Some future mummies on ultrasound in conclusion write "the tendency to macrosomia of the fetus." What is this, not every woman knows. But to monitor all the indicators during pregnancy is important.
Doctors monitor the weight of the pregnant woman, the balance of the hormonal background and the intrauterine weight. They evaluate pregnancy by weeks, fetal development and feelings of the expectant mother. And one of the important indicators is the fetal weight of the fetus, it directly affects the birth activity.
Macrosomy: what is it?
Fetal macrosomy is the overweight of a newborn. An accurate diagnosis can only be made after the baby is born. It is generally accepted that macrosomia is when the weight of a newborn is more than 4 kg. According to statistics, approximately 7% of infants are born with a weight of more than 4 kg, 1% - 4.5 kg, and only 0.1% - more than 5 kg.
In medicine, the pathology code is designated: ICD 10: O33.5 (a large fetus that provokes a disproportionality that requires emergency medical attention). This is usually a caesarean.
Often such a pathology occurs in women who are not nulliparous, after the age of 30 years, as well as who are obese and diabetes. Large babies require close medical supervision.
Possible causes of pathology
The development, weight and growth of the baby increases in the presence of at least one of the provoking factors directly related to the health, nutrition of the mother, as well as the course of the previous and current pregnancies.
The following common causes of fetal macrosomia are distinguished:
- Metabolic imbalance. Problems of fat and carbohydrate metabolism affect the acceleration of negative processes in the fetus. Often such a diagnosis is made to women insulin-dependent, with obesity and diabetes.
- Fetal macrosomy in gestational diabetes occurs in 15-45% of women in labor. A future mother should monitor her health and regularly visit a doctor, because macrosomia in GDM occurs only in case of untimely diagnosis and treatment.
- Failure to comply with the diet. Rapid increase in body weight is observed in women who consume high-calorie foods in the diet that violate the ratio between the main nutrients. The risk of developing pathology increases if you abuse carbohydrates and fats, as well as with a lack of copper, phosphorus, calcium and vitamins, which favorably affect the bearing of the child and its development.
- Repotting. If the gestation period of the fetus increases, then it continues to further develop and grow, gaining body weight, and increase in growth. This is one of the factors that non-primiparous women should pay attention to, since each subsequent pregnancy is usually longer than the previous one.
- Heredity. This is about factors that affect pathologies due to a genetic predisposition, not fully understood, and the relationship is not traced. It is believed that weighty babies are born in women large and tall (height 1.70, weighing more than 70 kg).
- Large fetus during a previous pregnancy. Given the statistics, the weight of the second child is approximately 25-30% more than the first. There is a hypothesis that this is due to the fact that the woman’s body is already ready for all the processes that occur with her during pregnancy.
- Anabolic drugs. An association has been established between increasing infant growth if a woman takes drugs that accelerate anabolism. Hormone-based drugs (gestagens) and other components.
The mechanism of development of pathology
The main cause of this is an increase in blood sugar during gestation. This happens with diabetes, overweight and obesity. In this case, a high concentration of glucose in the blood is observed in the unborn child. This provokes the stimulation of the production of insulin and growth hormone in his body. Then they activate the growth of the fetus due to the deposition of glycogen and fat in the tissues. The process is rapidly accelerated during porting.
Studies have shown that macrosomia is often found in women with low glucose tolerance before pregnancy, and body weight does not matter. Another factor is the content of triglycerides in the blood. Given this development mechanism, it can be concluded that a biochemical imbalance in the female body, even before pregnancy, can provoke macrosomia. There is a risk of not only maternal, birth injury, but also fetal death in the womb.
Types of Macrosomia
There are two types of macrosomia:
- Constitutional type. The influence of hereditary factors. The fetus is large, but intrauterine development occurs normally without deviations. A potential problem is trauma during childbirth.
- Asymmetric type. An increase in internal organs in which functions and their work are impaired. This type is considered pathological. The large circumference of the chest and abdomen is characteristic in comparison with the head. Visually, such children are proportionally different from others. Asymmetric macrosomia has consequences for the child in the form of obesity, the development of cardiovascular disease, diabetes and hypertension.
How to recognize a hazard?
The attending physician can identify the pathology during the ultrasound using the embryonic biometrics labeling pathway. Quite often, pathology is determined only after childbirth, when accurate measurements of the baby were performed. A pregnant big belly may indicate active growth of the fetus or polyhydramnios.
Signs of illness
Signs of the disease:
- abdominal circumference over 100 cm;
- bottom height from 40 cm.
You can identify a large fetus for a period of 36-38 weeks, during each visit to the doctor, the weight of the woman in labor increases by 500 g. A reliable method is ultrasound.
The consequences of the disease for mother and baby
Macrosomy is a dangerous pathology for both the mother and the fetus. During labor with the process of intrauterine hypertrophy, the risk of complications increases:
- prolonged labor;
- severe bleeding;
- damage to the passageways of the uterus;
- atony;
- stop labor;
- postpartum infections.
Complications are also possible for the baby. At birth with overweight, the risk increases, in the first place, injuring the baby. These include: dislocation of the humerus, fracture of the clavicle, damage to the facial nerve, and paralysis of the shoulder joint. A complication may be hypoxia, which will lead to encephalopathy (developmental retardation and even death).
Children with such a pathology may encounter various disorders that will occur after childbirth: underdevelopment of the respiratory system, hypertrophy of the heart channels or metabolic disorders.
Consequences may occur in the later stages of a child’s life. Various carbohydrate disorders (diabetes, glucose tolerance), overweight, and hypertension are possible.
Childbirth with Macrosomia
Many mothers who have a large fetus are interested in how long a planned caesarean section is prescribed. With a large fetus, a woman is recommended to be under the supervision of doctors before the onset of labor, and surgery is prescribed for about 39 weeks.
Childbirth can take place naturally or promptly (emergency, planned cesarean section).
Indications for cesarean:
- narrow pelvis;
- age peak to 18, after 30 years;
- contraindications to attempts;
- entwining the umbilical cord of the fetus;
- repotting;
- uterine pathology;
- diabetes;
- amniotic fluid prematurely departed;
- preeclampsia;
- history of complications.
You can prepare for independent birth. It is necessary to maintain the body in physical form (yoga, fitness, swimming), you need to work with the muscles of the vagina according to the method of A. Kegel, as well as attending courses for pregnant women, they will teach you proper breathing, show exercises and much more. All this is allowed only if there are no contraindications.
There is no method that will help completely avoid pathology. But you can apply prevention methods: monitor your health, diet, visit the gynecologist on time, take the necessary tests. During pregnancy, you need to evaluate the development of the fetus and sensations during the weeks, especially if you are at risk. And, most importantly, preparing in advance to become a mother is a great responsibility.