cervix does not open, and no stimulation of labor does not help. The baby's head is not able to sink into the pelvis and press on the neck, thereby contributing to its opening. In this case, only .

The most difficult option is when the cervix has opened, attempts have occurred during childbirth, the pregnant woman makes every effort, and the fetal head cannot fall. In such a situation, an emergency cesarean saves.

Shoulder dystocia - when the baby's shoulders do not turn into the desired position. This complication is difficult to predict. But the degree of possibility of occurrence directly depends on the weight of the fetus, most often this happens with a baby weighing more than 4 kg. If the fetus weighs less than this mark, such a complication hardly threatens him.

In this case, an obstetric appointment is used when the child's collarbone is broken. This may seem terrible, but there is no other way out, since the life of the crumbs is in danger. A clavicle fracture at this age heals quite quickly, since the periosteum does not break in newborns.

Prerequisites for a large fruit

It is not uncommon for the second child to be larger than the first. But this rule does not always work. The factors that affect the size of the baby during the second and subsequent pregnancies are: the amount of hemoglobin, the absence of anemia, the functioning of the placenta, the threat of miscarriage and preeclampsia.

Another common opinion: if a pregnant woman is large, has an excellent appetite during pregnancy (weight gain should be controlled), she will definitely have a big baby. Not true.

The weight of a child depends on genetic parameters. That is, if the parents of the baby were born large, the probability of a large weight of the fetus is very high.

If the expectant mother has endocrine pathologies, most likely, the baby will inherit a disturbed metabolism.

Every expectant mother wants her child to be born healthy. Therefore, when she hears that a large fetus is growing in her, she will probably be delighted. But not everything is as simple as it seems at first glance. In fact, it is important that the parameters of the child do not go beyond the established norms, because otherwise the risk of various complications is high. But each case must be considered individually, since there are exceptions to any rule.

General information

In obstetrics, there are several concepts that characterize the condition of the fetus. The first of these is compliance with the gestational age. A full-term baby can be born no earlier than 37 weeks of pregnancy. He will have all the functional systems ready for existence in the outside world, that is, it is believed that the fetus is fully ripe.

The second equally important characteristic is body weight at birth. It becomes one of the criteria for full-term or may be an independent indicator of fetal health. The average weight of a newborn child is in the range of 3200–3600 g. At the same time, girls have a slightly smaller mass than boys. And another indicator of physical development is the height or length of the body, which at the time of birth is normally from 48 to 53 cm. It is important to remember this when considering the problem of a large fetus during pregnancy.

Causes

Children with physical indicators exceeding the norm are not so rare - this happens in almost every tenth case. Moreover, in recent years, the frequency of this phenomenon has been increasing. This is associated with various factors - both positive and negative. The birth of a large baby may be the result of an improvement in the quality of life of the expectant mother and an increase in the diagnostic capabilities of medicine. A significant role is played by the hereditary factor and constitutional features of a woman. It is known that tall pregnant women give birth to children with a greater mass. In addition, a situation has been statistically proven when each subsequent child becomes larger than the previous one.

It is imperative to take into account the nature of the woman's diet, since foods with a high energy value and carbohydrate content contribute to an increase in fetal weight. If the pregnant woman herself cannot use up the calories that she received, for example, due to a sedentary lifestyle, then they pass to the child. Therefore, one should not think that, being in a position, you need to eat for two. You need to adhere to a rational diet and moderate physical activity, and nature will take its toll anyway.

But along with this, there are much more serious reasons for the increase in fetal weight. Faced with a similar situation, you should think about some obstetric or extragenital pathology:

Postponed pregnancy.
Hemolytic disease of the fetus.
Obesity.
Diabetes.
Hypothyroidism.

It is assumed that the use of certain drugs that improve placental blood flow and fetal nutrition, such as vascular agents or vitamins, can lead to a similar effect. Although the role of this factor has not been proven, it should still be taken into account when identifying the causes of the appearance of a fetus with a larger mass.

Large children can be born for various reasons, ranging from the constitutional features of the mother or her nutrition, and ending with obstetric or extragenital pathology.

Symptoms

A large fetus or macrosomia is spoken of in cases where its mass exceeds 4 kg. The weight of the child is a determining factor in establishing this diagnosis. Of lesser importance are the dimensions of the body (primarily length), although they also increase proportionally compared to the average. The growth of a large child is more than 54 cm. If the weight of the fetus exceeds 5 kg, then it is considered gigantic.

To establish the diagnosis at the initial stage, it is important to carefully collect obstetric and general history. This requires the following information:

Husband's height and build.
The weight of a woman at her birth.
The mass of children born earlier.
The nature of the diet of a pregnant woman.
The presence of endocrine pathology.

Of particular importance for the doctor are the results of measuring the physical parameters of the expectant mother. This is done regularly at every examination in the antenatal clinic. It is possible to assume a large fetus according to the following clinical data:

Weight gain of more than 500 g per week (in the absence of edema).
The height of the fundus of the uterus exceeds 40 cm.
The circumference of the abdomen is more than 100 cm.

These indicators are indicated for the last week of pregnancy, and in other periods they will differ, which must be monitored using special tables. You can also roughly calculate the weight of the child (± 200 g) according to the formula, multiplying the height of the fundus of the uterus by the circumference of the abdomen. Indirect signs of a large fetus during pregnancy include the following patient complaints:

Dyspnea.
Heartburn.
Pain in the back, under the ribs.
Constipation.
Varicose veins of the lower extremities.
Stretch marks on the abdomen.

The pronounced intensity of these symptoms suggests that the uterus takes up more space in the abdominal cavity, putting pressure on neighboring organs and creating a load on the spine. Therefore, it is necessary to monitor the general condition of the pregnant woman, especially at the end of the third trimester.

The clinical picture during pregnancy with a large fetus consists of morphological signs and indirect symptoms.

Consequences

It should be understood that giving birth to a large child in a natural way is quite difficult. The fetus is large, and therefore may simply not pass into the channel intended for it. Therefore, women bearing such a baby should be aware of possible obstetric complications. These include:

Clinically narrow pelvis.
Premature discharge of amniotic fluid.
Weakness of labor activity (primary and secondary).
Ruptures of soft tissues.
Divergence of the pubic articulation (symphysitis).
Birth injuries in a child (cephalohematoma, clavicle fractures).
Fistulas (urogenital, recto-vaginal).
Postpartum bleeding.

Due to the discrepancy between the dimensions of the pelvis and the fetal head, there is no correct insertion, in which the amniotic fluid column is divided into an anterior and posterior part. And with a slight opening of the neck, the water pours out completely. A large fetus, further passing through the natural paths of the mother, contributes to their injury - ruptures of soft tissues, divergence of the symphysis. Even uterine rupture can occur if the pelvis is too narrow.

During prolonged labor, the head presses on the anterior and posterior walls of the vagina, which are adjacent to the urethra and rectum. This leads to local ischemic disorders and the appearance of fistulas. The child himself also suffers a lot, as he is also exposed to trauma in childbirth. Sometimes the head is damaged very badly - with the appearance of intracranial hemorrhages. With the weakness of labor, hypoxic disorders and fetal asphyxia occur.

Additional diagnostics

To confirm the diagnosis of a large fetus, to establish the factors contributing to its development and the associated risks, it is important to conduct an additional examination. The methods prescribed by the doctor are included in the standard screening of pregnant women. The most important is ultrasound (fetometry), which allows to identify the excess of the physical parameters of the fetus:

Biparietal size (more than 94 mm).
Fronto-parietal size (more than 120 mm).
The length of the femur (more than 75.8 mm).
Chest circumference (more than 100 mm).
Abdominal circumference (more than 108.2 mm).

In addition, they find out the thickness of the placenta, which will be more than 45 mm. These figures are the upper limit of normal for a gestational age of 40 weeks. At earlier dates, the sizes will naturally be smaller. The calculation is carried out according to special tables. A large fetus is evidenced by physical parameters that go beyond the 90th centile. Additionally, a woman is recommended to take a blood test (for sugar and hormonal spectrum), to conduct a carbohydrate tolerance test.

Identification of a large fetus during pregnancy is an important task of dynamic screening carried out by antenatal clinic doctors.

Birth management

When conducting childbirth through natural routes, it is necessary to identify in time the discrepancy between the sizes of the head and pelvis. The correct tactics of the doctor will help to avoid complications and lead to a favorable end to the pregnancy. With a large fetus, you must be prepared to perform a caesarean section (planned or emergency). Indications for such an operation will be:

Anatomically narrow pelvis (III and IV degrees).
Incorrect presentation of the fetus (extensor, pelvic, foot, oblique, transverse).
Premature detachment and placenta previa.
Threatened uterine rupture.
Severe weakness of labor activity.
Severe gestoses.
Tumors of the small pelvis.
Fetal distress syndrome.
Prolapse of the umbilical cord.
Extragenital pathology (heart defects, high hypertension, myopia, lung diseases, cerebrospinal fluid hypertension), etc.

Childbirth is carried out with constant monitoring of the condition of the woman and the fetus (cardiotocography). In any case, you should listen to the recommendations of doctors. If there are indications for surgery, then in no case should you refuse surgical intervention, because the health of the child and mother can directly depend on this.

Prevention

If a woman heard about a large fetus in the middle of pregnancy or at the beginning of the third trimester, then you can try to correct the situation. It is necessary to pay attention to rational nutrition with restriction of carbohydrate and fatty foods, to optimize the level of physical activity. It is important to carry out the appropriate correction of endocrine pathology - diabetes mellitus and hypothyroidism in time. And then, conducting dynamic monitoring, you can see that the size and weight of the fetus will return to normal parameters. And in terms close to childbirth, an adequate assessment of the obstetric situation is needed, which will avoid unnecessary risk by performing a caesarean section. A woman and a doctor are deeply interested in a favorable outcome of pregnancy in any situation, including with a large fetus.

When a baby is born with a lot of weight, many are happy and consider this a sign of the health of mom and baby. Being pregnant, women, on the contrary, are afraid of this, since a large fetus is associated with many dangers, in particular, it can significantly complicate the course of childbirth.

In fact, a golden mean is needed: this is not a pathology and a very serious problem, but this fact cannot be taken lightly. This is just a risk factor, and if you fall into this group, you should find out all the nuances, pitfalls and features of delivery when the child is too large.

Many people mistakenly believe that a baby is born with a lot of weight due to the fact that the parents are not small, that is, the heredity factor is triggered. In fact, the features of the skeleton and the general type of figure, transmitted to a person from a mother or father, begin to appear at a much later age, but not immediately after birth.

There are special causes of a large fetus during pregnancy, and if you know about them in advance, you may not be at risk. Among them, the most common are:

maternal malnutrition: eating a large amount of carbohydrates (flour, confectionery, sweets), overweight up to obesity;
number of children: each subsequent child, according to statistics, is born larger than the previous one; so that all subsequent ones, most likely, can be complicated by the large size of the fetus;
sedentary lifestyle;
a woman has a metabolic disorder due to hypothyroidism or diabetes mellitus - accordingly, a large amount of glucose enters the blood of a child even in the womb, which leads to an increase in his body weight; so if at some point in pregnancy a large fetus is diagnosed at the same time, the mother is sent to be tested for sugar;
long-term use of certain medications: a version not confirmed by research, but doctors consider it as one of the causes of a large fetus, especially if during pregnancy the expectant mother took Actovegin and other drugs that improve uteroplacental blood flow;
a thickened placenta provides intensive intrauterine nutrition, which leads to the formation of a large fetus;
active intake of nutrients can occur due to the fact that the placenta is attached to the back wall of the uterus;
postmature pregnancy is also one of the causes of a large fetus, and it can also be diagnosed at 40 weeks if, in addition to a large weight, the child has a number of other signs of postmaturity: he has dry wrinkled skin, there is no original lubrication, long nails and hair are observed, too hard cranial bones, already closing fontanelles;
there is a theory that the fetus can be large if the mother took multivitamin complexes during pregnancy, but she does not find scientific confirmation.

Usually, if a doctor suspects a large fetus, he tries to establish the cause of this feature of pregnancy. Sometimes this allows you to identify diseases in the mother (, for example), or placenta previa, or put in order the nutrition and lifestyle of a woman even before childbirth. Sometimes there is enough time for the mass of the child to return to normal - then the course of childbirth is not complicated by anything. However, another question arises here: how to understand whether the fruit is large or not, is it worth sounding the alarm or not worrying about this?

We replenish vocabulary. The birth of a large child in obstetrics is called macrosomia.

signs

Doctors rarely make mistakes in such a diagnosis: there are certain signs of a large fetus that can be detected even during pregnancy. It should be noted right away that these include not only the weight of the baby: other factors matter here.

A large child is called a child whose birth will be difficult due to its size and weight. When a woman in labor, for example, even a 3.5-kilogram baby can be considered large.

Dimensions

In the course of research (ultrasound), all kinds of measurements of the fetus are made, as a result of which it is concluded whether it is large or not. With a full-term pregnancy at 40 weeks, these figures should not exceed the following norms.

Fetal parameters:

BDP (biparietal, i.e. between opposite bones of the crown, skull size) ≈ 93.9 mm;
LTE (fronto-parietal, i.e., the gap between the forehead and the crown, the size of the skull) ≈ 120 mm;
DB (this is the length of a small thigh) ≈ 75.8 mm;
SDGK (stands for the average diameter of the child's chest) ≈ 99.9 mm;
SDJ (as the average diameter of the abdomen is indicated) ≈ 108.2 mm;

Mother parameters:

weekly in the absence of edema and symptoms of preeclampsia ≈ 500 gr;
Coolant (this is the circumference of the abdomen) ≈ 100 cm;
VDM (designation for the height of the fundus of the uterus) ≈ 40 cm.

Having studied all these indicators, one can understand which fetus is considered large: if these indicators exceed the indicated values, the mother is at risk. In addition, doctors have an interesting formula by which you can calculate the approximate weight of a baby still in the womb: WDM is multiplied by coolant.

Symptoms

If the baby is overweight, it takes up a lot of space. Accordingly, the various organs of his mother, located nearby, are subjected to severe infringement and compression, experiencing an enormous load. Therefore, a pregnant woman in such cases may notice the following symptoms during the last 2-3 weeks before childbirth, which will indicate a large fetus:

frequent urination;
constipation;
fainting in the supine position, as the enlarged uterus puts strong pressure on the lower vein;
pain in the legs, ribs, spine, lower back due to the increased load on the musculoskeletal system;
development or exacerbation of varicose veins;
stretch marks on the abdomen;
increased tone of the uterus.

All these symptoms and signs need to be thought about already a few weeks before the birth and draw the attention of doctors to them. If for some reason you have to give birth prematurely and you know this for sure, consult your doctor which fetus is considered large at 38 weeks (or at the time when your baby appears). As a rule, for such a calculation, 5-6 units must be subtracted from the above parameters (the size of the mother and child). For example, coolant should be ≈ 94-95 cm.

Keep in mind! Many people mistakenly consider too large a belly in a pregnant woman to be the first and surest sign of a large fetus. This is not at all the case: it can also indicate polyhydramnios or multiple pregnancy. Even a small belly and a large fetus are possible.

What to do?

If 2-3 weeks before the birth, at the next examination, the gynecologist reported that you have a large fetus, you should not panic and immediately start talking about a caesarean section. You still have time to correct this risk factor, so consult a doctor who will tell you what to do in this situation. You will need:

undergo medical examinations to exclude multiple pregnancy and polyhydramnios;
conduct a glucose tolerance test and visit an endocrinologist to make sure that there is no diabetes mellitus;
find out the estimated weight of the fetus;
daily exercise therapy;
adjust nutrition: avoid sweet and starchy foods, i.e., easily digestible carbohydrates and refractory fats;
cancel or limit (in accordance with medical recommendations) the use of anabolic steroids.

If you follow these tips, by week 40 the situation may well improve and the doctor will be happy to inform you that the baby's weight is now within the normal range. In this case, you do not have to resort to: you will have a natural birth with a successful outcome, without any complications associated with the large size of the child.

But what if it's too late or the correction failed? Then you will have to intensively prepare for surprises, and maybe for operative delivery.

The most helpful advice. Very often, young mothers, having heard that they have a large fetus, begin to worry so much and exhaust themselves with all kinds of diets that they only worsen the situation. As a result, they are on the delivery table ahead of schedule, and the baby is born restless and nervous. So the most important thing is not to panic, calm down and rely on the experience and professionalism of doctors in everything.

Possible Complications

Why, when a large fetus is detected during pregnancy, the question is often raised: caesarean or natural childbirth? It's all about the complications that the independent birth of a large child is fraught with. They can affect not only the health, but also the life of the baby. And the mother will have a very difficult time. Among the consequences, the following are considered the most dangerous.

narrow pelvis

This pathology is diagnosed if the baby has a large skull that does not correspond to the size of the pelvis in a woman (by the way, they can meet the standards) even with full opening of the cervix of the uterus. Strong, good contractions do not save the situation. If a woman in labor has a narrow pelvis and a large fetus, in most cases she is advised to have a caesarean section.

Premature discharge of water

Due to its large size, the fetal head cannot press against the pelvic bones, and it occurs early. This is fraught with the fact that the loop of the umbilical cord and even the arm or leg of the baby may fall out, the uterine pharynx opens much more slowly, childbirth is delayed and exhausts the woman. Without amniotic fluid, the child will last no more than 12 hours: then intrauterine infection may occur.

Anomalies of labor activity

A large fetus delays childbirth, which depletes the strength of the woman in labor. Diagnose, in which the intensity and frequency of contractions is significantly reduced. This can lead to intrauterine hypoxia. The way out of this situation is the stimulation of childbirth, which, however, does not affect the fetus in the best way.

breaks

Due to the large size of the fetal head, the lower uterine segment is overstretched, which leads to numerous ruptures in the uterus. Often the pubic joint is also damaged - the ligaments are torn, the pubic bones diverge. All this will have to be corrected after childbirth surgically.

Fistulas

If the fetal head, due to its large size, presses on the pelvic bones for too long, the neck, vagina, bladder, anus experience an enormous load. Among the consequences - circulatory disorders in soft tissues, ischemia, necrosis, in the future - rectovaginal fistulas.

Birth trauma in a child

Due to its large size, the fetus cannot pass through the birth canal on its own without injury. The bones of the skull (and with them the brain) are damaged, fractures of the shoulders, collarbone, and neck are diagnosed. The child may remain disabled for life or die. For the same reason, cerebral hemorrhage can occur.

Given all these complications, a woman, together with a doctor, needs to make the right decision on how to give birth: or by caesarean section. If the risk of complications is not so great, the size of the fetus is only slightly larger than the norm and they can be corrected, and the parameters of the pelvis of the woman in labor allow him to be born on his own, you should not insist on surgical intervention. But if the situation is critical and the doctors advise the CS, there is no need to resist: at stake is the life and health of the unborn baby.

Facts, facts. If doctors suggest that you have a large fetus, get ready to go to the hospital ahead of time: at 37-38 weeks of pregnancy.

Indications for caesarean section

Proper management of childbirth with a large fetus reduces the risk of complications by 80%. An experienced doctor who knows his business, even if it was decided to give birth naturally, will always keep a team of doctors and the necessary equipment for carrying out at the ready. Indeed, at any stage of labor, unforeseen circumstances may arise that threaten the life of the mother or child.

As a rule, a caesarean section for a large fetus is prescribed for the following indications:

age up to 18 and after 30 years;
breech presentation;
a large fetus detected on ultrasound and - in this case, a CS is necessarily prescribed, because such a baby cannot be born on its own;
delayed pregnancy;
anatomically narrow pelvis;
third births, if both previous ones were complicated by a very large fetus;
myomatous nodes and any other pathology of the uterus;
contraindications for attempts: problems with the heart and blood vessels, myopia;
poor obstetric history: if there was a stillbirth, prematurity, infertility, etc.

Polyhydramnios or moderate oligohydramnios with a large fetus are not considered absolute medical indications for caesarean section. In these cases, the baby is not in danger, and in the absence of other pathologies, he is quite capable of being born on his own.

Statistics. According to the latest data, 75% of cases with a large fetus end in a caesarean section.

Features of childbirth

Doctors know all the features of a caesarean section with a large fetus, which require them to have high professional skills and a certain amount of experience. Beginners do not trust such operations. Physicians take into account the following nuances:

caesarean section is carried out under monitor control;
a partogram is being drawn up - drawing up a schedule indicating the time of the period of childbirth, parameters of the opening of the pharynx, indicators of the intensity of contractions;
re-measurement of all dimensions is carried out;
anesthesia is done, antispasmodics are used;
reducing agents are used for preventive purposes;
a narrow pelvis should be diagnosed in a timely manner;
bleeding is prevented.

If doctors diagnosed a large fetus during pregnancy, do not be afraid of such news. You need to know all the risks associated with this fact and how to avoid them. A doctor's consultation is essential here.

Do not rush to insist on a caesarean section, fearing ruptures: for a baby, this will not be the best option for the development of events. Perhaps its size is not so colossal as to seriously harm you during childbirth. Listen to the recommendations of doctors - and complications can be avoided.

Pregnancy is a time of expectations, dreams of a beautiful and future baby. During pregnancy, there is a certain plan for observation by a doctor and a certain number of scheduled ultrasound examinations. And on one of the ultrasounds, any woman can hear the phrase "You are bearing a hero." This means that a large fetus is developing inside you.

There are certain norms for the weight and height of the baby at the time of birth. It is considered normal when a child with a height of 48 - 54 cm has a weight of up to 4,000 kg. If the baby weighs from 4 to 5 kg at the time of birth, then they talk about a large fetus during pregnancy. But it is strange that in this case they do not take into account the growth of children. After all, large kids are always taller than children, which, as they say, are normal. The growth of large babies is usually 54 - 56 cm.

According to statistics, today the number of large children is 5-10% of all pregnancies. Doctors believe that this is due to improved working conditions, good and healthy nutrition, as well as the living conditions of pregnant women.

There are also cases of the birth of giant babies: weight over 5 kg. But such cases are recorded much less frequently.

How to identify a large fruit?

Starting from the 12th week of pregnancy, the doctor at each examination listens to the baby's heartbeat, measures the circumference of the hips and abdomen of the pregnant woman, and the weight and pressure of the pregnant woman is also measured in the pre-medical office. All these measurements are not made in order to indicate to the woman how she has recovered and to offend her. All this is done in order to clearly draw a picture of the course of pregnancy and monitor the health of the baby and expectant mother.

Diagnosis of a large fetus during pregnancy is made not only on the basis of an examination of a woman. An experienced doctor always takes into account heredity and diseases. The doctor should ask about the physique of the father, about the weight with which the future parents themselves were born. If, from all the data of the examination and interview, a suspicion of a large fetus is diagnosed, only then a referral for an ultrasound is issued. Only on the basis of ultrasound can you calculate the estimated weight of the baby.

On such an unscheduled study, the size of the fetal head, the diameter and circumference of the abdomen, the length of the femur and humerus of the baby are determined. And based on these data, it becomes possible to calculate the estimated weight of the fetus.

Causes of a large fetus

There can be many reasons why you are carrying a hero. Some of them are associated only with heredity, some are a reflection of the mother's lifestyle or an echo of her state of health. Let us dwell in more detail on the reasons that the fetus is overweight during pregnancy.

1. Increase in duration of pregnancy. There are two terms that are associated with a long gestation period: the prolongation of a physiological pregnancy and the prolongation of a pregnancy. Prolongation is due to the fact that the timing of childbirth was incorrectly set. In this case, a healthy baby is born, but 10-14 days later than the deadline set by the doctors. The health of the baby is determined by the absence of signs of overbearing and aging of the placenta. With a true prolongation of pregnancy, a baby is born with the following signs:

wrinkling of the skin;
greenish or grayish tint of amniotic fluid;
lack of original lubrication; dryness.

2. A disease such as diabetes, can lead to a large fetus during pregnancy. A pregnant woman with diabetes mellitus should be examined more carefully than the others. Among such women, the statistics of the birth of large children is much higher.

Such pregnant women should be hospitalized no later than 32 weeks of pregnancy. In the hospital, they undergo a thorough examination, after which a decision is made on the timing of childbirth. If a patient with diabetes bears a large fetus, then the issue of artificial stimulation of labor is decided not earlier than 36 weeks. This decision is also made when the woman's health deteriorates (preeclampsia, decreased blood sugar,). Childbirth in this case takes place under the close supervision of a therapist. Insulin is administered during all births. Insulin treatment continues after delivery, depending on test results.

3. Hemolytic disease of the fetus- a serious reason for the development of a large fetus during pregnancy. This disease is caused by Rh-conflict mother and child. It occurs in Rh-negative women when the baby inherits an Rh-positive father. As a result of this disease, the baby not only has a decrease in hemoglobin levels and jaundice appears, but also overweight due to the accumulation of fluid in the body cavities (swelling appears), the spleen and liver increase.

4. Heredity in the development of a large fetus plays an important role. If the mother or father of the baby is tall and large at the moment, then it is likely that the child will be large. Also today, small parents could be born large. Then the baby can inherit this very fact and will also be a hero.

5. There is also a tendency for large fetuses to develop in subsequent pregnancies. According to statistics, the second and subsequent children are born with a weight of 30% more than their older brothers and sisters. This is primarily due to the psychological factor (during the second pregnancy, the mother no longer experiences such great stress and fear). The second reason is the readiness and training of the woman's body to bear a baby (now the metabolism between mother and baby is improving due to better blood circulation).

6. Nutrition of a pregnant woman can also affect the excess size of the baby. A large amount of food containing carbohydrates (bakery, sweets) contributes to obesity of the mother and child. In this case, the baby's body begins to work like a mother's and gains excess weight. Already in the womb, obesity can develop.

Danger with a large fetus

The final stage of pregnancy - childbirth, is one of the most responsible and difficult moments of expecting a baby. Carrying a large child can cause certain difficulties in the process of delivery. These difficulties can affect both the health of the mother and the health of the newborn.

First of all, with a large fetus during pregnancy, there may be discrepancy between the size of the baby's head and the mother's pelvis . Even if the pelvis is not narrow, the head of a large baby may not pass through the birth canal. In this case, even a good, strong labor activity will not be able to provide natural delivery.

The head of a large fetus stands high in the pelvic cavity, this is the reason for the lack of distinction between the anterior and posterior amniotic fluid. This difference from normal physiological childbirth causes early effusion of amniotic fluid. If the fetus is large, then along with the discharge into the vagina, the umbilical cord or the baby's pen may fall out. In this case, an immediate surgical intervention is performed. Early outflow of water slows down the process of opening the uterus, and the period of contractions makes it very painful. The fact that the baby is without water for a long time can cause infection of him and the uterus.

The development of a large fetus during pregnancy can cause labor disorders . Such a violation is characterized by good and strong activity in the first stage and a decrease in labor activity in the later stages of childbirth. As a result, the woman in labor gets tired and cannot push. Also, cases of violations of the activity of the nervous, cardiovascular system are not uncommon. A large fetus in this situation suffers from a lack of oxygen - hypoxia. Such a violation may be characterized by very weak contractions in the first stage of labor.

During attempts, when the baby's head takes the form of a woman's small pelvis, uterine rupture problem . This happens, again, due to the discrepancy between the size of the small pelvis and the head of a large fetus.

emergence urinary or rectovaginal fistulas not uncommon at birth of large children. This is due to the long standing of the baby's head in the pelvic area of a woman. In this case, necrosis of the tissues of the bladder, rectum and urethra occurs. Dead tissue is then torn off, forming fistulas. The problem is solved only by surgical intervention after childbirth.

With a long period of childbirth, pinched nerve in leg , there is also a possibility of damage to the articulation of the pubic bones. This is reflected in the gait of a young mother, limping and pain appear when moving the foot. If the degree of nerve damage is high, then surgery is required to solve the problem. With a mild degree of paresis, bed rest and a bandage are recommended. At the discretion of the doctor, pain medication may be prescribed.

All of the above can occur even before the birth of the baby's head, which was considered large during pregnancy. But even when, it would seem, the most difficult thing is behind, problems can arise. After the birth of the head of a large fetus, difficulties may arise in removing the baby's shoulder girdle. If the child is large, then, first of all, the neonatologist pays attention to the condition of his clavicles and arms.

A mismatch between the mother's pelvis and the baby's head can cause hemorrhage in the brain in a child or cephalohematoma. If there are no complications, then after 6-8 weeks the hematoma subsides without affecting the health of the child. Hemorrhage can also remain without consequences for the development and health of the baby. It all depends on its size and zone of outpouring.

We must not forget that a woman who gave birth to a large baby may have inadequate contraction of the uterus . As a result, bleeding may occur after the baby is born. The causes of bleeding are both retained placenta in the uterus, and ruptures of the tissues of the genital tract.

What to do?

If, after another examination by a doctor, you were told that you have a large fetus, you should not panic. A large fetus during pregnancy is the need for more careful monitoring in the future and during childbirth. Having learned that the baby is large, the doctor, first of all, will try to find out the reason.

If the cause is any pathology of the development of the fetus or the health of the woman, treatment in a hospital will be prescribed. In this case, in most situations, the woman is under observation until the very birth, as there is a need for constant teaching of drug treatment.

If the cause of a large fetus is heredity or mommy's overeating, then a diet is prescribed. According to the diet, the mother should receive only wholesome food that will not contribute to weight gain.

It is also not worth being afraid of childbirth with the development of a large fetus. The only thing you need to do in advance is to talk to your doctor about the progress of your labor. In some cases, a caesarean section is immediately prescribed, in others they take expectant tactics.

Indicators for caesarean section already in the process of labor is the presence of signs of discrepancy between the head of the child and the pelvis of the mother within 4 hours.

That is, if the birth is scheduled for natural, then subject to the spontaneous course of labor and the departed waters, the doctor can decide on the operation if the life of the mother or child is threatened.

Also, during childbirth, a caesarean section can be used if symptoms of uterine rupture appear.

Large fetus during pregnancy: how mom can help

Having considered the reasons for the development of a large fetus, it can be understood that the mother's first aid is to healthy eating even before conception (that is, getting rid of excess weight that a child can inherit) and proper nutrition during pregnancy.

It is not for nothing that at each scheduled examination, the gynecologist gives recommendations on the amount of certain nutrients in each trimester of pregnancy. So, for example, the amount of carbohydrates per day in the last trimester should be only 300-400 g.

If the reason lies in heredity, then it is worth relying on the experience of doctors who will give competent advice, provide information about possible diets and successfully carry out delivery. In this case, diet comes first.

Yes, even during pregnancy, sometimes you need to sacrifice something. But you should be driven by the heartbeat of your child, it is for the sake of it that you need to deny yourself some pleasures.

Help with pathologies of a large fetus is mother's consent to receive medical care. It is impossible to hope for a miracle with the swelling of the baby, enlargement of the spleen and liver. All these symptoms are perfectly visible on ultrasound and, with proper treatment during childbirth and after, they may not affect the health and development of the child.

Remember, pregnancy is a wonderful time when a woman is already responsible not only for herself, but also for a new little life. A hero is a baby who, while still living in the womb of his mother, already requires special attention, and not a reason to worry and be afraid.

A good video about a large fetus and caesarean section

Answers

There is an opinion among our grandmothers and mothers that a child born with a large weight is a "hero", "strong man" and so on. In fact, this is not an indicator of good health. A large fetus during pregnancy is one of the pathologies that can lead to a number of complications for the health of a woman and a child, as well as problems during childbirth.

What is a large fruit?

In order to dispel the fear of expectant mothers and define the concept of this pathology, let us clarify that a large fetus (or macrosomia) is called which, in terms of indicators, differs from normal development. With macrosomia, the development of the fetus is ahead of the norms established for a specific period. At birth, children with this diagnosis will weigh more than four kilograms. In addition to weight, the height of the child also increases. Normal is 48-54 centimeters. Children with macrosomia are over 56 centimeters tall. Sometimes they are born even with a height of 70 centimeters.

If at birth the baby has a weight of five or more kilograms, then this is called a "giant fetus". The birth of a giant baby is a very rare occurrence that occurs once out of several thousand births.

A large fetus is accompanied by a number of risks that you need to know about and which can be prevented in time.

signs

Symptoms that a woman may suspect that she has a large fetus may appear in the middle of pregnancy. The circumference of the belly of the expectant mother is noticeably increasing every day. It is worth noting that this may not always be a large child. An increase in the circumference of the abdomen can serve as polyhydramnios, which is also quite common.

During pregnancy, you need to clearly control your weight. That is the mark of a large child.

The rate of weight gain of a pregnant woman

In addition to your own weight, you should monitor the growth and weight gain of the baby. Modern ultrasound machines provide such information.

The rate of increase in height and weight of the child

The gynecologist can make the most accurate diagnosis only closer to the beginning of the third trimester. It is during this period that one can judge by the circumference of the abdomen: if the waist of the expectant mother already exceeds 100 centimeters, then the doctor assumes the presence of a large fetus. After that, the pregnant woman is sent for an ultrasound to rule out polyhydramnios. In addition, a few weeks before the preliminary date of birth, some more activities need to be carried out:

find out the weight of the child on ultrasound;
take a blood test for glucose tolerance and a mandatory visit to an endocrinologist;
limit or cancel the intake of anabolics (drugs aimed at enhanced formation and renewal of new cells and tissues);
get rid of flour, sweets and other foods that have carbohydrates and fats;
do physical therapy every day.

Important advice for all expectant mothers! You should not start to panic and get upset if you find out from a big baby. It is important to correctly analyze the possible causes of a large fetus during pregnancy. If the reason is nutrition - exhausting yourself with diets is very dangerous for the baby and for the mother. At the same time, excessive nervousness can lead to premature birth, which can also lead to a lot of consequences.

In addition, frequent nervous situations can affect the further psychological state of the child: he can be born very restless. In this situation, you need to trust the doctors and impeccably adhere to all recommendations.

Causes

You should immediately dispel the myth for people with a large physique. You can often hear that if the parents are not small, then why would a child be born a three-kilogram baby. In this case, heredity does not play any role. The general type of figure is passed on to the child much later. Therefore, if the doctor said on an ultrasound scan that a woman has a large fetus, this is not because of the full physique of her or the father of the child. A baby cannot inherit a dense constitution even in utero.

The causes of a large fetus during pregnancy can be several factors, knowing about which in advance, you can prevent the risk of falling into this category.

Wrong food

One of the main causes of a large fetus is precisely overeating during pregnancy. Increased appetite is quite normal. This is due to the fact that the child is growing and also requires food. In utero, the baby receives the necessary substances for growth from the mother's food.

Very often, pregnant women face the problem of constant hunger throughout the day. Trying to drown it out, the expectant mother constantly eats. This is what contributes to the weight gain of both the baby and the mother. As you know, after giving birth, it is very difficult for a mother to get rid of extra pounds.

Therefore, in order for the child not to rapidly gain weight, the expectant mother should follow a diet. And with a feeling of hunger that will occur between meals of the main meal, you should choose low-calorie snack foods. It can be vegetables, diet bread, yogurt, cottage cheese or fruits.

Medications

Due to individual characteristics during pregnancy, some women are prescribed certain medications. If during pregnancy there are problems with the preservation of the child or with insufficient uteroplacental blood flow, special drugs are prescribed to preserve the pregnancy. It is these drugs that can cause a large fetus to develop. When using various drugs, the expectant mother is observed by a gynecologist, so any changes are recorded and canceled if they have a negative effect on the development of the child.

Number of births

If a woman does not have her first birth, then each subsequent child is born larger than the previous one. Although a large fetus during the first pregnancy also occurs.

Sedentary lifestyle

If a pregnant woman leads a sedentary lifestyle, this also causes excess weight for both her and the child. Of course, expectant mothers need a lot of rest, but in moderation. There is fitness for pregnant women. This is a great way to lead a moderately active lifestyle, keep fit, while not harming the child.

Diabetes

In some cases, women develop gestational diabetes during pregnancy. It may be due to heredity. If someone in the family had diabetes, then this can be passed on to the expectant mother, since during the bearing of the child the body experiences severe hormonal disruptions.

Also, the reason for the development of diabetes can be frequent viral and autoimmune diseases of the expectant mother. They affect the pancreas, which is responsible for the production of insulin in the human body.

Another cause of gestational diabetes may be the birth of a child in the past over 4.5 kilograms or stillbirth for unknown reasons.

Location of the placenta

If the placenta is attached to the back wall of the uterus, then the supply of nutrients is more active. Also, if it is thickened in its condition, it requires intensive intrauterine nutrition of the baby, which can cause a large fetus during pregnancy.

Postterm pregnancy

A post-term pregnancy is when a woman does not give birth within fourteen days after 40 weeks. It is during this period that the child is most actively gaining weight and increasing in height. In addition, at birth, the baby has dry skin, long fingernails and toenails, no primordial lubrication and already hardening skull bones.

Rhesus conflict

If the expectant mother has a negative blood Rh factor, and the child has a positive Rh factor, then there can be many consequences. One of them is fluid retention in the tissues of the fetus, which affects the weight of the baby.

The cause of the Rh conflict may be the inheritance of the father's blood type by the child. It can also occur if the expectant mother has gone through a procedure such as a blood transfusion.

Not in all cases, a large child can cause serious complications. But clearly the causes and consequences of a large fetus during pregnancy are accompanied by the peculiarities of bearing a child. The most severe complications that a woman may face will be in the last weeks of pregnancy: fainting, digestive problems and heavy breathing, constipation. The heavier the child, the more discomfort it provides to the mother. There may be pain in the ribs and lower back, as well as varicose veins and fainting in the supine position. In addition, the appearance of stretch marks on the skin of the abdomen, unfortunately, is almost inevitable.

Based on the causes and consequences of a large fetus in a pregnant woman, the question is raised about the method of delivery. If the expectant mother has a narrow pelvis, and the child is large, then natural childbirth is not recommended. With a large fetus, a caesarean section is the best choice.

If the baby is large, then during natural childbirth, many consequences can appear: birth injuries in the child, fistulas and tears in the mother. If the fetus is only slightly higher than normal, then you should not insist on a caesarean section. Mom will be able to give birth on her own. Moreover, with a timely identified reason why the baby is ahead of development in utero, by the end of pregnancy, its growth can be corrected.

The most important thing for a future mother is her child. Therefore, she must be calm, reasonable, listen to doctors and undergo all necessary medical examinations. Then the baby will be healthy, and the mother will be happy.

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