Large for Gestational Age--Ack!

[dcgrl]

Can any of you who have had other pregnancies advise me on this? I had an appointment today, and my midwife measured my fundal height--once at 33 and once at 34 (they had my husband measure once, which I thought was cool). I'm 27w3d. She says that usually the fundus measurement should equal your week--so I should be measuring 27cm. She said that they'll look at it again next time, and if I'm still measuring ahead, she wants me to have an ultrasound to assess the baby's growth. Argh!

Does anyone know how fundal heights can be reliable measures of growth given the above rule of thumb when women start their pregancies with differing amounts of padding on their bellies? I was 209 to start, weighed in today at 219, so I'm a big girl. There has got to be 5cm of belly fat that throws off that measurement, right?

I'm worried about an ultrasound, because the weight estimates can be so inaccurate, and I worry about the midwives' expectations that I'm going to have a big baby, because that leads to increased risk of premature induction/c-section.

Anyone been here? Anyone have any advice?

[pumpkinhead]

Measuring big doesn't always indicate a big baby. It could also mean that you have excess fluid.

[AimeeandBrian]

My midwife said as long as you are within two centimeters, its totally normal. But even measuring bigger than that could just be how the baby is positioned at the moment. I measured 22 at 20, still measured 22 at 24, and just measured 29 at 28! So who knows if any of it even means anything.

[Curlita]

Originally Posted by AimeeandBrian

So who knows if any of it even means anything.

This tends to be my feeling about any kind of estimates about baby's size or weight based on measuring, U/S, eyeball assessments, etc. I know that an U/S can pretty accurately determine baby's length, because they can measure the length of leg bones, etc.

Fundal height especially seems like something that would be hard to figure out accurately and use to gauge anything accurately... so much variation in moms and babies. When is your next appt? I'm wondering what a fundal measurement two weeks later would show...

Either way, I would try not to worry until an U/S shows that the baby really is super-long or whatever. If that does seem to be the case, then you can gird your loins for the anti-induction battle.

[dcgrl]

A little research shows that the fundus should be measured 30 minutes after the bladder is emptied, because a full bladder can significantly alter the measurement. Mine was painfully full, since I was expecting to have to give a sample (but didn't). anyway, I feel some degree of comfort now. I'll just be sure to pee well before my appointment next time...

[Undercover Hippie]

We had a thread on this maybe a month ago too... I think the gist of it was, fundal height measurements are subjective and pretty unreliable so don't worry about them too much. As mentioned, mamas can measure big due to extra padding, mama's anatomy, extra amniotic fluid, baby's position, baby just had a growth spurt, etc... lots of reasons other than an LGA baby. Or it could be a LGA baby which may be perfectly normal for you... your body won't grow one you can't birth and all that jazz.

I had a friend who is just built in a way that her babies stick straight out right away, and she measures very big (6-9 cm ahead) for most of her PGs. Then for some reason as she gets closer to her due date the measurements pretty much stop growing so by the last month she starts to measure right on track... end result has been two very healthy, vaginally birthed, 9 pound baby girls--just perfect for her!

[crunchywannabe]

fundal measurements are not very accurate.
nor is external palpitation for size
nor is ultrasound at this point--it can vary 1+lb either way

I wouldn't worry mama!!!!

[GinaRae]

I'm bigger than you and supposedly measuring small. But the babe was also head down and firmly lodged in my cervix. It could have been the opposite for you - did they palpate the baby and do you remember if it was high?

[dcgrl]

Originally Posted by GinaRae

I'm bigger than you and supposedly measuring small. But the babe was also head down and firmly lodged in my cervix. It could have been the opposite for you - did they palpate the baby and do you remember if it was high?

Yeah, the baby is up pretty high--I haven't experienced any of those lovely cervix kicks y'all talk about--everything's above my belly button.

[cheeseRjedi]

I've measured 30 at 28 wks with both pregnancies and my DD was 7 lbs even.

[maisiedotes]

I am so glad you asked this- I just got home from my appointment where I measured 32 weeks (I am 27w2d). So... well, I am going to see how I do at my next appointment. I am nervous- of course, when am I NOT nervous???

[dcgrl]

Oh Maisie--sorry you had this too! I'm doing my best not to worry about it. I've read all kinds of things that throw the accuracy of the measurement into question--the position of the baby, whether you're short or long-waisted, the fullness of your bladder or bowels, etc.

I'm just going to try to steel myself against any ultrasounds for fetal weight estimates, since predictions of macrosomia increase your chances of induction/c-section.

did your practitioner make it sound like she/he was worried about it?

[pixiedust]

I'm measuring way ahead as well or was last time anyway. She wanted to wait and see what this measurement was looking like (I was measuring 5 weeks ahead) and just from my measurements (I've been right so far LOL) I'm now measuring about 6 weeks ahead. If my midwife does ask for an u/s I'm going to gladly get one because I've had a nagging worry of twins for awhile now .. even before I knew I was measuring ahead. So, I'd like to get that worry out of the way! Otherwise a big baby measurement doesn't really worry me since my midwife is very anti-induction, etc..

[melissakc]

At my 24-week appt. I measured 27. Four days later I had to have another U/S (long story) and the baby measured exactly on schedule and perfect. I don't trust either measurement completely, but I think everything is fine. I bet everything is fine with you too.

I stick straight out, BTW. Maybe it's bc I'm short and there isn't anywhere else for the baby to go! Who knows!

Try not to worry. (I know, easier said than done.) Why do they like to make us pregnant mamas so anxious?!

[maisiedotes]

Originally Posted by dcgrl

Oh Maisie--sorry you had this too! I'm doing my best not to worry about it. I've read all kinds of things that throw the accuracy of the measurement into question--the position of the baby, whether you're short or long-waisted, the fullness of your bladder or bowels, etc.

I'm just going to try to steel myself against any ultrasounds for fetal weight estimates, since predictions of macrosomia increase your chances of induction/c-section.

did your practitioner make it sound like she/he was worried about it?

Nah. She saw the panic in my face and said "do NOT worry- you may just have a big baby but a number of things can attribute to it. I will see how your glucose test comes back." She keeps a very watchful eye on everything with me- I will keep you updated if anything comes of it. I have had 5 ultrasounds and an OB appointment 3 weeks ago and was measuring fine at all of them so I don't think there is anything to worry about... I hope you are doing OK with it too!

[LittleLlama]

Baby supposedly measured small according to fundal height but then a week later I had an u/s and they said she's measuring two weeks ahead. Sometimes I think they makes things up as they go!

ETA: DS measured big for gestational age my whole pregnancy. Last estimates put him at 11 pounds, he was 9.3 with a great delivery. A woman does not build a ship in her basement that she cannot get out the front door

[dcgrl]

Originally Posted by LittleLlama

A woman does not build a ship in her basement that she cannot get out the front door

Sarah, what a great sentiment--thank you for that!

[Frisbee]

Just to add my experience to everyone else's, at 27 weeks I "measured" 23, despite having gained 6 lbs that month. When I had an ultrasound 2 weeks later, the baby "measured" at the 80th percentile for size for that gestational age. ("Big"). I don't think that the measurements are too much to worry about, unless maybe they are WAY off, and consistently so.

I wonder if the fundal height accuracy also has to do with how different from average the mama is in her build. I'm on the small side (5'5" and 120 lbs pre preggo, short torso), and I wonder how my measurement could possibly be the same on a given week as a long torsoed mama who started at 6'-0" and 220?

[GinaRae]

Last week I was measuring a week behind and this week I measured a week ahead. So in one week, my measurement moved up by two weeks. It's impossible to get consistency I think.

Last week she shamed me and told me I needed more protein and THIS week she told me it was probably due to the baby stretching out. THAT really ticked me off!