3rd Trimester

Ultrasound sched -- excessive fetal growth

At my appointment on Friday, for the first time my doctor actually got to feel my bbabies limbs (he or she tends to hang out towards my back and has been that way at every appointment until this one)... and immediately started saying "omg... wow... and asked me if I was okay." BEGIN PANIC MODE?!

Turns out... she thinks my baby is very large and I am carrying very small. An ultrasound was scheduled for the 15th to get a better look. She said if it's on track to be 9-10 pounds, she's going to recommend at C-section around 38 weeks... or, if it's just fluid, she said we may want to consider an induction around the same time... I am of course now freaking out and March 15 feels so far away before I can get some answers!

I am not a tiny person... I am extremely fit, about 5'7", and weight around 140-145 not pregnant and do not see why a 9 lb baby is "too big" for me. I of course, like most, do not want an ultrasound, but will do whatever is best for baby...

Anyone have this happen to them? Advice? Experience? After we talked about it for about 60 seconds (and she partially blamed me for being so "tight" and "carrying so well" as the reason she could not tell it was big) and I was rushed out of the doctors office (another issue altogether), head spinning...  

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Re: Ultrasound sched -- excessive fetal growth

  • Pardon me, but your doctor sounds like a jerk. I don't think feeling the baby through your belly could give a very accurate idea of how big the baby is or how big it will become. For that matter, u/s are not known to be that accurate this late in pregnancy either. AND, a 9 to 10 lb baby is not something to panic and plan a c-section about, women give birth to babies that size (and larger) all the time.









  • I've heard a lot of stories where women are told they are having a "big baby" and baby is a whopping 7 lbs.  Personally, I would not get a c-section because of a "big baby" unless some health issue arises.  Women are perfectly capable of birthing 10 and 11 lb babies vaginally.

    Don't freak out yet.  Wait and see what shows up on the u/s and go from there. 

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  • Just noticed my typo -- I meant to say, "I of course, like most, do not want a C-SECTION" did not mean ultrasound haha I'm actually looking forward to seeing the little one on the ultrasound!
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  • Slight differences from you, but some similarities.  I'm 5'2, 34w4d and baby is measuring at 37 weeks with his dad's bigger than average head.  I AM HUGE.  In addition to a baby that currently weighs 6 1/2 pounds (give or take a pound), I have 23cm of amnio fluid, which is just about borderline too high.  

    So even with a big baby and extra fluid AND being short, my doctor is not worried at all.   No discussion of induction at all.  My baby could weigh between 8.5-9.5 pounds so I'm surprised that your doctor has this sense of urgency to get the baby out.  What are the risks of delivering without an induction?  Do you know how much fluid you have?  25-26cm is considered the beginning of what is considered too much but even then it's not necessary to induce.  A lot of times these things sort themselves out by the time we are term.  No need to jump to induction quite yet unless there are other underlying risks.  

    Call your OB and ask lots of questions so you KNOW you are doing what's best for you and baby :)   

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  • Also, the growth scans can be up to a pound off. They thought my daughter was going to be well over 10 1/2#s and she was born at 9# 5oz. Granted I did have a c-section but that's because she wouldn't decend.

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  • image ShadyKull:

    Pardon me, but your doctor sounds like a jerk. I don't think feeling the baby through your belly could give a very accurate idea of how big the baby is or how big it will become. For that matter, u/s are not known to be that accurate this late in pregnancy either. AND, a 9 to 10 lb baby is not something to panic and plan a c-section about, women give birth to babies that size (and larger) all the time.


    This. A 9 or 10 lbs baby is not really that big. Many women have babies much bigger. A possibly big baby isn't a good reason to start planning a c-section or early induction. 

  • I gave birth to a 9lb. 10 oz baby and it was waaaay easier than my first birth of a 7lber.  I had no tearing or anything...she was just fat and fat is squishy :)  I think it is crazy for your OB to think cs right away.  My OB and none that I have ever had would think this way.  They are usually thinking that natural is best for me and baby.

  • I, too, am carrying a suspected larger baby. At 29 weeks, he measured 3 weeks ahead, (90th percentiles for head and abdomen). My doctor is only concerned because I am also attempting a VBAC with this larger than normal baby. Though he has kept an eye on it (I go in for a follow-up ultrasound tomorrow) and has said he'd prefer if I went into labor spontaneously this week, he has not once mentioned moving up my RCS date or anything about induction before 41 weeks.

    The current recommendation is not to induce or c-section for a larger baby alone. If he's too big at 41 weeks, chances are he was probably too big at 39 weeks. They don't really grow that much more in the final weeks, they just plump up and it's the head size that really matters (possibly the shoulders, but that's only in relation to the size of your pelvis). Position also means more than size. I'm told my little 6lb 12oz firstborn gave the doctors a bit of pause because she decided to come out face-up, making it a difficult labor and causing complications. Being a modest size didn't help either of us there. We still had heart decels, I had to put on an oxygen mask, and they gave me an episiotomy because they needed to get her out quickly. My mom commented that my little girl gave the doctor's more trouble than any of her deliveries, and she delivered a 10lb 11oz baby boy at one point.

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  • Please don't let this freak you out.  You'll find there are others out there who are in EXACTLY the same boat.  My doctor told me at my appointment last week that the ultrasound I'd had the day before indicated my baby was already at 8lbs 1oz (at roughly 37.5 weeks) and I had a bit of a meltdown too, especially when she started talking about doing membrane sweeps and not wanting to let me go 5 days beyond my due date due to baby's size, etc.

    This was the first indication that baby was anything but average, and you're probably the same.  Despite the u/s results, my doctor expressed surprise at how small I still looked and how everything else indicated that baby was still only of an average size.  And all my previous ultrasounds had looked fine.

    Ultrasounds are often "off" because the professionals looking at and interpreting them are basing their estimate only on what they can see.  Everyone in both families (DH and I) are tall, and DH's side of the family tend to have big heads (damn them, lol) ... so for all I know, the baby's size could have been over-estimated based on long limbs and a big head.  The same could very well be true for you too.

    I really think that doctors in general prefer to err on the side of caution just in case baby does turn out to be larger than average, so don't let the talk of inductions or c-sections (which may or may not end up being necessary) scare you.  Big or not, that baby's gotta come out one way or another.  You've just got to try not to stress about HOW that will be happening!  

    As an aside, all of us who were told "big baby!" will have to compare notes once our LO's are here, I'll be curious to see how accurate these darn ultrasounds were for estimating weight.

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  • ACOG does not support induction (let alone a CS at 38w) based on a baby's potential size. I would absolutely not consent to a CS based on measurements alone, especially at 38w.

    I have measured large with both pregnancies (about 3 weeks ahead, baby showing around 80-90th percentile on the US) and my OB has never so much as mentioned induction or CS. DS was born 3 days late at 8 lbs. 1 oz. so it's not like he was massive or anything. They are saying this one will probably be a little bigger. 

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  • image tmsgrl:
    I gave birth to a 9lb. 10 oz baby and it was waaaay easier than my first birth of a 7lber.  I had no tearing or anything...she was just fat and fat is squishy :) 

    I think I love you, lol. Wish I'd read this when my SIL (a R.N.) and DH were both trying to talk me down after the initial shock of my appointment (see above). Fat IS squishy, isn't it!?

    I also agree it's more the position of the baby, the way they make their exit, etc. that determines what kind of a labour experience you're going to have.  I've read about many women who had a harder time delivering a smaller baby (due to the way they chose to make their exit) compared to a larger one. 

    Thanks for reminding us all that size isn't everything!

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  • My husband's grandmother is a scrawny, tiny lady and she popped out 3 babies weighing from 9lbs10oz to 10lbs13oz and she surivived and with it be 50+ years ago did it no (or less effective) drugs than mom's now a days have the option of...so don't doubt your body's ability to get a 9pounder out!!

    I wouldn't put much trust in a belly feel sizing attempt!  And for that matter I wouldn't put much trust in one ultrasound late in the third trimester as they greatly lose their sizing prescision the later in pregnancy you get.

    If everything else has been healthy this pregnancy I would be weary of an early induction or c-section just based on weight.

    This is coming from a FTM that is highly likely to be induced in 3 or so weeks (at 38 weeks) but I've got numerous other factors in addition to a baby that has been 97th percentile for over 6 ultrasounds in the last few months the weight doesn't so much scare me it's other factors baby and I are up against.

    Try not to panic and seek full information before deciding and make sure you are not pressured into what 'they' want over what you want for you and your babe!!

     

  • There really does seem to be a lot of cases of big baby threats! 

    I'm also a victim.  Induction at 39 weeks has been thrown out there as a possibility, but no concrete date has been set yet and the main reason for my induction would be because I am Hypothyroid.  I had my 35 week ultrasound last Friday and LO is measuring at 7.2 lbs already.  I have heard time and time again that these ultrasounds can be off by up to a lb in either direction and I've also heard of countless examples from various threads of the final weights being roughly a lb below what Dr's had estimated.  Even with the hypothyroid condition, I hated the idea of an induction, but I've come to terms with it.  Had it only been for the size, I would not allow it (unless other health factors were to arrise, of course). 

    I also agree with the PP that I find it very hard to believe your OB could really estimate a 9lber just by the feel.  Even Ultrasounds can be off, so I would certainly assume an experienced OB could be well off (and for that matter that the position of the baby could throw him/her off). 

    Either way, good luck with your ultrasound! 

     

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  • I agree with PPs, be aware of everything from here on out.

    DD was "huge" as well at 37w, so they stripped my membranes.  I wish I had a clue then.  3 days later, when my water broke (with no contractions) and they induced me, out popped a 5lb baby.  I'm not sure who was more stunned, the OB or me.  I am still angry about the choices I didn't exercise with that.

    Although I had two inductions (40w failed, elected to stop and go home and 41w1d quick success) with DS, they were of MY choosing and collaboration with my (new) OB.

    Get informed and make your own decisions.  Don't let your OB TELL you what to do, rather guide you with information. 

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  • Neither a c-section nor induction is consider the proper "treatment" for big babies unless there is another reason for your baby to be big. Big babies pop out of vaginas all the time. Unless yours is caused by gestational diabetes or another disorder, you should be allowed to attempt a vaginal birth.  Your doctor doesn't know and can't know until you're delivering that baby if your pelvis is big enough and if your vagina will stretch enough for that baby to come out. But if your body is creating a big baby, there is a better chance than not that you can deliver it.

    Your doctor needs to read his latest ACOG information too. Unless there is a medical reason, which "might be a big baby" is not considered, he should not induce anyone before 39 weeks and should not induce anyone with no medical reason and an unfavorable cervix before 41 weeks. ACOG is finally looking at evidence based studies about induction and your doctor should be keeping caught up on his reading to help deliver babies safely.

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  • image MrsWindyCity:

    ACOG does not support induction (let alone a CS at 38w) based on a baby's potential size. I would absolutely not consent to a CS based on measurements alone, especially at 38w. 

    I agree. I'd question why your doctor chooses not to follow evidence based practices. Does he/she have some place to be that they need to schedule your birth?

    In addition, the ACOG JUST released a statement in the last couple of weeks advising against non-medically indicated inductions of labor or c/s prior to 39 weeks 0 days. (Possible big baby is NOT medically indicated according to the ACOG) They also advised against non-medically indication inductions of labor between 39w0d and 41w0d unless the cervix is deemed favorable. 

    http://acogpresident.org/2013/02/21/with-routine-medical-tests-and-procedures-choose-wisely/ ;

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  • They kept saying my first was going to be a 10 pounder...I was measuring 4 weeks ahead by week 20..."good luck" one of the OB's at the practice said.

    He was a week late and only weighed just over 7lbs.

    This little guy is currently following the same course as his brother...measuring 4 weeks ahead which gets me another ultrasound next week to check measurements and fluid levels.

    There is no way to tell how big your baby is until he is born...all of the measurements, etc are just guestimates.

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  • Run far away from an OB that wants to schedule a c/s due to size at 38 weeks.  There are so many things wrong there, like other posters have pointed out. 
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  • My Ob felt my stomach and was like "baby is measuring big" she pulled out her tape measure and everything and she schedualed me for an ultrasound today and baby is just fine, measuring perfectly. Nice to know drs know how to spend our money ;3
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