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What weight of a child is considered a large fetus. Large fetus during pregnancy

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The birth of a large baby has always been considered a great success. The large weight of the child meant his vitality and good health. However, today doctors are ambivalent about this issue, and modern women are often not physically ready for the birth of a large baby. This article is about how to give birth to a large child.

What fruit is considered large

Neonatologists - doctors who monitor and treat newborns - call large those children whose birth weight exceeds 4 kilograms and whose body length is 54 centimeters. The birth of such a baby is not only a reason for the pride of parents, but also a reason for a close examination by doctors, since the large size of the newborn can signal the presence of diseases in the child.

What is the danger of the large size of the fetus

Determining the size of the fetus today is possible even before childbirth with the help of ultrasound and special formulas that allow you to calculate its weight and size by the length of individual parts of the child's body. Therefore, already before the onset of labor, both the mother and the obstetrician are aware of possible complications if the fetus is large. Immediately after birth, doctors examine the physical condition of such a baby, because a large child experiences more stress at birth and may suffer from asphyxia or bruises in childbirth.

Reasons for the birth of a large child

In this case, it is impossible to speak 100% about the hereditary factor, since large children were born to miniature women, but it should not be ruled out either. Naturally, if the father or mother had large children in the family, then the newborn is most likely to be a hero. However, there are several other factors that can lead to an increase in the size of the baby during fetal development:

1. Endocrine diseases of parents

First of all, mothers, if a woman in labor has diabetes, then the risk of having a large child increases. In this case, the entire pregnancy should be under the supervision of a specialist, to monitor the health status of both the mother and the child. In obstetric practice, often women with diabetes are advised to be observed in a hospital in the last weeks of pregnancy and, if complications arise, to cause an artificial birth.

2. Prolongation of pregnancy

If this pregnancy is indeed delayed, and not the result of an incorrectly calculated period, then this, as a rule, means an increase in the weight of the child. In the last weeks before the birth, the baby is already fully formed and gaining weight, so overbearing directly leads to an increase in the weight and size of the fetus. It is worth noting that doctors do not welcome such a “delay” of childbirth, since the placenta also has its own reserve and after 39 weeks it begins to age and does not provide the child with the substances he needs in full, so the baby born during a post-term pregnancy is subjected to a thorough examination for exhaustion, the presence of purulent-septic diseases or inflammation.

3. Maternal nutrition during pregnancy

Women who are overweight or have a poor diet during pregnancy often give birth to large children, but the large weight of such a child is not an indicator of his good physical condition - this means a metabolic disorder in the baby during fetal development and possible diseases. That is why doctors advise women during pregnancy to be very careful about their diet and carefully monitor weight gain.

All the possible problems indicated above are cases of clinical practice, but these are, first of all, particulars, because, as a rule, large children are healthy and strong babies, whose condition is assessed as excellent.

Problems with the birth of a large child

A large fetus during pregnancy is a colossal burden on the expectant mother, in addition to the main problems that almost every woman faces - toxicosis, edema, weight gain, etc., a pregnant woman with a large child increases the risk of "stretch marks", varicose veins, and even fainting - as a consequence of squeezing the blood flow in the lumbar region by the fetus.

The main problems that a woman in labor may experience:

The discrepancy between the size of the mother's pelvis and the parameters of the child's body - "narrow pelvis"
In this case, they mean not only the large head of the child, but also the possible failure of the shoulders to pass through the birth canal.
There are two types of "narrow pelvis":

1. Anatomical narrow pelvis, that is, the size of a woman’s pelvis does not allow her to give birth on her own

In this case, we mean the insufficient size of the small pelvis of a woman, as a result of past diseases (rickets and others) or external factors (injuries).

2. Clinical narrow pelvis, that is, with ordinary parameters of the pelvis, a large child cannot pass through the birth canal on his own
It is this concept that implies the clinical picture of childbirth, in which the birth of a child is hampered by the insufficient size of the mother's pelvis.

How to give birth to a child with a narrow pelvis

The main solution to this problem is a caesarean section, which can be both planned and an indication in the birth process. However, it happens that even with an anatomically narrow pelvis, a woman can give birth on her own with a small child, but the birth of a large fetus with a narrow pelvis is a direct indication for caesarean section, as there is a threat of injury to the mother and child.

Long duration of labor

The larger the child, the more difficult it is for him to move through the birth canal, and the more effort the mother needs to make in attempts, so the birth of a large child, as a rule, lasts much longer.

Long postpartum recovery period

Childbirth is a huge stress for the female body, especially the birth of a large child - tears and incisions very often accompany this process.

How to give birth without tears and incisions

First of all, you need to prepare your body for childbirth:
- do not start yourself during pregnancy and be in good physical shape - this will help save strength for all childbirth and give you the opportunity to push as the doctor says;
- increase the elasticity of the muscles of the perineum (Kegel exercises) - this exercise will help control contractions and make attempts more effective;
- learn breathing techniques during childbirth - proper breathing during childbirth helps a woman in labor not only maintain self-control, but also control the strength of contractions and attempts;
- and most importantly, listen to the doctors - even with a large child, there is a chance to give birth without tears and incisions, the main thing is to hear what the obstetrician says and follow his commands.

Weak labor activity

This concept includes both weak or fading contractions, and incorrect (weak) attempts of the woman in labor. The main causes of this pathology are called hormonal failure, a narrow pelvis or other physical abnormalities in a woman's body, as well as a large fetus or polyhydramnios. Often the cause of weak labor activity is also called the small weight of a woman.

How to give birth to a large child if the mother has a small weight
The diminutiveness or low weight of the mother does not always lead to difficult childbirth - easy childbirth, first of all, is an indicator of the good physical condition of the woman in labor. Of course, it will be more difficult for weak women, since all forces are involved in childbirth, and the frailty of the body can lead to attenuation of contractions. However, even thin women have the opportunity to give birth to a large child on their own, you just need to properly prepare yourself for this process.

Bleeding

Bleeding during childbirth of a large child is the first signal to the obstetrician about damage. In this situation, the woman in labor should not lose her composure and listen carefully to the doctors, since only specialists can understand the type of this bleeding and how critical it is for the expectant mother.

There are many opinions on how to give birth if the fetus is large, but the traditional method under the supervision of a doctor will be the most correct. Even with excellent health of the mother and child, with good indicators for independent childbirth, it is not worth the risk, since childbirth with a large fetus is the responsibility of professionals and independent "home" childbirth can lead to terrible consequences.

Premature birth of a large baby

Premature or early birth is the premature appearance of a child. Children born prematurely, as a rule, need special medical supervision, because they may have low viability or incompletely formed organs, reflexes, and immunity. In this matter, the weight of the child, of course, matters, but not the key, since weight is not an indicator of the physical strength of the fetus. Large children also need the help of a neonatologist and a thorough examination.

How to give birth to a large baby after cesarean

This problem has been repeatedly discussed by specialists, because a large child during pregnancy and childbirth puts more pressure on the internal organs of the mother, and doctors express serious concerns about the health of women who decide to give birth on their own after cesarean. A caesarean section is a surgical intervention in the body, which is accompanied by an opening of the uterine cavity, so there is always the possibility that with complications in childbirth, the old sutures may disperse. It is because of this factor that the decision on how the birth will take place should only be made by a specialist.

The birth of a large child requires the correct behavior of the mother, both during pregnancy and in the process itself. Do not be afraid of the size of the future baby - in medical practice, more than once, miniature women have successfully given birth to real heroes on their own, the main thing is not to be afraid and follow the doctor's advice. The easy delivery of a large child is not a myth - the right attitude and thorough preparation will help a woman calmly and without complications go through this difficult path and give birth to a large baby.

It just so happened in our country that a newly-made woman in labor will be interested in the weight of the baby before the name. But is the weight of the baby at birth so important and how does it affect the course of pregnancy? All your life you dreamed about such a man as in Vasnetsov's painting "Bogatyrs". Not three at once, of course, but one did appear in your life.

And here you rejoice, do not rejoice. With him as behind a stone wall, and such a caring, in general, truly brave Russian fellow. You have a happy family and you are expecting a baby. Only before pregnancy, it seemed to you that your future daughter would inherit your genetics, be small and petite, and more like a Frenchwoman than a Russian princess of an indefinite weight category. But a boy is born, with a weight of 4500 and red cheeks. And the birth is going well.

Fairy tales, you think. How can that be? But a lot depends not on the weight of the baby itself, but on the individual characteristics of the mother's body. You can suffer with a child weighing two and a half kilograms and calmly give birth to four kilograms.

In general, during pregnancy, your doctor is simply obliged to monitor the possible weight of your unborn child. This is necessary in order to establish how the baby is developing, what the birth will be like. The exact weight of the child can be calculated thanks to ultrasound diagnostics.

There is an opinion that if the child is too large, the mother is recommended to do a caesarean section. But it is not so. In order to prescribe a caesarean section, it is necessary to know exactly the individual physiological characteristics of the woman's body, in particular the width of the pelvis.

If the pelvis is too narrow, or the child's head is not commensurate with the woman's pelvis, or there is a breech presentation of the baby, these are clearer indications for a caesarean section.

In other cases, the expectant mother will be able to give birth to a baby in a natural way, whatever his weight. The most important thing is to keep calm and find a good doctor who will be able to determine the presence of deviations in time.

Reasons why a large fetus during pregnancy

A large fetus during pregnancy is most often the result of genetic inheritance. If you and your husband are 1.60 tall and with the appropriate weight, then the likelihood that you will have a two-meter hero is negligible. Look at the children of your relatives, with what weight they are born. On the children of your husband's relatives.

This will help you figure out what size your baby will be. Another caveat: the second child is often larger than the first, so if this is not your first pregnancy, keep in mind.

If the expectant mother has diabetes, it is likely that the baby will have a large body weight. This is due to impaired metabolism and glucose in the body. Such children develop faster than others, and sometimes it becomes necessary to induce labor artificially, especially if late preeclampsia has begun and the level of glucose in the blood is reduced.

If a large fetus during pregnancy what to do

A large fetus during pregnancy can also result from the expectant mother's zeal to relax for nine months and eat for herself and for the guy who is in her stomach. By the way, this is not the best option. The fact that a woman needs to eat like an elephant during pregnancy is nonsense and nonsense. In the diet, it is necessary to connect those foods that the baby needs for development, enriched with calcium, vitamins and minerals. And it’s not pointless to stuff buns into yourself and think that in this way you will make an invaluable contribution to the development and health of the child.

Recently, there has been a tendency to increase the body weight of newborn babies. Is it good or bad? Be happy or upset if your doctor tells you that you are expecting a large fetus during your pregnancy.

Everything is quite difficult. Gone are the days when the development of a large baby during pregnancy was considered a sign of the strength of the health of both mother and child. Today, both specialists and future mothers know and understand that the birth of a hero is associated with some dangers during pregnancy and childbirth. And these are real dangers for both the mother and the child.

In this article, we will figure out which baby can be considered large, why the fetus can be large, how the estimated weight of the fetus is determined, what dangers a mother and a large baby can face and how to avoid them.

What kind of baby can be considered large?

Some time ago, a large fetus was considered a child who was born with a weight of 3600 g. Now a large newborn baby is called if he was born with a body weight of 4 to 5 kg. It happens that heroes are born and more than 5 kilograms. In this case, obstetrics use the concept of a giant fetus.

The growth rate for a newborn is considered to be 48-54 cm. And a height of 55-57 cm is inherent in large babies. I am a district pediatrician, and in my area I clearly see that less and less babies are born with a height of less than 55 centimeters. Moreover, long, with a height of 55-56 cm, babies are born and with relatively low weight, in the region of 3600 g.

As a rule, when defining the concept of "large fetus", we are talking only about the body weight of the child. We are not talking about growth. Many people ask: “why is the growth of the child not taken into account?”

In fact, this sign is also taken into account, but only indirectly. The fact is that the diagnosis of "large fetus" is made before the birth of the child, according to the results of ultrasound. The height of the baby, even presumably, cannot be determined at the same time due to the peculiarity of his posture. Although the length of the femur is taken into account on ultrasound, height can be accurately measured only after the birth of the baby. That is why at the stage of pregnancy, the definition of fetal growth is not indicative.

Why can the fetus be large?

According to the latest statistics, in 7-10% of cases a large child is born. Researchers explain these statistics by improving the quality of life of the population, the absence of food shortages, and improving working conditions (“light” work, maternity leave). Yes, part of the increase in the average weight of newborn babies is due to these factors.

As a rule, the development of a large child is a consequence of the peculiarities of the lifestyle of the expectant mother, her state of health, burdened heredity for this factor. I'll tell you about everything in detail and in order.

1. Genetic predisposition.

It seems clear that there is a high probability that large-sized parents will have large babies. But even if future parents in adulthood do not differ in great height and weight, then at their birth everything could be exactly the opposite. Ask your parents what height and weight you were born with. This will help to some extent assess the likelihood of having a large child.

2. Features of nutrition and lifestyle of a pregnant woman.

Risk factors are:

- lack of physical activity (physical inactivity);

- abuse of junk food (salty, fatty, smoked, fried, marinades, "fast food");

- easily digestible carbohydrates (flour and pasta, sweets, pastries).

The more risk factors you can count from those listed, the more likely it is that a large baby will develop. All this will certainly lead to excessive weight gain for the entire pregnancy. Moreover, both mother and baby will become weightier.

3. Prolongation of pregnancy.

This is possible only in case of incorrect calculation of the gestational age. Only a true gestation for 10-14 days after the fortieth week of pregnancy can have a negative impact. In such a situation, the fetus spends more time in the womb than required. And all the while it is growing. Naturally, during the period of overgestation, the child will gain more weight. In addition to increased body weight, at birth, such a child can be observed with long nails, wrinkled skin with a strongly striated pattern of skin lines, and harder, more unyielding skull bones. Cheese-like lubrication on the body of post-term children is practically absent.

4. Repeated births.

Experts have noticed that there is some (not absolute) statistical relationship between the number of births and the body weight of babies born. That is, it is highly likely that for the same woman each subsequent baby will be born with a greater weight than the previous one.

Of course, the possibility of the birth of a large first-born child and the development of events during repeated births in an inverse relationship is not excluded. But still, the likelihood of having larger children with repeated births is higher.

5. Rh-conflict pregnancy.

Rh incompatibility occurs when an Rh-negative mother has a baby who has inherited a positive Rh factor from her father.

Due to the Rh conflict, the child may develop hemolytic disease, the main manifestation of which is the destruction of red blood cells (erythrocytes). Let me remind you that hemoglobin is “stored” and works in erythrocytes, with the help of which oxygen is delivered throughout the body to each cell of the body, and carbon dioxide is excreted back.

In turn, the destruction of red blood cells leads to anemia (oxygen starvation of the body due to insufficient amount of hemoglobin in the blood) and icteric staining of the skin, fluid retention in the child's body (edematous form), an increase in the size of the liver and spleen.

6. Metabolic pathology of a pregnant woman (hypothyroidism, obesity, diabetes mellitus).

With such diseases, a lot of excess glucose circulates in the mother's blood, which is not absorbed in time by the mother's body. This glucose then in excess then enters the blood of the fetus.

Glucose is fast energy, calories. It is clear that excess glucose will lead to a rapid weight gain of the baby.

By the way, sometimes a diagnosed or already born large fetus is the first prerequisite for examining the level of glucose in the blood of a mother or a pregnant woman. There are frequent cases of the development of gestational diabetes mellitus, whereas before pregnancy, the woman had no problems with an increase in blood glucose levels.

7. Features of the placenta.

The placenta (the place of contact between the organisms of the mother and child) can form in the uterus in different places. Practice shows that the placenta located on the back wall of the uterus contributes to a greater intensity of metabolic processes.

It has also been noted that another reason for the development of a large child is a large, thick, with a large number of vessels, the placenta. This leads to a more active metabolism between mother and child, and the child's weight grows faster.

8. Taking certain medications.

In the specialized literature, there is an opinion of experts that weight gain can be provoked by prolonged uncontrolled intake of certain drugs. These drugs include drugs that improve blood flow from the uterus to the placenta (Actovegin, Pentoxifylline).

Also, some gynecologists attribute this action to the intake of complex vitamins. But so far this information has not been confirmed by scientific research.

How is the estimated weight determined?

At each appointment, the gynecologist examines a pregnant woman, measures the height of the fundus of the uterus above the pubic symphysis, the circumference of the abdomen, compares changes in the size of the pelvis at different stages of pregnancy. Based on the data obtained, we can make an assumption about the development of a weighty baby.

Next, the doctor finds out from the future mother the data on her genetic predisposition to the development of a large toddler. The card records and analyzes data on the birth weight of the future fathers and mothers themselves, on the mass of other children born to them, if any.

I will tell you more about the parameters of the uterus. In obstetric practice, there is a formula for calculating the approximate weight of the baby. The circumference of the abdomen is multiplied by the height of the fundus of the uterus in centimeters. For example, if the circumference of the abdomen is more than 100 centimeters, and the height of the fundus of the uterus above the pubic symphysis is even or more than 40 cm, then at birth the baby will weigh more than 4 kg.

Even to calculate the weight of the child at the time of birth, the weekly weight gain of the pregnant woman is estimated. When gaining body weight more than the weekly maximum allowable norm (more than 500 g) and with a total weight gain during pregnancy of more than 15 kg, a conclusion can be drawn about the possible development of a large child.

It is worth mentioning that such an assessment is valid only for a normal pregnancy. That is, when the mother has no concomitant pathology, no edema is observed, blood pressure and blood glucose levels are not elevated, there are no disturbances in the functioning of the kidneys, which can be judged by the presence of protein in the urine.

Only an ultrasound examination will help to more accurately determine the estimated weight. On ultrasound, various parameters are evaluated: the circumference of the tummy and breast, the length of the femur and humerus, the distance between the most protruding parts of the temporal bones of the skull (biparietal size). The ratio of the length of the femur to the size of the circumference of the tummy is also determined.

The assessment and analysis of all these parameters together allows the specialist to draw a conclusion about the estimated weight of the child and the compliance of its main dimensions with a certain gestational age. As a rule, the indicators of a large child correspond to a later gestational age, that is, an ultrasound can show a gestational age of up to two weeks more than it really is.

What are the symptoms of a large pregnancy?

The big belly of the expectant mother as a clear sign of the hero sitting in it is an erroneous opinion. Most often, the big belly of a pregnant mother makes you think about polyhydramnios.

Due to the fact that the enlarged uterus presses on nearby organs, during a large-fetal pregnancy, a pregnant woman may feel some specific symptoms more pronounced.

Various disturbances in the work of internal organs and systems can be observed (especially in the last stages of pregnancy).

Namely:

  • from the digestive system - severe heartburn, frequent constipation;
  • from the urinary system - frequent urination, swelling;
  • on the part of the cardiovascular system - shortness of breath, varicose veins of the lower extremities. There are frequent cases when a rather weighty uterus disrupts the blood flow through the inferior vena cava, bringing a pregnant woman lying on her back to a pre-fainting state;
  • from the musculoskeletal system - pain in the joints of the legs and in the lumbar spine.

What dangers can lie in wait for a mother and a large baby in childbirth?

Obstetrician-gynecologists conduct examination and preparation for childbirth of mothers with large children more carefully. This is no accident. The birth of a hero may be associated with some complications of the process of childbearing. Let's take a closer look at some of these complications.

— Premature (before contractions) or earlier (before cervical dilatation) rupture of amniotic fluid. The cause in both cases is the high head of the fetus. Having not descended to the entrance to the pelvic ring formed by the pelvic bones, the child's head is not able to distinguish between amniotic fluid into their anterior and posterior parts. At the same time, the shape of the fetal bladder changes, which cannot adequately provoke the opening of the cervix and its readiness for childbirth.

The rapid outflow of a large amount of amniotic fluid can lead to the prolapse of the umbilical cord loops or even the limbs of the child from the uterus. This is a very dangerous condition that requires emergency surgery.

We also remind you that a long anhydrous period is a risk of infection for the fetus.

  • Weakness or incoordination of labor occurs to some extent also due to the undescended fetal head. In this case, there may be a delayed opening of the cervix of the uterus. Therefore, contractions can be painful, irregular, with fading strength. All this makes it difficult for the child to move along the birth canal and lengthens the birth. Often in such situations, it is necessary to use emergency surgery (caesarean section) in order to prevent the child from developing hypoxia (hypoxia - oxygen starvation).
  • Clinically narrow pelvis(revealed in childbirth). During childbirth, there is often a discrepancy between the size of the baby's head and the size of the pelvis of the expectant mother. Moreover, the pelvis can have dimensions that are quite consistent with the norm. A large head will not be able to pass through the birth canal. And here neither strong attempts, nor good contractions, nor full disclosure of the cervix will solve the problem. The solution is an emergency caesarean section.
  • Dystocia (difficulty moving) of the baby's shoulders. The fact is that, due to its streamlined shape, the head of a child (even a relatively large one) passes through the birth canal, gradually pushing the soft tissues apart. But the broad shoulders of a weighty fetus can get stuck. This condition requires the midwife to provide special assistance during childbirth, which will facilitate the birth of the widest part of the body of a large child and will avoid ruptures of soft tissues and oxygen starvation of the child. But sometimes it can lead to a fracture of the collarbone in a child.
  • Breaks. Often in childbirth, mothers of a large toddler have gaps. There is also a threat of uterine rupture, ligament rupture, pubic symphysis divergence. To minimize complications in the form of ruptures, an episiotomy (oblique incision of the perineum) is performed during childbirth, more often a perineotomy (dissection of the perineum towards the anus).
  • Childbirth trauma. Very often, large children, due to their size, receive birth injuries during natural childbirth. Possible fractures of the baby's bones, the formation of a cephalohematoma (blood bump), up to a cerebral hemorrhage.

All of the above indicates that it is very important to know in advance that the birth of a large baby is expected. This will allow you to decide on the tactics of conducting labor in order to exclude the possibility of complications and trauma during childbirth.

What can be done to avoid complications in childbirth?

After it turned out that the baby is large, the gynecologist must comprehensively examine the woman in labor to find out the reasons for such a weight of the child. If the examination showed that the expectant mother does not have somatic diseases, and the reason is genetics and unlimited food, then the main recommendation is diet.

Compliance with the diet and a feasible increase in physical activity will help to correct the excess weight of the expectant mother until the end of pregnancy and stop the overweight in the child.

If some pathology is found that provokes weight gain in mother and baby, then inpatient treatment and hospitalization will be required long before delivery.

To determine the tactics of childbirth, the need for surgical intervention or medical assistance (prevention of bleeding, thrombosis) in childbirth can only be observed by a doctor in childbirth. And in each case, this will be decided individually.

Trust an experienced specialist and do not worry about anything. The main task of the future mother is to lead the right way of life, in the whole wide sense of this concept. After all, this is a guarantee of the health of a woman and her future children.

Good luck with your birth!

The doctor says: be strong mother, you are carrying a hero! What does it mean? What fruit is read large and why?

There are certain norms for the weight and height of the baby, the norm is a height of 48-54 cm with a weight of up to 4 kg. If the baby has already gained more than 4 kg by the time of birth, then it is generally accepted that the fetus is large, and the growth at the same time reaches 58 cm.

According to the statistics of such children, about 7% of all pregnancies, this is not so much, and even more so giant children, weighing more than 5 kg, there are only a few such cases. Is it possible to know in advance what the fetus will be in a pregnant woman, for how long?

How to identify a large fruit?

Already from the 12th week, you can clearly draw a picture of the course of pregnancy and identify signs of a large fetus. The diagnosis of such a factor is made not only on the basis of an examination of a woman, but also takes into account the birth predisposition, ultrasound data, formulas for calculating the estimated weight of the baby.

At an unscheduled examination, the doctor measures the proportions of the fetal head, the diameter and circumference of the abdomen, the length of the femur and humerus bones of the crumbs. Based on such data, there is a high probability of calculating the weight of the unborn child.

In fact, there can be a lot of reasons for this phenomenon, ranging from heredity to the mother's lifestyle while carrying a baby. Here are some of the factors for the appearance of a large fetus:

  • incorrect determination of the date of birth, downward;
  • overbearing a baby;
  • violation of metabolic processes;
  • diabetes;
  • Rh factor conflict;
  • heredity;
  • subsequent pregnancy and childbirth;
  • eating habits, especially overeating.

Most often, the cause of an enlarged fetus is considered to be an incorrect determination of the timing of delivery, a child is born with the following symptoms:

  • wrinkled skin;
  • green or gray amniotic fluid;
  • without original lubrication.

One of the serious causes of a large fetus is hemolytic disease of the fetus, this disease is caused by Rhesus conflict between mother and baby. In the unborn child, the level of hemoglobin decreases, jaundice appears, and most importantly, overweight, the liver and spleen increase in size.

Attention! In the womb, the baby may begin to become obese if the pregnant woman eats a lot of bakery products, her diet is not balanced and wrong. These factors provoke an increase in the size of the child.

Childbirth is a crucial period for the birth of a baby, and here a large fetus can create certain difficulties when it is born. These difficulties can affect both the health of the mother and the child.

With a large fetus, the following problems may occur:


  • large head and small pelvis of the mother, such a mismatch can lead to huge tears or even oxygen obstruction;
  • the threat of uterine rupture at the first attempts;
  • violation of the kidneys with the impossibility of a normal outflow of urine;
  • complication of varicose veins in the postpartum period;
  • uterine heavy bleeding;
  • internal fetal hypoxia, brain damage;
  • possible fractures of the baby's bones during labor.

With prolonged childbirth, pinching of the nerve of the leg may occur, the likelihood of damage to the joints of the pubic bones. If the degree of damage is high, then surgery will have to be performed to improve the patient's condition.

With a mild degree, prolonged bed rest and wearing a bandage, taking painkillers are required.

After the birth of a large baby, a woman may have insufficient contraction of the uterus, heavy bleeding, rupture of the tissues of the genital organs.

First, it is not necessary to panic, but you need to undergo a more thorough examination and try to identify the cause of this phenomenon. If this is a sign of any pathology, then you will be prescribed treatment in a hospital.

When it's all about heredity or overeating, then you need to switch to a more balanced and proper diet, introduce more vegetables and fruits into the diet, remove empty carbohydrates and junk food, fiber and vegetable fats will be useful.

You should not be afraid of childbirth with large fetuses, it is important to discuss this point with your doctor, you may be prescribed a caesarean section, or they will take expectant tactics. If symptoms of uterine rupture appear, surgery will be immediate.

Prevention and lifestyle features of a pregnant woman

  1. Healthy eating, you don’t need to eat for two, and even more so eat heavy carbohydrates and fats.
  2. If overweight, even before childbirth, resolve this issue so that the child is not born with the problem of obesity.
  3. The amount of carbohydrates should be no more than 400 g per day.
  4. During pregnancy, you need to move moderately, do simple regular exercises.
  5. Take care of the health of the unborn child, undergo all examinations in a timely manner and follow the recommendations of the leading gynecologist.

Be healthy and give birth to strong children!

First, let's define terms. If the weight of the child at birth is 4000 - 5000 g, the fetus is considered large. With a mass of 5000 g or more, the fetus is called gigantic. At the same time, the height of the child is not taken into account, although, as a rule, the body length of such a “hero” also exceeds the average. So, if the "growth" of the fetus is 48 - 54 cm, then in large children this figure can be 54 - 56 cm. It should be noted that in recent years there has been an increase in the average weight, height and physical development of newborns. This is probably due to the improvement of working conditions, life and nutrition of pregnant women. According to studies, the number of newborns with a birth weight of 4000 g or more is 5-10%. The birth of giant children is much less common.

Why is the baby so big?

Risk factors for the birth of large children are: heredity, diabetes, some other endocrine diseases, an increase in the duration of pregnancy, etc.

Increasedurationpregnancy can lead to the birth of large children. In this case, both the prolongation of physiological pregnancy and true overbearing are possible.

Prolonged pregnancy is considered to be a pregnancy that lasts longer than the physiological one by 10-14 days and ends with the birth of a functionally mature child without signs of overmaturity and "aging" of the placenta.

True overgestation is characterized by the birth of a child with signs of overgestation and pronounced changes in the placenta.

At the same time, the signs of overwearing are the lack of original lubrication, dryness, maceration (wrinkling) of the skin. The fetus's need for oxygen increases during pregnancy, and the placenta can no longer provide the fetus with the required amount of oxygen and other vital substances. The amount of amniotic fluid also decreases. With a significant overdose, an admixture of meconium (original feces) appears in the waters and their color becomes greenish or grayish.

pregnant women, patients with diabetes, it is necessary to be hospitalized in the department of pathology of pregnant women in the maternity hospital in the second half of pregnancy (no later than the 32nd week). There they are examined in detail, and doctors decide on the date of their delivery. Artificial preterm birth (not earlier than the 36th week of pregnancy) is carried out in cases where a woman carrying a large fetus has progressive late preeclampsia, significant polyhydramnios, a decrease in blood sugar, as this raises the risk of intrauterine death of the fetus and birth trauma . During childbirth, insulin is needed. Insulin treatment continues into the postpartum period, taking into account the level of sugar in the urine and blood.

The reason for the large size of the fetus can be edematous form of hemolytic disease- a serious condition associated with the incompatibility of the blood of the mother and fetus according to the Rh factor. This disease occurs when a pregnant woman with Rh-negative blood carries a fetus whose red blood cells contain a positive Rh factor inherited from her father. As a result, the fetus develops anemia (decreased hemoglobin content in the blood), which is often accompanied by jaundice. In the most severe forms of hemolytic disease, anemia and jaundice are accompanied by general edema, fluid accumulation in the fetal cavities, enlargement of the liver and spleen. It should be noted that in a mother with Rh-negative blood and an Rh-positive fetus, pregnancy does not always proceed in this way. The situation is less favorable if the pregnancy with a Rh-positive fetus is repeated, a transfusion of Rh-positive blood was previously performed (even long before pregnancy), and also if the pregnant woman had the flu or other infectious diseases.

In order to prevent hemolytic disease in subsequent pregnancies, women with Rh-negative blood are administered anti-Rh immunoglobulin immediately after childbirth.

And yet, most often the cause of the large size of the baby is heredity. So, if the parents of the child had a large birth weight, it is likely that the baby will be large.

The reason for the formation of a large fetus can be malnutrition pregnant. So, an excess of carbohydrates (pasta, bakery, confectionery) in the diet contributes to fluid retention in the body, maternal obesity and the formation of an excessively large fetus. In this regard, most experts recommend limiting the intake of foods containing a large amount of carbohydrates, especially in the second half of pregnancy, to 300-400 g per day.

There is also a tendency to form a large fruit during the second and subsequent pregnancies. According to statistics, the second child is 20 - 30% larger than the first. It can be assumed that this is determined by several factors. One of them is psychological, that is, when carrying a second baby, the expectant mother is more calm, since she is no longer familiar with pregnancy and childbirth. Another reason may be that during the second pregnancy, the mother's body is already trained to carry the baby, blood circulation in the uteroplacental and fetal-placental vessels provides a greater supply of nutrients to the fetus than during the first pregnancy.

It is worth noting that with a genetically determined birth of a large fetus, the length of the baby's body is also quite large, so the size of the fetus is proportional. In this case, the dimensions of the baby's head, which play the main role during childbirth, are also quite large. If the cause of a large weight is any pathology (for example, hemolytic disease of the fetus), then the size of the fetus can be increased due to soft tissue edema. In post-term pregnancy, the bones of the fetus are less mobile and adapt worse to the birth canal of the mother, which creates additional difficulties and predisposes to injury to the mother and fetus during childbirth.

Diagnosis of a large fetus based on history and examination data. The doctor finds out what height and build the father of the child has, with what weight and height the children were born during her previous birth, whether the woman has endocrine disorders. On examination, the doctor pays attention to the increase in the volume of the abdomen (more than 100 cm), the size and density of the bones of the head, the large length of the fetus (more than 54 cm) and its estimated weight. If a large fetus is suspected, an ultrasound examination of a pregnant woman is mandatory, which allows, according to the fetometry of the fetus (head size, diameter and circumference of the abdomen, length of the femur and humerus), to calculate its estimated mass.

childbirth with a large fetus, they often proceed normally, but there is some likelihood of complications, which we will discuss in more detail

Possible Complications

In the case when, after the full opening of the cervix, there is no advancement of the head, they say about the discrepancy between the size of the fetal head and the mother's pelvis- the so-called clinically narrow pelvis. In this case, the size of the pelvis can be absolutely normal, but nevertheless it will present difficulties or obstacles for the course of these births. With anatomical narrowing of the pelvis (when all dimensions of the pelvis or at least one of them are shortened by 1.5-2 cm or more compared to normal ones), in combination with a large fetus, childbirth becomes impossible even with strong labor activity and good head configuration.

Untimely rupture of amniotic fluid during childbirth with a large fetus, it is associated with a high standing of the fetal head in the cavity of the small pelvis and the lack of differentiation of water into anterior and posterior (as occurs during normal physiological childbirth). There are situations when at the time of the outflow of water into the vagina, the umbilical cord or the handle of the fetus may fall out. In such cases, it is necessary to provide timely assistance to the woman in labor. Untimely discharge of amniotic fluid, as a rule, slows down the process of opening the cervix during childbirth. Contractions can be painful, and the first stage of labor (when the cervix opens) can be protracted. With a long anhydrous period, there is a risk of infection of the fetus and uterus.

During childbirth with a large fetus, complications such as labor anomalies(primary and secondary weakness of tribal forces). Their cause can be infantilism - underdevelopment of the internal genital organs, difficult childbirth and postpartum diseases suffered in the past. At the same time, contractions from the very beginning of labor are usually weak, rare (primary weakness of labor activity). Sometimes the active labor activity that developed at the beginning of labor weakens later (secondary weakness of labor activity). At the same time, childbirth is delayed, the woman in labor gets tired. It may disrupt the functions of the nervous, cardiovascular and other systems, and the fetus has signs of hypoxia (lack of oxygen).

The greatest difficulties in childbirth with a large fetus can occur with attempts. This is due to the fact that the head undergoes a significant change: the bones of the baby's skull move over each other, as if adapting to the shape of the woman's small pelvis. If there is a discrepancy between the size of the fetal head and the mother's pelvis, then the lower segment of the uterus undergoes significant overstretching and possible uterine rupture.

With prolonged standing of the fetal head in the pelvic cavity of a woman, compression of the soft tissues of the birth canal between the bones of the pelvis and the fetal head can occur. In this case, in addition to the cervix and vagina, the bladder and urethra are compressed in front and the rectum in the back. In soft tissues, blood circulation is disturbed, edema occurs. The mother may stop urinating. If tissue necrosis occurs, which is then rejected, then urogenital fistulas or rectovaginal fistula. Fistulas are passages between the bladder and vagina or rectum and vagina. This complication requires surgical intervention in the postpartum period.

With a prolonged period of exile, compression of the nerves is possible, with the subsequent occurrence in a woman paresis of the leg muscles. This condition, accompanied by limping, is difficult to treat. If the passage of the head through the pelvis is difficult, damage to the pubic symphysis(articulation of the pubic bones). Women in childbirth have pain when moving their legs, gait is disturbed. With pressure on the area of ​​​​the pubic symphysis, pain occurs. The divergence of the pubic bones during childbirth is of varying severity. In severe cases, which is extremely rare, surgical treatment is performed. In other cases, bed rest, wearing a postpartum bandage, and the use of painkillers are required.

In cases of a slight discrepancy between the size of the fetal head and the mother's pelvis, expectant management is used during childbirth. This means that with normal labor activity and the absence of complications, childbirth proceeds spontaneously, but if signs of inconsistency do not disappear within 3-4 hours with good labor activity and departed waters, a caesarean section is performed.

If symptoms of a threat of uterine rupture occur, the woman in labor is immediately performed a caesarean section.

Even if childbirth goes through the natural birth canal and the head has already been born, complications often arise when removing the shoulder girdle of a large fetus. In this regard, the neonatologist conducts a thorough examination of the newborn for fractures of the clavicle or arm.

Prolonged labor and frequent anomalies of labor activity can cause a violation of the uteroplacental blood flow and fetal hypoxia. With excessive displacement of the bones of the fetal head and its sharp compression, hemorrhages can occur in the brain or under the periosteum of the parietal bones. As a result of hemorrhage of the second type, a cephalohematoma is formed. In the first days after birth, it is covered by a birth tumor and becomes noticeable only after it disappears. In the absence of complications, cephalohematoma resolves on its own after 6-8 weeks and does not affect the child's condition. Hemorrhages in the brain depending on their size and affected area, they can have different outcomes - from minor to severe.

It should be noted that in women in labor with a large fetus, the contractility of the uterus may be impaired, which may be due to bleeding after childbirth. It can also be caused by retention of parts of the placenta in the uterus, rupture of the soft tissues of the birth canal.

If it is assumed that the size of the fetus is large enough, then during childbirth, careful monitoring of the work of the fetal heart is carried out. The obstetrician-gynecologist conducting labor listens to the fetal heartbeat every 15 minutes in the first stage of labor and after each attempt - in the second stage of labor. Indispensable in this case is cardiac monitoring, in which a special sensor is attached to the abdomen of the woman in labor, which monitors the heart rate of the fetus. In cases of signs of fetal hypoxia, the necessary treatment is carried out.

The born child is carefully examined for hypoxia and birth injuries. The examination will help the doctor identify signs of hemolytic disease, diabetes, and other disorders.

It should be noted that the described complications during childbirth with a large fetus in many cases are absent or are not very pronounced. With good care and proper feeding, large children do not differ from their peers.

So, if the doctor has told you that your baby was born large, know that you will need especially careful medical supervision.