3rd Trimester

measuring big?

Last week at my normal check up my dr informed me that my ute is measuring 5 weeks ahead of my due date. My first U/S showed baby boy measuring right on track and at our A/S he was measuring a week ahead. Could my little guy just be really large?

My dr is worried about him becoming to large for me to carry and is thinking about inducing in mid April rather than the first week in May. Should I be concerned that she wants to do this? DS was born at 38w6d and had a huge scab on his scalp due to him rubbing against my pelvic bone, he was only 20" at birth.

Thanks for any advice.

Re: measuring big?

  • I'm not a fan of inductions based on weight. Both measuring fundal height and ultrasounds can be pretty far off as far as size indications go. 
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  • I completely agree with you. She is worried that the same thing that happened with DS might happen again with this little guy.

    I think her worry stems from the fact that I was almost an 8lber, MF was almost a 9lber, and of course my dad was almost a 10lber.

    I don't know if I should get a 2nd opinion on this or what. I love my dr but I do not want to risk my baby.
  • Our baby is measuring big as well. We get biweekly ultrasounds (high-risk from Type 1 diabetes). She is consistantly 4 weeks big. While ultrasounds are by no means accurate, after so many ultrasounds consistently saying she is measuring the same 4 weeks big (97th percentile) I have the feeling they are somewhat accurate in this case. If she was 4 then 2 then 6 then 4 weeks big I might doubt it a bit more.

     Needless to say that I am being induced at 38 weeks, possibly sooner. I am followed by a whole team of high risk professionals. They are concerned that baby will continue to get bigger, and bigger babies are more prone to shoulder dystocia (sp?). Which is very painful for the baby.  As well, for some reason type 1 diabetics have a slightly (over so slight) higher chance of still birth during last few weeks. Therefore I am not fighting the early induction.

     I would be weary of being induced based on only 1-2 measurements that read ahead.  I am friends with an ultrasound doctor and she said that the later in pregnancy you get the less accurate the scans are.

     Our baby was breathing solidly at our 30week scan and they said that she was an 'overachiever' and gave her bonus points for breathing so well through the whole scan.  At that point the babies usually only try a few breathes here and there.  This at least gave me some reassurance that by the time they force her out she will be that little bit more ready for the world on her own.

     Do you have more scans booked to follow up on her size? 

    My husband was born at 34 weeks, fully developed (lungs and all) and 6lbs, 10oz.  Which if our baby continues at 4 weeks ahead she will be the same size at the same time...this worries me, despite the doctors saying my husbands early arrival has nothing to do with my babies arrival.  Needless to say we are fully ready and the bags are in the car (31weeks tomorrow).  If this baby takes after her daddy she will be trying to overachieve and be first at everything!

     

  • Did she send you for an ultrasound or is this just based on your fundal height measurement?  Usually if your fundus is measuring 5 weeks ahead, your OB will look into it with and ultrasound.  1 or 2 weeks is no big deal but 5 is definitely a  big difference.

  • Agree with the others - I would not induce based on measurements alone (especially fundal height). Is your OB planning a growth u/s? The weight measurements in those can also be off, but it might give you a better idea of why you're measuring ahead. I've measured large with both pregnancies - with the first, it was a combo of a slightly larger than average baby (8+ lbs), excess amniotic fluid, and just the way I carry. No issues delivering my first vaginally (and 3 days late). I'm measuring ahead this time, as well, and have a growth u/s at my next appt. There has been no talk of induction, and there wasn't the first time around, either.
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  • We have an U/S scheduled next Wednesday and possibly another one at 36wks. I definitely feel a lot bigger with pregnancy than I did with my first.
  • ACOG does not recommend induction based on the size of the baby.

    This was taken from: "Practice Guidelines, ACOG Issues Guidelines on Fetal Macrosomia" (large baby)

     "...In cases of term patients with suspected fetal macrosomia, current evidence does not support early induction of labor. Results from recent reports indicate that induction of labor at least doubles the risk of cesarean delivery without reducing the risk of shoulder dystocia or newborn morbidity..."

     http://www.aafp.org/afp/2001/0701/p169.html

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  • I agree with the PPs on not inducing based on possibly large size. Measurements can be so off. 

    I had a BPP done two days before I went into (natural) labor. They estimated then that DD was going to be "a good 8 and a half pounder." She was 6 pounds 11 ounces.  

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  • Based on my 1st experience I would not induce on weight. They estimated Z was going to be huge and he was 8lbs 4oz, but they said 10lbs. They induced 2 days earlier and I was lucky that my induction went well. I had him vaginally and it was no issue with his size. They make it seem like inductions are no big deal, but there is a lot of things that can go wrong when labor is false started. Things I didn't look into when I was in the same situation you are in 3 years ago.
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  • image beppes1013:
    We have an U/S scheduled next Wednesday and possibly another one at 36wks. I definitely feel a lot bigger with pregnancy than I did with my first.

    I would wait until the growth u/s to really put a lot of thought into this. Although the measurements can be off, they're still a little more accurate than fundal measurements, especially with your second baby. It's still early enough that your LO could have gone through a major growth spurt and the weight/size will even itself out before your EDD.

    I was told that I was having a large baby from roughly 20 weeks on, and had two growth u/s. They estimated him at 9 1/2 lbs, and he was just slightly over 9. They were pretty close but even the u/s can be off by 1-2 lbs. Ultimately, you need to make the decision that YOU are most comfortable with for your body. They cannot force you to schedule an induction based on ultrasound/fundal measurements alone--- that's not part of ACOG guidelines for induction.

    Induction comes with it's own risks but so does having a large baby. Again, this is something that you need to look into for yourself and be at peace with whatever decision you end up making. That being said, I would definitely wait until AT LEAST 39 weeks if you end up scheduling an induction. 

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  • Thank you ladies. I definitely don't want to have another induction, last one ended up in an emergency csection, so I guess we will wait to see what the U/S says and hopefully it was just a major growth spurt last week.
  • With my first child I measured 4 weeks big from about 20 weeks on...Dr kept saying he was going to be a 10+ pounder and would go into labor before 40 weeks.

    Well...he came on his own at 41 weeks and was just over 7lbs...its all just a guess and an estimate.

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