Macrosomia Fetal

Description

The term "macrosomia fetal" is used to describe a newborn baby is much bigger than the average.

A baby who is diagnosed as having macrosomia fetal weighs more than 8 pounds, 13 ounces (4,000 grams), regardless of gestational age. Approximately 9% of babies all over the world weighs more than 8 pounds, 13 ounces.

Risks associated with macrosomia fetal increases greatly when the birth weight is more than 9 pounds 15 ounces (4,500 grams).

Macrosomia Fetal can complicate vaginal delivery and can put the baby at risk of injury during birth. Macrosomia Fetal also puts the baby at a higher risk of health problems after birth.

Symptoms

Macrosomia Fetal can be difficult to detect and diagnose during pregnancy. Signs and symptoms include:

  • Large fundal height. During prenatal visits, your health care provider may measure your fundal height — the distance from the top of your uterus to your pubic bone. A larger than expected fundal height may be a sign of macrosomia fetal.
  • Excess amniotic fluid (polyhydramnios).Having too much amniotic fluid (the fluid that surrounds and protects the baby during the pregnancy could be a sign that your baby is larger than average. The amount of amniotic fluid that reflects your baby's urine output, and a larger baby produces more urine. Some conditions that cause a baby to be bigger may also increase the production of urine.

Excess amniotic fluid (polyhydramnios). Having too much amniotic fluid (the fluid that surrounds and protects the baby during the pregnancy could be a sign that your baby is larger than average.

The amount of amniotic fluid that reflects your baby's urine output, and a larger baby produces more urine. Some conditions that cause a baby to be bigger may also increase the production of urine.

Causes

Genetic factors and maternal conditions, such as obesity or diabetes, can cause macrosomia fetal. In rare cases, a baby may have a medical condition that makes him or her grow faster and larger.

Sometimes it is unknown what causes a baby to be larger than average.

Risk factors

Many factors can increase the risk of macrosomia fetal — some you can control, but others you can't.

For example:

  • Maternal diabetes.Macrosomia Fetal is more likely if you have had diabetes before pregnancy (pre-gestational diabetes), or if you develop diabetes during pregnancy (gestational diabetes). If your diabetes is not well controlled, it is likely that the baby has a higher shoulders and a greater amount of body fat that a baby whose mother did not have diabetes.
  • A history of macrosomia fetal. If you've previously given birth to a large baby, you are at greater risk of having another big baby. Also, if you weigh more than 8 pounds, 13 ounces at birth, you are more likely to have a big baby.
  • Maternal obesity. Macrosomia Fetal it is more likely that if you are obese.
  • Excessive weight gain during pregnancy. Gaining too much weight during pregnancy increases the risk of macrosomia fetal.
  • Previous pregnancies. The risk of macrosomia fetal increases with each pregnancy. Until the fifth pregnancy, the average birth weight for each successive pregnancy usually increases until about 4 ounces (113 grams).
  • To have a child. The male babies usually weigh a little more than female infants. The majority of babies weighing more than 9 pounds 15 ounces (4,500 grams) are men.
  • Expired pregnancy. If the pregnancy continues for more than two weeks before your due date, your baby is at increased risk of macrosomia fetal.
  • The maternal age. Women older than 35 years are more likely to have a baby with a diagnosis of macrosomia fetal.

Maternal diabetes. Macrosomia Fetal is more likely if you have had diabetes before pregnancy (pre-gestational diabetes), or if you develop diabetes during pregnancy (gestational diabetes).

If your diabetes is not well controlled, it is likely that the baby has a higher shoulders and a greater amount of body fat that a baby whose mother did not have diabetes.

Macrosomia Fetal is more likely to be a consequence of maternal diabetes, obesity or weight gain during pregnancy, and other causes. If these risk factors are not present and macrosomia fetal suspected, it is possible that your baby could have a rare medical condition that affects fetal growth.

If a rare medical condition that is suspected, the doctor may recommend diagnostic testing prenatal and perhaps a visit to a genetic counselor, depending on the results of the test.

Complications

Macrosomia Fetal poses risks to the health of you and your baby during pregnancy and after childbirth.

Maternal risks

Possible maternal complications of macrosomia fetal may include:

  • Labor problems . Macrosomia Fetal can cause the baby to become wedged in the birth canal (shoulder dystocia), sustain birth injuries, or require the use of forceps or vacuum during delivery (vaginal delivery operative). Sometimes a c-section is necessary.
  • Lacerations of the Genital tract. During the delivery, macrosomia fetal can cause the baby to injury to the birth canal — and for the tearing of the vaginal tissues and the muscles between the vagina and the anus (perineal muscles).
  • The bleeding after childbirth. Macrosomia Fetal increases the risk of uterine muscles do not properly contract after giving birth (uterine atony). This can potentially lead to serious bleeding after delivery.
  • Uterine rupture. If you have had a previous caesarean section or major uterine surgery, macrosomia fetal increases the risk of uterine rupture during labor — a rare but serious complication in which the uterus breaks down along the line of the scar of cesarean section or other uterine surgery. An emergency cesarean section is necessary to prevent life-threatening complications.

Newborn and childhood risks

The possible complications of macrosomia fetal for your baby can include:

  • Lower than normal level of sugar in the blood. A baby with a diagnosis of macrosomia fetal is more likely to be born with a blood sugar level that is lower than normal.
  • Obesity in childhood. The research suggests that the risk of obesity increases as birth weight increases.
  • The metabolic syndrome.If your baby is diagnosed with macrosomia fetal, he or she is at risk of developing metabolic syndrome in childhood. The metabolic syndrome is a cluster of conditions — increased blood pressure, a high blood sugar level, excess body fat around the waist and abnormal cholesterol levels — that occur together, increasing your risk of heart disease, stroke and diabetes.

The metabolic syndrome. If your baby is diagnosed with macrosomia fetal, he or she is at risk of developing metabolic syndrome in childhood.

The metabolic syndrome is a cluster of conditions — increased blood pressure, a high blood sugar level, excess body fat around the waist and abnormal cholesterol levels — that occur together, increasing your risk of heart disease, stroke and diabetes.

More research is needed to determine whether these effects could increase the risk of adult diabetes, obesity and heart disease.

Prevention

You might not be able to prevent macrosomia fetal, but it can promote a healthy pregnancy. Research shows that exercise during pregnancy, and eating a low-glycemic diet may reduce the risk of macrosomia.

For example:

  • Schedule a preconception appointment. If you are considering pregnancy, talk with your health care provider. If you are obese, you may also be referred to another health care provider — such as a dietitian or a specialist in obesity — which can help you reach a healthy weight before pregnancy.
  • Control your weight. Gaining a healthy amount of weight during pregnancy — frequency of 25 to 35 pounds (11 to 16 kilograms) if you have a normal weight before pregnancy — it supports your baby's growth and development. Women who weigh more when they are pregnant have lower recommended pregnancy weight gain. Work with your health care provider to determine what is right for you.
  • Control diabetes. If you have had diabetes before pregnancy, or if you develop gestational diabetes, work with your doctor to manage the condition. Control your blood sugar level is the best way to prevent complications, including macrosomia fetal.
  • Be active. Follow your health care provider recommendations for physical activity.

Macrosomia Fetal

Diagnosis

Macrosomia Fetal cannot be diagnosed until after the baby is born and weighed.

However, if you have risk factors of macrosomia fetal, your health care provider is likely that the use of tests to monitor your baby's health and development during pregnancy, such as:

  • Ultrasound.Towards the end of their third trimester of pregnancy, your doctor or another member of your health care team can do an ultrasound to take measurements of parts of your baby's body, such as the head, abdomen and femur. Your health care provider then connect these measures in a formula to estimate the weight of your baby. However, the accuracy of ultrasound imaging to predict macrosomia fetal has been unreliable.
  • Antenatal testing.If your doctor suspected macrosomia fetal, he or she can perform antenatal, such as a nonstress test or fetal biophysical profile, to monitor your baby's well-being. A nonstress test measures the baby's heart rate in response to its own movements. Fetal biophysical profile combines effortless, testing with ultrasound to monitor your baby's movement, tone, breathing and the volume of amniotic fluid. If your baby is excess growth is thought to be the result of a disorder of the mother, your health care provider may recommend antenatal — starting as soon as the 32nd week of pregnancy. Please note that the macrosomia alone is not a reason for antenatal testing to monitor your baby's well-being.

Ultrasound. Towards the end of their third trimester of pregnancy, your doctor or another member of your health care team can do an ultrasound to take measurements of parts of your baby's body, such as the head, abdomen and femur. Your health care provider then connect these measures in a formula to estimate the weight of your baby.

However, the accuracy of ultrasound imaging to predict macrosomia fetal has been unreliable.

Antenatal testing. If your doctor suspected macrosomia fetal, he or she can perform antenatal, such as a nonstress test or fetal biophysical profile, to monitor your baby's well-being.

A nonstress test measures the baby's heart rate in response to its own movements. Fetal biophysical profile combines effortless, testing with ultrasound to monitor your baby's movement, tone, breathing and the volume of amniotic fluid.

If your baby is excess growth is thought to be the result of a disorder of the mother, your health care provider may recommend antenatal — starting as soon as the 32nd week of pregnancy.

Please note that the macrosomia alone is not a reason for antenatal testing to monitor your baby's well-being.

Before your baby is born, you may also consider consulting a pediatrician who has experience in the treatment of infants with a diagnosis of macrosomia fetal.

Treatment

When it's time for your baby to be born, a vaginal birth is not necessarily out of the question. Your doctor will discuss the options and the risks and benefits. He or she is going to supervise his work closely for possible signs of a complicated vaginal delivery.

Induction of labor by stimulating uterine contractions before labor begins on its own — is not generally recommended. The research suggests that the induction of labor does not reduce the risk of complications associated with macrosomia fetal and may increase the need for a cesarean section.

Your doctor may recommend a c-section if:

  • You have diabetes. If you have had diabetes before pregnancy or gestational diabetes and their health care provider believes that your baby weighs 9 pounds, 15 ounces (4,500 grams) or more, a cesarean section may be the safest way for your baby.
  • Your baby weighs 11 pounds or more, and you have no history of maternal diabetes. If you do not have pre-gestational or gestational diabetes and their health care provider believes that your baby weighs 11 pounds (5,000 grams) or more, a cesarean section may be recommended.
  • You had a baby whose shoulder got stuck behind your pelvic bone (shoulder dystocia). If you have delivered a baby with shoulder dystocia, you are at higher risk of the problem happening again. A c-section might be recommended to avoid the risks associated with shoulder dystocia, such as a fracture of the clavicle.

If your health care provider recommends an elective caesarean section, be sure to discuss the risks and benefits.

After your baby is born, he or she will likely be examined for signs of birth injuries, abnormally low blood sugar (hypoglycemia), and a blood disorder that affects the red blood cell count (polycythemia). He or she may have special care in the hospital in the neonatal intensive care unit.

Keep in mind that your baby may be at risk of childhood obesity and the insulin resistance and should be monitored for these conditions in the future revisions.

Also, if it has not previously diagnosed with diabetes and their health care provider is concerned about the possibility of diabetes, which may be tested for the disease. During future pregnancies, you're going to be closely monitored for signs and symptoms of gestational diabetes, a type of diabetes that develops during pregnancy.

Coping and support

If your doctor suspected macrosomia fetal during pregnancy, you may feel anxiety for childbirth and your baby's health — and worrying can make it difficult to take care of yourself.

Consult your health care provider about what you can do to relieve stress, and promote the health of your baby. Also consider the possibility of requesting information and support to women who have had babies with a diagnosis of macrosomia fetal.

Preparing for your appointment

If you have risk factors of macrosomia fetal, the issue is likely to reach the routine prenatal appointments.

Below are some basic questions to ask your health care provider about macrosomia fetal:

  • What is likely to cause the disease?
  • What kinds of tests do I need?
  • What needs to be done now?
  • I need to follow any kind of restrictions?
  • How macrosomia fetal harm my baby?
  • I have to have a c-section?
  • My baby need tests or special care after he or she was born?

In addition to the questions that we have prepared, do not hesitate to ask questions during your appointment.

Symptoms and treatment of macrosomia Fetal