Large for Gestational Age Fetus
- Large Fetus for Gestational Age
- Large Fetus: Signs and Diagnostics
- Do the Women Pregnant With the Large Fetus Need to be Hospitalized Prior to Delivery?
- How to Prevent a Large Fetus?
- It’s My First Pregnancy and a Large Fetus, is the Caesarian Section the Must for Me?
Large Fetus for Gestational Age
The fetal age may be defined by pre-birth method as follows: by the date of the last period, by the date of first fetal movement (as a rule, first fetal movements are felt at 16-18 weeks of pregnancy), by hearing first heart sounds (at 10-12 weeks using the ultrasonic Doppler examination) and ultrasonography (most accurate results are obtained up to 20 weeks).
The fetal age may be defined most accurate in the prenatal period within the first trimester. Postnatal evaluation of the gestational age is not reliable and this is especially difficult for prematurely born and postmature children.
As per American Academy of Pediatrics recommendations, all newly born babies should be classified by the body weight and gestational age at birth. This article will address the most popular methods to define the after-birth gestational age.
Large Fetus: Signs and Diagnostics
Large fetus regarding its gestational age (large fetal size and body weight of the baby for the particular gestational age). This fetal condition is diagnosed as per two standard deviations – excess average weight for the gestational age and over 90 percentile. Large fetus for gestational age refers to the fetus of women who suffer from diabetes mellitus, fetus with Beckwith-Wiedemann syndrome and other syndromes. The fetus may be large for its gestational age just for its constitutional peculiarity of parents with known overweight or due to fetal hydrops.
If a pregnant woman has a protruding belly, it does not mean a large baby. Multifetal pregnancy and polyhydramnios (most pregnant neglect ultrasound examination at this critical pregnancy period) should be first excluded
By the Week 38 of pregnancy, and even earlier, the objective evidence obtained during the obstetrician’s visit will be the clinical signs of a large fetus. Any time when a pregnant visits the prenatal clinics, her body mass is checked. A weekly 500 g increase in the weight with no edema and other signs of gestational toxicosis will be the reason to suspect a large fetus.
A large fetus takes a larger place in the uterus and the woman feels her inner organs significantly compressed and impacted. Such organs bear a greater load applied to them. As a result, a pregnant woman is reported to have more frequent urination, heartburn (spread of the gastric material to the esophagus), constipation and apnoea. A womb greater in size applies the pressure to the inferior vena cava that may provoke faint when lying on the back. The load to the musculoskeletal system increases causing pains in legs, in lumbar region, in the spinal column and ribs. Varix dilatation may occur or get worse if any. A woman is at the risk to develop stretch marks on the belly and increasing uterus tone.
Ultrasonography is an excellent method to diagnose a large fetal. It allows accurate measurements of fetal metric data and its expected weight. The fetal head and abdomen circumference, the length of femoral bone and upper arm are measured. A larger head and considerable abdomen values, enlarged liver and spleen, any liquid visualized in body cavities tell of the dropsical haemolytic disease.
Do the Women Pregnant With the Large Fetus Need to be Hospitalized Prior to Delivery?
Certainly, all women diagnosed with a large fetus are recommended that they are hospitalized at 38-39 weeks of pregnancy. A doctor will take accurate measurements of the pelvis and belly, will evaluate the health state of a pregnant (whether any extragenital diseases or pregnancy complications are available), readiness of uterine cervix (maturity) and will make the labor management plan. If there are any indications, the doctor will address the issue of elective caesarian section and pre-surgery preparation procedures.
How to Prevent a Large Fetus?
First, a woman should keep to a balance diet from the first days of pregnancy. The diet should contain the adequate proportion protein, fat and carbohydrates required for the fetus. A mother-to-be should avoid overnutrition, excess of sweets, pastries, fat and fried meal, and, as per the health condition, to do special pregnancy exercise and avoid physical inactivation (lying and sitting frequently and for long).
It’s My First Pregnancy and a Large Fetus, is the Caesarian Section the Must for Me?
It’s not absolute indication, especially in case of first delivery in young women. Most frequently, young healthy women do not have problems during pregnancy and they successfully deliver a healthy large fetus with no complications.
Video: How accurate are ultrasounds in determining the size of a baby?