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baby getting too big?? - Page 2  

post #21 of 30
10/17/08 at 11:06am
BS!!!

First of all a baby's skull bone sutures dont start closing at 40 weeks. The posterior suture closes around 2 months and the anterior suture closes at 18 months!

Heres AAFP's stance on managing fetal macrosomia:
http://www.aafp.org/afp/20010115/302.html

Quote:
Elective Cesarean Section
Elective cesarean section for suspected macrosomia has been proposed as a way to spare the parturient an unproductive labor and to prevent birth trauma.2 Unfortunately, the difficulties in predicting macrosomia17 and the favorable outcome for most women who undergo a trial of labor21 imply that a large number of unnecessary cesarean sections would have to be performed to prevent a single bad outcome in the pregnancy complicated by suspected fetal macrosomia.22 A recent decision analysis estimated that to prevent one case of permanent brachial plexus injury, 3,700 women with an estimated fetal weight of 4,500 g would need to have an elective cesarean section for suspected macrosomia
Bold mine.
post #22 of 30
10/17/08 at 12:40pm
PP's have already correctly explained that induction for fetal macrosomnia goes against all medical evidence.

The reason that doctors still do it is out of concern for shoulder dystocia. The Gaskin Maneuver, having the woman deliver on all-fours, is the way to get the baby "unstuck." One study with a small sample indicates that a lot of doctors may have never even heard of this, which is why they're always reaching for the knife. The Gaskin Manuever works best when a woman can feel her labor and doesn't have a bunch of crap attached to her, so natural childbirth is important for avoiding cesarean delivery.

As the study indicates, sometimes the woman has to educate her doctor instead of the other way around!
post #23 of 30
10/17/08 at 1:43pm
Quote:
Originally Posted by alegna View Post
My ds was 43 weeks 5 days. Yes, my dates were correct.

-Angela

I am trying to figure out what going "post dates" has to do with being induced for fetal macrosomia?

To the OP: www.ican-online.org has some good information about c-section prevention and they have this white paper on induction:
http://www.ican-online.org/pregnancy/induction-labor

I am hoping to write a white paper for them on fetal macrosomia, but haven't had time yet.
post #24 of 30
10/17/08 at 1:46pm
Quote:
Originally Posted by turtlewomyn View Post

I am trying to figure out what going "post dates" has to do with being induced for fetal macrosomia?
The idea that bones fuse and such...

-Angela
post #25 of 30
10/17/08 at 2:10pm
but how on earth did this OB get the evidence that this baby's bones are starting to fuse? maybe I'm completely niave... but I've never heard of a test for such a thing being given. (but than again... I'm not above learning something new lol)
post #26 of 30
10/17/08 at 5:24pm
If your sis wants medical literature, send her this:

Management of Suspected Fetal Macrosomia. Zamorski, M.A., and Biggs, W.S. Am Fam Physician 2001;63:302-6.

Abstract: "Fetal macrosomia, arbitrarily defined as a birth weight of more than 4,000 g (8 lb, 13 oz) complicates more than 10 percent of all pregnancies in the United States. It is associated with increased risks of cesarean section and trauma to the birth canal and the fetus. Fetal macrosomia is difficult to predict, and clinical and ultrasonographic estimates of fetal weight are prone to error. Elective cesarean section for suspected macrosomia results in a high number of unnecessary procedures, and early induction of labor to limit fetal growth may result in a substantial increase in the cesarean section rate because of failed inductions. Pregnancies complicated by fetal macrosomia are best managed expectantly. When labor fails to progress as expected, the possibility of fetopelvic disproportion should be considered within the context of the best estimate of the fetal weight."

You may also want to use Google Scholar to access the scientific literature. (You will probably get mostly abstracts.)
post #27 of 30
10/17/08 at 5:48pm
3 days before my first daughter was born I had an ultrasound that said she was no bigger than 8 lbs. She was 10 lbs. 12 oz. and 26 in. long.

Ultrasounds are horrible indicators of baby's size!!!!!
post #28 of 30
10/19/08 at 9:32am
Thread Starter 
thanks for the replies everyone. my sister ended up going into labor on her own yesterday. out of exhaustion (although i think she was about to hit transition) she asked for an epidural after 24 hours of hard contractions. she was having contractions every 3 minutes and i truly do think she was almost there. the epi slowed her contractions way down. the hospital staff is telling her since they slowed down now they are going to give her pitocin. i am a mix of all emotions for my sister. but there is not much i can say or do now that intervention has already begun.
post #29 of 30
10/20/08 at 10:00am
Any updates?
post #30 of 30
10/20/08 at 3:35pm
The u/s to check the weight of the baby is not accurate at that point. With my 2nd pregnancy, I had GD (not very high controllable with diet) but the midwife was concerned about a large baby. When I was 38 1/2 wks they did a u/s to make sure ds was not too big. He was measuring @ 7-8 lbs. They were worried that he would get too big and decided to induce me in 3 days. When he was born he was 9#1oz. I dont think he gained 1-2 lbs in 3 days.
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