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When a child is born big ... Fetal macrosomia

When a child is born big ... Fetal macrosomia


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Large birth weight of the child is becoming more common. is a big challenge for modern medicine. In our generation, the birth of a baby weighing around 4 kilograms was a great event. It happens more often today. Does this mean that 4,000 grams are no longer surprising? Are we still talking about in this case? too big baby? Or maybe the norms are changing and fetal macrosomia means something different today?

What is fetal macrosomia?

Definition, what is fetal macrosomia (LGA (Large fo gestational age), it varies depending on the source we refer to. Some midwifery textbooks indicate that we are talking about her, when the weight of the child exceeds 4000 grams, others about the fact that macrosomia is a condition when the child is born with a weight over 4,200 grams, other manuals this limit is set at 4500 grams. The differences between the individual values ​​are quite significant. Naming difficulties also. At present, delivery wards a bit higher than 4000 grams are often found, while 4500 much less often. The average weight of a newborn baby is still between 3250 and 3400 grams.

Another definition is that fetal macrosomia is when the birth weight exceeds 90 percentile body weight for the appropriate fetal age, race and sex.

Most experts believe that macrosomia is:

  • birth weight higher than 4000 grams - 1st grade macrosomia,
  • birth weight higher than 4500 grams - macrosomia of the second degree,
  • birth weight higher than 5000 grams - 3rd grade macrosomia.

Too small for a child too bad, too bad. Why are children born too big?

As it happens in nature, the most favorable is moderation, the so-called golden mean, because when a child is born too small, it is not a favorable situation. On the other hand, giving birth to an oversized child is also not a simple fact - most women have a problem (though this is not the rule!) With the birth of large children. A large newborn is a risk of prolonged delivery, increased loss of blood in the woman giving birth, the risk of using ticks or vagina and delivery by caesarean section increases. In addition, the risk of complications increases with delivery by nature - collarbone fractures, brachial plexus paralysis, facial nerve damage and hypoxia.

Despite the ever better development of medicine and extensive research, still we do not know all the causes of fetal macrosomia. The most common in this context are:

  • maternal diabetes (may also cause low birth weight),
  • severe overweight or obesity,
  • hypertension,
  • delivery after the deadline,
  • pregnancy after 40 years of age,
  • newborn male sex,
  • genetic predisposition (family tendency to give birth to large children).

There is an opinion that large children are usually born healthy and are not as worried about their health as they are for small infants. This is not entirely true. For large newborns it is necessary observation for postpartum hypoglycemia (low blood glucose), breathing problems, neonatal jaundice (increased bilirubin). For large children it exists greater risk of perinatal injuries. It is also necessary to observe the feeding and the degree of weight loss.

Sometimes large children, weighing 5000 grams and more, give birth to short and slim women with similar partners. There is no rule. Childbirths during which large newborns are born usually surprise. When the child does not fit into the cone and fills the whole stroller ... Special shock was experienced by the doctors who received delivery of a 18-kilo (!!!) newborn child born to a woman living in Australia, weighing 270 kilograms. The delivery took place by caesarean section, the baby was born healthy.

It is increasingly said that Fetal macrosomia for newborns weighing more than 4 kilograms is not a problem, but the norm of today. It is to be associated with increasing prosperity, a sedentary lifestyle and access to caloric foods.

Symmetrical and asymmetrical macrosomia

In women non-diabetic patients have symmetrical macrosomia, which is manifested by an increase in body weight and body fat. IN asymmetric macrosomia, which is observed in children of women with diabetes, the changes are uneven, body proportions are disturbed, the circumferences of the shoulders and abdomen are increased, the circumference of the head in relation to the chest is reduced.

When can you expect the birth of a big child? Medical diagnosis

Your doctor can predict the birth of a large child during your medical history and pregnancy. Observation future mother's weight gain is significant in this respect. A large increase in weight during pregnancy is usually associated with the birth of a larger child.

A very valuable tool is ultrasound examination, which lets you predict how big your baby will be born. Unfortunately it is not perfect. It happens that during the examination the child "seems" big, and the birth is much smaller, and vice versa. It is worth bearing in mind the possibility of underestimation or distortion in the case of received ultrasound results - the quality of the equipment used and the experience of the doctor are also important.

If macrosomia is suspected, depending on the stage of development of the pregnancy, it is planned to:

  • inducing labor
  • Caesarean section
  • observations

In macrosomia, however, the most important thing is prevention - controlling diabetes during pregnancy, avoiding excessive blood glucose, using a healthy, balanced diet that will not lead to fluctuating blood sugar. Systematic weight control and efforts to avoid excessive weight gain are key. If physical activity is not prohibited by the doctor, good take care of regular walks and repetition of exercises recommended during pregnancy.

Prevention is very important because fetal macrosomia increases the risk of future childhood obesity and the occurrence of metabolic diseases.