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Macrosomia can actually be detected and intervened early
A mother gave birth to a huge child weighing 13 pounds and 6 pairs, comparable to the weight of 2 normal newborns! Amazingly, her first litter also weighed 11.4 pounds!
There is also a mother, one child is 12.8 pounds of huge child, the overall weight of the second twin is more than 15 pounds.
Is it possible that one child is a huge child, and the second child is also prone to giving birth to a huge child?
Let's analyze the analysis.
Which women are prone to having gigantic babies?
In medicine, newborns weighing ≥ 4,000 grams are called "macrosomia". According to the degree of risk of maimation or death of the newborn or mother in macrosomia, the birth weight of the newborn is divided into three stages: 4000-4499 g; 4500-4999 g; ≥ 5000 g.
High-risk factors for macrosomia include:
| gestational diabetes mellitus (GDM) and obesity
The study found that the proportion of normal-weight pregnant women who gave birth to macrosomia was 7.7% and that of obese women was 12.7%; the proportion of GDM pregnant women who gave birth to macrosomia was 13.6% and 22.3% of obese women; and the incidence of macrosomia in pregnant women with GDM was higher.
| Pregnant mothers gain weight too quickly
Excessive weight in pregnant women may increase the chance of metabolic diseases, and excessive weight growth in the short term is likely to cause pregnancy complications such as preeclampsia and diabetes, and is prone to macrosomia.
Again, offer a copy of the Standard Gestational Weight Edition with both hands:
So moms have to assess the magnitude of their weight gain based on the preconception BMI index (weight/height 2).
| genetic factors
Parents are tall, and fetuses are usually larger.
| have many births and a history of large births
Fetal weight can increase with the number of deliveries.
| placental function is good
Women with good placental function are also prone to fetal weight gain.
Therefore, the mother who gives birth to a huge child in the first child will indeed be easier for the second child to give birth to a huge child.
Macrosomia or affect a child's life
The study found that as the birth weight increases, the risk of injury, disability and death in newborns and mothers gradually increases.
For women, macrosomia can lead to prolonged labour and delay in labour, postpartum haemorrhage and soft birth canal lacerations, increasing the rate of caesarean section and making it more difficult to recover from childbirth.
The impact of macrosomia on children is long-term, and the incidence of obesity, diabetes and other diseases in macrosomia children will increase significantly, and may also have an impact on intelligence.
How to avoid giving birth to a huge child?
According to the 2020 ACOG Macrosomia Pediatric Guidelines, it is clinically necessary to screen pregnant women and fetuses in combination with medical history, physical examination and ultrasound measurements. At present, there is no optimal method for screening and estimating macrosomia, clinical and ultrasound predictions are not accurate enough, and the diagnostic value of the two methods is higher than the diagnostic value.
Therefore, in the daily clinical work of obstetrics, obstetricians and gynecologists will make comprehensive judgments through regular obstetric examinations combined with a number of indicators:
The height of the palace + abdominal circumference ≥ 135cm
The height of the palace ≥ 38cm
B Super Double Top Diameter ≥ 9.5cm (combined with gestational age)
Pregnant women are ≥ 165cm tall
Pregnancy is postponed for more than 7 days
Weight gain in pregnant women ≥ 20 kg
Prenatal weight ≥ 68 kg
Those who meet the above 3 items can predict the possibility of macrosomia, the accuracy rate can reach 72%, and combined with ultrasonography to estimate the fetal weight, the diagnosis of macrosomia can be achieved.
If the mother's weight gain during pregnancy is too fast, the corresponding intervention will be taken clinically to control the mother's weight.
If the mother detects gestational diabetes, it is clinically recommended to perform blood glucose management and develop diabetes recipes for GDM pregnant women. If you can't achieve your blood sugar control goals through diet or exercise, you need to add insulin therapy.
Early intervention after high blood sugar is detected in pregnant women is very important to prevent the occurrence of macrosomia in pregnant women with GDM. The first mother failed to control blood glucose levels and fetal growth in time because of the lack of regular obstetric examinations.
In addition, moderate aerobic exercise during pregnancy and maintaining a low-sugar and high-fiber diet can effectively reduce the risk of reducing the delivery of macrosomia.
How can a giant baby give birth safely?
In "suspected macrosomia", vaginal delivery can lead to an increased risk of shoulder dystocia, and elective caesarean section is usually chosen with the aim of reducing maternal and neonatal harm to mothers and newborns with adverse outcomes or abnormal deliveries. Before delivery, fully evaluate, actively communicate with the patient, rationally use the guidance of midwifery delivery, and prepare for possible shoulder dystocia.
In summary, effective blood glucose management, dietary guidance, exercise guidance, and evaluation during childbirth, and the selection of appropriate delivery methods for pregnant women can effectively reduce the occurrence of macrosomia and maternal and child complications.
bibliography:
[1] Black MH，Sacks DA，Xiang AH，et al． The relative contribution of prepregnancy overweight and obesity，gestational weight gain， and IADPSG-defined gestational diabetes mellitus to fetal overgrowth［J］． Diabetes Care，2013，36( 8) : e 128．
Sun Pingping, Li Huaping, Zhao Fang. Risk factors for the occurrence of macrosomia due to abnormal glucose metabolism during pregnancy[J]. Journal of Practical Obstetrics and Gynecology, 2012, 28(1):4.
Yang Weibo, Tang Shifang, Ma Juan, et al. Interpretation of the "Giant Pediatric Guidelines (2020)" of the American Association of Obstetricians and Gynecologists[J]. China Family Planning and Obstetrics and Gynecology, 2020, 12(8):5.
Source of this article: Medical Community Obstetrics and Gynecology Channel
Author: Red bean barley
Interview experts: Obstetric expert team of Shanghai First Maternity and Child Health Hospital
Editor-in-Charge: CiCi