How to determine that the fetus is large. Large fruit - good or not so

29.07.2019

A big belly during pregnancy does not mean. That you will certainly have a big baby. But there are several signs by which this can be determined with a high degree of certainty.

In the first trimester, around the 8-12th week of pregnancy, the expectant mother undergoes the first planned ultrasound. It is during this study that the specialist specifies the gestational age, measures the length of the fetus in centimeters, or rather, its coccyx-parietal size (KTR). From this moment on, the tiny creature will take on specific shapes for you. There are still a few months ahead, during which the baby will develop, grow stronger and prepare for the birth.

Diagnosis of the size of the fetus

Predictions about the size of the fetus can only be made starting from the middle of the third trimester. The doctor will pay attention to the increase in the volume of your abdomen. If the waist size exceeds 100 cm, the doctor will suspect that you have a growing hero. And he will definitely send you for an ultrasound, which will allow you to determine the size and circumference of the fetal head, as well as the size of his abdomen and chest. Then the doctor will calculate the estimated weight of the fetus using a formula that takes into account all these parameters.

Control yourself: weigh yourself every week and keep a weight gain schedule. And don't forget to take it with you when you go to your doctor's appointment. Until the 20th week, you can add no more than 700 g per week, from the 20th to the 30th - about 400 g, and after the 30th - only 300-350 g.

The overall weight gain for the entire pregnancy is individual and depends on your constitution. Find out your rate. Thin women by the time of childbirth can gain up to 15 kg. If you have an average build, then the increase should be 10-12 kg. If you are considered "chubby", be especially vigilant: the upper limit of your weight gain is about 7 kg. Don't overdo it so you don't regret it later!

Fetal size by week

The doctor will determine the size of your pelvis during the first visit, at registration. The necessary parameters (there are five of them) are measured using a pelvis meter in the supine position and on the side, as well as during a vaginal examination. If at least one of the sizes is less than the norm by 1.5-2 cm, they speak of an anatomically narrow pelvis. It occurs in 5-7% of women.

The indication for caesarean section is a functionally (clinically) narrow pelvis. Such a diagnosis is made when there is a discrepancy between the size of the head of the fetus and the pelvis of the expectant mother. These cases make up only 1-2% of all births. But it happens that an anatomically narrow pelvis is functionally sufficient for natural delivery.

Table of Fetal Sizes (KTR) by week

big baby

A large baby can be born due to some ailments of the expectant mother or due to her improper behavior during pregnancy.

Incorrectly formulated diet may adversely affect the health of the fetus. Most often, a large baby is born in those women who combine foods incorrectly and love large portions. To eat right, follow our recommendations when compiling a menu for every day.

Heredity- the second most influential factor leading to the development large fruit. If you or your husband were born large, be prepared for the birth of a hero.

Diabetes pregnant woman causes an increase in glucose levels in the baby, which stimulates excess secretion of insulin in his body. This hormone is known to be a growth factor. In this case, you will need constant medical supervision. Therefore, you will have to go to the hospital in advance, no later than the 32nd week. Doctors will monitor the level of sugar in the blood and urine and help you in time.

Prolongation of pregnancy also leads to overweight of the fetus. After all, it continues to grow, despite the missed best time for birth. The doctor observing you will try to prevent this and take the necessary measures in time.

healthy eating

Love buns and a day without cookies and chocolate? Do not forget that an excess of carbohydrates leads to excess weight. In your position, you both get better. In this case, the baby lacks the nutrients necessary for normal growth and development. And extra grams are stored in reserve. Believe me, it is better to watch this now than to fight with an overweight baby when he is born.

Eat more fresh vegetables and fruits. Make salads, add greens to them and season with vegetable oil.
Avoid fried foods. Switch to stews, boiled and baked dishes.
Limit the use of salt (this is a wonderful prevention of edema!) And spices.
Save the sweet buns for later. Buy rye bread or products made from whole wheat flour.
Prepare a variety of drinks from fresh fruits. Cook unsweetened compotes, squeeze juices, make cocktails.
Don't forget dairy products. They improve the work of the intestines, enrich the body with calcium and protein.

Follow these simple rules - and the baby will grow up healthy even before it is born. And the birth will be successful!

A large fetus is sometimes a contraindication for natural childbirth. In each case, doctors make a decision individually, based on a number of indicators.

Which fetus is considered large during pregnancy?

Doctors speak of a large child if its weight before birth ranges from 4 to 5 kg. Children weighing over 5 kg are considered giant. Weighty babies, respectively, have a large body length and circumference sizes.

Why can the fetus be larger than the term?

The baby in the womb grows according to certain patterns. In many ways, the placenta is responsible for its development. If its functions are violated, then the growth of the fetus slows down or accelerates, for example, this often happens in women with diabetes.

So, the reasons for excessive growth and largeness of the fetus can be:

Poor diet and lack of physical activity. A high caloric content of food in tandem with a decrease in physical labor is the first reason for an increase in the growth of a child. It is necessary to reduce the consumption of foods containing a lot of simple carbohydrates (pasta, confectionery and bakery products), and spicy-aromatic substances that stimulate appetite. The obesity of a woman also affects the baby;
features of the placenta. If it has a large size and volume, then the child will be larger than usual;
Increase in volume and intensity of circulating blood. As a result, more nutrients are supplied;
Second and subsequent pregnancies. The uterus has greater extensibility, the vessels in its wall are already sufficiently developed, the abdominal press has less resistance;
Prolonged and uncontrolled use of substances that improve uteroplacental circulation;
Heredity;
Endocrine-metabolic disorders (diabetes mellitus, obesity);
Overwearing;
Menstrual irregularities, history of inflammatory diseases.

Large fetus: nuances and features of the course of childbirth

Often, childbirth begins at the set time, but when overdue, they are late, and with diabetes, they can begin prematurely.

Let's look at possible complications (their frequency increases with an increase in the weight of the child).

Untimely discharge of amniotic fluid. It can be premature (before the onset of labor) or early (before the opening of the cervix). Both cases are associated with the lack of delimitation of waters into posterior and anterior, high standing of the head, features of the fetal bladder and polyhydramnios. The outflow can be accompanied by a prolapse of the umbilical cord loop, which poses a threat to the life of the baby.

Anomalies of labor activity (discoordination, weakness). The contractions are painful, irregular and of varying duration, or weak and infrequent, which causes a delay in the opening of the cervix. Weak birth forces are due to overstretching of the uterus, a large placenta and the need to make significant efforts to move a large child through the birth canal.

Hypoxia (lack of oxygen) can occur due to a long delay in childbirth, woman's fatigue, infection against the background of an anhydrous gap.

Large fetus and clinically narrow pelvis. A complication occurs when the size of the baby's head and the mother's pelvis do not match (even if the latter is of normal size). In this case, in the absence of violations, good labor activity, childbirth occurs naturally.

Shoulder dystocia with a narrow pelvis. The head gradually advances, expanding the birth canal, but the shoulders can get stuck. The obstetrician must perform a series of tricks to free the shoulder girdle. Very often, such actions can lead to a fracture of the collarbone, shoulder, neck injury. Dystocia is often observed in large babies whose mothers have diabetes.

An increase in the number of surgical interventions due to frequent complications during childbirth. Much more often they resort to caesarean section with a narrow pelvis, weak contractions and attempts that cannot be corrected. In a planned manner, caesarean section is used for breech presentation of a large fetus, a scar on the uterus, overcarriage of the first-born by an older woman, the presence of diseases, complications during previous pregnancies and childbirth.

Amniotomy (artificial opening of the fetal bladder) and excitation of generic detail. Basically, stimulation is planned from 38 weeks, when pregnancy is combined with extragenital pathology, and in case of overdose.

What is the risk of complications?

Often, during natural childbirth, the contractility of the uterus is disturbed, so bleeding occurs. Accordingly, the number of manual examinations of its cavity increases. During the examination, the unseparated parts of the placenta are removed, a massage is performed, which helps to contract the muscles and stop bleeding.

Dissections are widely used, since the risk of rupture of the vagina and perineum is high.

In women who have given birth to weighty children, uterine involution (reverse development) often slows down, anemia occurs (hemoglobin levels decrease), hypogalactia (not enough milk). In obese patients: blood clots are formed (mainly in the legs), purulent-septic lesions are noted, endometritis (inflammation of the uterine mucosa), symphysitis, mastitis occurs.

Why do overweight children need to be controlled?

As for babies, they most often suffer from hypoxia and are born in a state of asphyxia. Also, in newborns, the adaptation period is longer than in children with normal body weight.

Often newborns have neurological disorders (tremor, restlessness). Such phenomena are provoked by a violation of cerebral circulation. Sometimes there are quite severe birth injuries. However, they can also occur with a complication of the course of pregnancy.

Large babies may suffer from purulent-septic complications (eg, inflammation of the umbilical wound), which are caused by primary immunodeficiency (decrease in the level of immunoglobulins).

Weighty children after birth are under the supervision of a neonatologist, and later - a pediatrician. They need to visit an endocrinologist and a neurologist more often than others, because they are predisposed to obesity, diabetes, abnormalities in the neuropsychic status, and allergic reactions.

What to do if a large fetus is diagnosed

When the doctor said that the baby will be large, do not panic, it can only hurt. A weighty baby is a need for more careful monitoring during pregnancy and during childbirth. After making a diagnosis, the doctor will try to find out the cause.

If excessive growth is caused by any pathology, treatment with medications in a hospital may be necessary until the birth itself.

When the causes lie in heredity or obesity, then a diet is prescribed so that food does not contribute to weight gain, but supplies the body with the necessary nutrients. It is recommended to carefully monitor your diet in the first trimester to prevent significant weight gain, as well as to do special exercises for pregnant women.

The decision to give birth is made purely on an individual basis. It is worth discussing this issue with your doctor, taking into account the peculiarities of the course of pregnancy. Sometimes expectant tactics are chosen, in other situations a caesarean section is immediately prescribed.

Indications for surgical intervention already in the process of childbirth is a size discrepancy (large head, narrow pelvis), observed for more than 4 hours. Even if natural childbirth is scheduled, they may resort to surgical procedures, but only if there is a threat to the life of the child or mother.

It is customary to talk about a large fetus if at birth the child has a body weight of 4000 to 5000 g, a giant (giant) fetus is considered if its weight exceeds 5000 g. Both large and giant fetuses usually differ from other fruits not only greater weight - an increase in body weight is accompanied by an increase in body length and other indicators.

The development of the fetus is determined by the state of health of the pregnant woman and depends on the state of the placenta, which performs complex functions in the system of maternal-fetal relations. In the absence of damaging effects of external and internal factors, the fetus grows according to certain patterns. With a complicated course of pregnancy and impaired function of the placenta, the growth processes of the fetus are disrupted - the rate of its growth slows down or accelerates, as, for example, in women with diabetes mellitus.

In the last decade, the number of births of large fetuses has increased: it is 8-18.5%. The birth of giant children is much less common.

Why are babies born big?

There are many reasons for the development of large fruits, and they are not fully understood. The highest risk factors include alimentary-metabolic obesity (obesity due to increased food intake) and heredity.

Overnutrition of a pregnant woman. Nutrition should meet the needs of the mother's body and the growing fetus. Improvement of social and living conditions, excessive high-calorie nutrition - on the one hand, on the other - physical inactivity, a decrease in the use of physical labor, and therefore a decrease in energy costs - all this negatively affects the health of a pregnant woman. degrees of increasing appetite, excessive consumption of carbohydrates (bakery and confectionery products) and fats, fast food intake leads to the intake of excess calories and, due to the inability to adequately assimilate them, adversely affects metabolic processes: an increase in sugar, lipids, cholesterol is noted in the blood of a pregnant woman, This leads to obesity in the mother and increases the risk of developing a large fetus.

The main test for assessing the rational nutrition of a woman in the second half of pregnancy is an increase in body weight. It is the excessive weight gain of a woman in the second half of pregnancy that affects the rate of fetal weight gain, since at the beginning of pregnancy, the laying of organs and systems occurs, and in the second half (especially in the third trimester) - growth and muscle mass gain. An increase in the weight of a pregnant woman over 0.5 kg per week and its increase during pregnancy by more than 15 kg indicates either an increase in edema or fat deposition.

hereditary factors. The development of a large fetus in harmoniously developed, tall, healthy parents can be considered a physiological hereditary phenomenon. Large children in such cases are characterized by a proportional increase in body size and do not have any pathological manifestations. Children at birth have both a large body weight and length. The value of the ratio of the length of the femur to the circumference of the abdomen, determined by ultrasound, remains within normal individual fluctuations.

There is an increase in the risk of having large children in parents who themselves were born large (more than 4000 g).

The risk of having a large baby is high in women who have had a large fetus in the past. It is likely that the repeated birth of large fetuses in the same woman is not accidental and is probably due to the individual characteristics of the blood circulation in the uteroplacental system.

Endocrine-metabolic diseases(diabetes, obesity). In the presence of diabetes mellitus - a disease in which the process of glucose uptake is impaired, all types of metabolism are changed - or when it develops during pregnancy, there is a violation of carbohydrate metabolism in the direction of its acceleration. This leads to an excess of glucose in the blood of the mother and umbilical cord blood of the fetus, contributes to an increase in fetal weight, is often accompanied by changes in lipid metabolism with the accumulation of fat reserves, the fetus grows unevenly, its growth either accelerates or slows down, due to periods of increased or decreased content maternal blood sugar.

With diabetes, large children can be born with the following features: a moon-shaped puffy face, a short neck, a wide shoulder girdle, a large torso due to an increase in the liver, spleen, and subcutaneous fat layer. There is an increase not only in body weight, but also in its length, but the child is disproportionately complex. The size of the head and length of the femur are at the upper limit of the norm, the size of the abdominal circumference exceeds it, and the ratio of the length of the femur to the circumference of the abdomen is below individual normal fluctuations. up to 6 years).

There is a direct relationship between the degree of obesity of the pregnant woman and the average weight of the newborn, because. there is a violation of lipid metabolism: a high mobilization of free fatty acids from the blood of a pregnant woman to the fetus contributes to its rapid growth.

Obesity of the father of the child is also regarded as one of the risk factors for large pregnancies.

A large fetus does not develop in all women with obesity, since obesity can create conditions that are unfavorable for the blood supply to the fetus - inferiority of the uteroplacental system, complications of pregnancy.

The mechanism of the formation of a large fetus in obese women is as follows: in such women, the blood sugar level in the second and third trimesters of pregnancy is slightly increased, which indicates a possible deterioration in the absorption of glucose in case of its excessive intake with food and is due to relative insulin deficiency, i.e. e. latent diabetes mellitus. The penetration of a large amount of glucose into the body of the fetus leads to the fact that the pancreas begins to function with an increased load, which ultimately leads to the formation of a large fetus. Thus, the birth of a large fetus is one of the risk factors for diabetes in the mother.

Overwearing. An increase in the duration of pregnancy can lead to the birth of large children. It is possible both physiological prolongation (extension) of pregnancy by 2 weeks (pregnancy lasts longer than 40 weeks, while the condition of the fetus does not suffer), and biological true overgestation, in which there are signs of overmaturity of the newborn and placenta: the weight of the fetus is 4000 g or more, it is noted an increase in its length and volume of the head. With true overwearing of the skull bones of a large fetus, they are more massive and denser, the sutures and fontanelles are less wide and extensible, as a result of which the mobility of the skull bones in relation to each other (configuration) is reduced, which can complicate the course of childbirth.

features of the placenta. The morphological and functional features of the placenta also contribute to the development of a large fetus. In the case of the birth of a large fetus, large sizes and volume of the placenta are noted. Large thickness (more than 5 cm), area and volume of the placenta lead to a more intensive exchange and accelerated development of the fetus. The hormonal function of the fetal-placental system in a pregnant woman with a large fetus is characterized by instability, changes in the level of placental hormones in the blood indirectly affect the metabolic processes in the mother's body and thus affect the growth and development of the fetus.

An increase in the volume of circulating blood with an intensive blood supply also contributes to the development of a large fetus: in such conditions, the fetus receives more nutrients. The location of the placenta on the back wall of the uterus contributes to the development of a large fetus: probably, with this arrangement of the fetus, more favorable conditions are created for the blood supply to the fetus.

Larger children with repeated pregnancies are born due to better intrauterine nutrition associated with the development of a network of blood vessels in the uterine wall. A certain role is played by the best conditions for the development of the fetus due to the greater extensibility of the uterus and less resistance of the abdominal press. More often, an increase in fetal weight occurs between the third and fifth births.

Uncontrolled long-term use of drugs that improve uteroplacental circulation also contributes to fetal growth.

Other factors. Large sizes are more common in male fetuses. In young women (under 20 years old) and older women (after 34 years old), the birth of large children is also often noted. The presence of inflammatory diseases of the female genital organs, a violation of the menstrual cycle in the past can also affect the development of a large fetus.

How do they know about a large fetus?

The basis for the diagnosis of a large fetus during pregnancy and childbirth are:

The use of traditional methods - such as measuring the height of the fundus of the uterus above the womb and the circumference of the abdomen, which is carried out by the doctor at each visit to the pregnant woman. In a woman bearing a large fetus, already from the 24th week, a significant excess of the height of the uterine fundus and abdominal circumference is 3-3.5 cm or more from the norm for a given gestational age, and this trend continues until childbirth. A large fetus in childbirth is indicated by the volume of the abdomen (at the level of the navel) over 100 cm, the height of the fundus of the uterus above the womb is more than 42 cm. ), abdominal circumference, length of the femur of the fetus. In large fetuses, fetal measurements are usually 2 weeks longer than normal for a given gestational age. The ratio of the length of the femur to the circumference of the abdomen is also important.
Pregnancy weight control. Assuming a large fetus allows an increase in weekly weight gain by more than 0.5 kg, as well as a total weight gain of a pregnant woman of more than 15 kg in the absence of symptoms of gestosis - edema, increased blood pressure, and the appearance of protein in the urine.

Possible complications during childbirth

Childbirth with a large fetus, as a rule, begins on time. However, when they are worn out, they can be late, and in diabetes mellitus they can be premature.

In tall women with normal height and weight indicators, the frequency of complications during pregnancy and childbirth is insignificant. The features of the course of the birth act are the following complications (their frequency increases in direct proportion with the growth of the mass of the fetus):

Untimely rupture of amniotic fluid- before the onset of labor (premature) or before the opening of the cervix (early) - due to the high standing of the fetal head, the lack of differentiation of water into anterior and posterior, and also, apparently, with the peculiarities of the fetal bladder and often associated with polyhydramnios. With the current of water, a loop of the umbilical cord may fall out, which poses a threat to the life of the fetus.
Anomalies of labor activity- weakness, discoordination. Discoordinated contractions of the uterus are characterized by painful contractions of irregular intensity and duration, and weakness of labor is characterized by short contractions of low strength or rare contractions of normal strength and duration, which leads to delayed cervical dilatation. The high frequency of weakness of the labor forces is explained by the overstretching of the muscles of the uterus, especially its lower segment, the large area of the placenta and the need for significant efforts to move a large fetus through the birth canal.
Acute fetal hypoxia(insufficient supply of oxygen) develops as a result of delaying labor, fatigue of the woman in labor, infection against the background of an increase in the anhydrous gap.
The situation of a clinically narrow pelvis develops as a result of a discrepancy between the large head of a large fetus, even the normal size of the mother's pelvis. Such childbirth, in the absence of complications and good labor activity, often ends through the natural birth canal.
Shoulder dystocia is a form of a clinically narrow pelvis, since there is a discrepancy between the size of the woman's small pelvis and the size of the shoulder girdle of the fetus. At the same time, the fetal head, due to its rounded shape, gradually moves forward, stretching the birth canal, while the fetal shoulders, having a rectangular shape, seem to get stuck after the birth of the head. Such critical situations require certain professional skills in providing assistance (a number of techniques) to free the shoulder girdle and may be accompanied by a fracture of the collarbone, shoulder, trauma in the cervical spine in a newborn. Shoulder dystocia is more often observed in large fetuses with diabetic fetopathy, that is, size features characteristic of women with diabetes mellitus (we discussed them above).
Increase in the number of surgical interventions associated with complications during childbirth. There is an increase in the frequency of delivery by caesarean section with pronounced signs of a clinically narrow pelvis, weakness of labor, not amenable to drug correction. When a large fetus is combined with a breech presentation (the pelvic part is facing the exit from the uterus, and not the head of the fetus), a scar on the uterus, overcarriage of an older primipara, the presence of various diseases, the unfavorable course of previous pregnancies and childbirth, a cesarean section is performed in a planned manner.
There are more and more childbirth with amniotomy (artificial opening of the fetal bladder), using medical methods to induce labor. Labor induction can be planned from 38-39 weeks of pregnancy in the presence of a large fetal mass in combination with extragenital pathology, and also when the pregnancy lasts more than 41 weeks (in the absence of signs of intrauterine fetal hypoxia).

postpartum problems

Complications in the mother. During childbirth with a large fetus, bleeding is noted in the afterbirth and early postpartum period due to the reduced contractility of the uterus and the presence of a large wound surface at the placenta attachment. In this regard, the number of manual examinations of the uterine cavity is increasing; during this procedure, the unseparated parts of the placenta are removed, as well as uterine massage, which helps to contract the muscles of the uterus and stop bleeding. Women in labor with a large fetus often experience perineal ruptures, deep vaginal ruptures, therefore, in order to prevent trauma to the mother and fetus, perineal dissection is widely used,

In the postpartum period, there is a delayed involution (reverse development) of the uterus, anemia (decrease in the amount of hemoglobin), hypogalactia (insufficient milk production). complications: endometritis - inflammation of the mucous membrane of the uterine cavity, symphysitis - inflammation of the pubic symphysis (place of articulation of the pubic bones), mastitis - inflammation of the mammary gland.

Adverse outcomes for newborns. Intrauterine fetal hypoxia during pregnancy and childbirth can lead to the birth of a child in a state of asphyxia - the cessation of oxygen supply to the fetus. There is a slowdown in the period of adaptation in the newborn.

Often large newborns have neurological disorders (anxiety, tremor - muscle twitches, changes in muscle tone and reflexes), which is a manifestation of cerebrovascular accident, there are also quite serious birth injuries.

The high frequency of purulent-septic complications (for example, inflammation of the umbilical wound, etc.) in large children is due to primary immunodeficiency (decrease in the number of immunoglobulins).

These children cause concern not only for neonatologists and pediatricians, but also for neuropathologists and endocrinologists, because they are predisposed to diabetes mellitus, obesity, more often have deviations in the neuropsychic status, they have an increased allergic background.

Prevention

Childbirth with a large fetus can be put on the verge between the norm and pathology. Therefore, the main goal pursued in the management of pregnancy and childbirth with a large fetus is to prevent possible complications.

For women at risk, antenatal hospitalization is mandatory to prepare for childbirth and choose the method of optimal delivery. Childbirth is carried out with constant monitoring of the condition of the fetus and the contractile activity of the uterus. Careful monitoring of the progress of labor is carried out (the rate of cervical dilatation, the insertion of the head and its advancement through the birth canal) in order to timely diagnose weakness of labor activity or a clinically narrow pelvis.

If the size of the fetus exceeds the norm, constant monitoring of the woman in labor is necessary, the widespread use of the vitamin-energy complex, antispasmodics, pain relief, the timely appointment of labor-stimulating therapy, and the prevention of fetal hypoxia (drugs are used for this).

When deviations from the normal course of childbirth are detected, the choice is often made in favor of a caesarean section.

To prevent bleeding at the time of eruption of the head or immediately after childbirth, a woman is given a drug that promotes uterine contraction; after childbirth, they put a dropper with reducing drugs. Even with the successful completion of childbirth and the birth of a child in a satisfactory condition, careful monitoring of the newborn is necessary. With proper and careful care, large children and giant children develop normally in the future.

Prevention of macrosomia (large size) of the fetus is carried out primarily in women with identified metabolic disorders, in pregnant women with obesity, overnutrition, diabetes mellitus.

Diet and beyond...

To prevent a large fetus, the doctor gives the woman the following dietary recommendations:

It is necessary to eat rationally and balanced, reducing the amount of pasta, bakery, confectionery products in the diet, reducing fat intake while maintaining a sufficient amount of protein, including a large amount of fruits and berries in the diet. The energy value of the diet should be in the range of 2000-2200 kcal (proteins - 120 g, carbohydrates - 250 g, fats -65 g), and in case of violation of fat metabolism, up to 1200 kcal.
There should be no hurry.
It is advisable to eat often (5-6 times a day), in small portions.
Pregnant women who are at risk for the formation of a large fetus are prescribed a predominantly vegetable diet (salads, greens, green beans, tomatoes, cabbage, vegetable oils from fats). Such women are recommended to completely exclude easily digestible carbohydrates from the diet (sweets, pastries, confectionery).
Be sure to combine a diet with daily exercise for 20-30 minutes (in the absence of contraindications).
With insulin-dependent diabetes, its strict correction is necessary, that is, control of blood sugar.

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.

The reasons

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.

Who was born to you?

Boy, 3800.

It just so happened that the news about the birth of a baby is accompanied by information about his weight. Every pregnant woman wants to give birth to a healthy, strong baby. Very often you have to hear notes of pride in your voice: And our Vanka was born in 4500! Bogatyr!

So the pregnant mommy thinks, how can she give birth to the same! But is it worth it? - the opposite question arises.

There is no single answer, no matter how hard you try to analyze and compare everything. After all, every woman is different. If we write now that it’s better to give birth to an “average” hero, there will be mothers who will say: we gave birth to three of 4800 each - and nothing: we are alive, healthy and happy. Personally, I myself have such acquaintances. And they gave birth quite easily. At the same time, it is difficult to give birth to a kilogram baby. So, again, everything is individual.

Throughout pregnancy, the doctor calculates the estimated body weight of the unborn baby. Naturally, not for the sake of curiosity. These indicators indicate whether the baby is developing correctly, and can also suggest what the birth itself will be like. You can calculate the body weight of the child as accurately as possible using (the dimensions of the head, diameter and, length of the femur and humerus are compared). By external signs, it is impossible to reliably determine the weight of the unborn baby. A very large belly is not an indicator at all.

There is an opinion that if a large fetus is suspected, a pregnant woman is immediately prepared for a caesarean section. However, this is not always the case. For such an operation, such a factor is not enough. There must be other indications for a caesarean section. For example, an anatomically narrow pelvis occurs in 5-7% of pregnant women. Such a diagnosis can be made to you by taking a series of measurements. If there is a discrepancy between the size of the fetal head and the pelvis of the expectant mother, it will be safer to perform a caesarean section. An indicator for the operational resolution of childbirth is almost always the breech presentation of the child and the narrow pelvis of the mother. In this case, even a fruit weighing from 3.5 kg is large. But you should not worry, because women give birth even to heavy babies without complications. The main thing is to trust the doctor and believe in yourself.

So what exactly determines the mass of the unborn child?

One of the reasons for a large fetus is heredity. The same principle applies here, according to which twins and triplets are born. Therefore, if large children were born in your family or your husband's family before, the same fate awaits you. The physique of the father also matters. Naturally, the baby will have someone to go to if he is born with a body weight above 4 kg. Statistics also state that during repeated births, the weight of the baby is always several grams more than the previous one.

Definitely, you will give birth to a difficult baby if there is a post-term pregnancy. It is considered as such if its duration is increased by 14 days. 42 weeks of pregnancy is already a pathology. In addition to the fact that the baby will be large, there are more dangerous complications during childbirth.

Diabetes mellitus in a mother also provokes a large weight of her unborn baby. Indeed, in the body of a woman, the absorption of glucose is impaired, there is a failure in metabolism, because of this, too much glucose enters the baby's blood, which means that its growth rate is much higher than normal. It is likely that in this situation, the baby himself will inherit a disturbed metabolism. If a woman who is carrying a large fetus has a late one, the level decreases - the doctor can cause artificial premature birth. Indeed, in such cases, there is a danger of the death of the fetus in the womb.

And yet, the most common cause of the birth of heroes is the malnutrition of a pregnant woman. Eating "for two" is by no means impossible. Also give up extra buns and sweets in favor of vegetables and fruits. In the second half of pregnancy, eat no more than 400 grams per day of foods that contain a large amount of carbohydrates. Their excess leads to both you and the baby. It is best to take care of enriching the body with useful substances and vitamins. Both you and your baby need calcium. Therefore, do not forget about dairy products. Eat often, but in small amounts.

Remember, it doesn’t matter at all what weight your angel will be born with, the main thing is that both he and you are healthy!

Specially for- Tanya Kivezhdiy