Does food affect fetal weight? Why do weighty children have to be controlled? Large fetus: the nuances and characteristics of childbirth

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Most of the pregnant women, having learned that a large baby will be born, begin to worry much about the upcoming birth.

Indeed, as practice shows, complications in this case can not be avoided. As a rule, at birth of a large fetus, childbirth is protracted in nature and, as a result, the woman in labor is very exhausted, loses a lot of strength and there is no longer any chance of their attempts. What can greatly harm both the health of the mother and the health of the child.

In medicine, the concept of large fruit is divided into two types: large and giant. Their difference is only in body mass, if the first have a birth weight from 4 kg to 5 kg, then the second - more than 5 kg. The growth of such children also exceeds the average. Normally, it is 48 - 54 cm, while the growth of a large fetus is 54 - 56 cm, and the giant one is over 56 cm. According to research data, the number of births of large children in Russia is only 10%, and giant children - 3%.

Why are children born large?

The birth of large children is due to various factors that, to date, are not fully understood. But there are some reasons proven by scientific studies that directly affect the mass of the fetus. The most important of them are alimentary-metabolic obesity and genetic level.

The genetic level here is of great importance. If the childbirth or the biological father of the child had a large weight at birth, then the likelihood that the baby will be born with the same weight is very high.

If during the first birth a large baby was born, then the formation of a large fetus during the second birth is also possible. Studies have shown that the body weight of the second child and subsequent children at birth increases by 20–30%. For example, if the first child was born with a mass of about 3 kg 600 g, then the second child will have a weight of about 4 kg.
  As for alimentary-metabolic obesity, here the woman in labor herself is “to blame” for the formation of a large fetus. Frequent consumption of high-calorie foods, limited exercise stress - All this leads not only to the excessive weight gain of a pregnant woman, but also the child itself. Eating during pregnancy in the food of various spices increases the appetite, and an unlimited number of flour products, which have in their composition a lot of carbohydrates, lead to the formation of fat deposits.

A woman should carefully monitor their daily diet during the entire period of pregnancy. After all, the substances contained in some products, with excessive use, adversely affect the health of the woman and the health of the baby. In the period of gestation, doctors recommend women to eat more fruits and vegetables, which contain a large number of different trace elements and vitamins, especially necessary in the first and second trimester of pregnancy. After all, it is during these periods that vital organs, muscles and tissues form in the fetus. But overweight slows down these processes of formation, which significantly affects the development of the child.

Pregnant women need to regularly monitor weight gain, especially in the third trimester. During this period, the fetal muscle mass gains. Normally, a woman should gain no more than 0.5 kg per week, and for the entire gestation period no more than 15 kg. Excessive weight gain indicates the presence of an increase in edema or the formation of a large fetus.

In addition to the genetic level and alimentary-metabolic obesity, the formation of a large fetus can serve other factors:

• endocrine and metabolic diseases;
• retrofitting;
• features of the placenta;
• edematous form of hemolytic disease;
• other factors.

Endocrine-metabolic diseases include diabetes and obesity at all stages. Diabetes threatens a violation of the process of glucose uptake, which leads to an accelerated exchange of carbohydrates, due to which there is an increase in blood sugar levels in the mother and fetal umbilical cord blood. Accelerated absorption of carbohydrates helps to increase the fat mass of the child.

In pregnant women with diabetes, the fetus grows and increases its mass unevenly, due to frequent changes in blood sugar levels. That is, the growth of the fetus periodically accelerates, then slows down. The mass of the fetus at birth directly depends on the duration of the disease.

If a woman has diabetes, then the likelihood that a child will be born large is very high. But due to uneven weight gain, the child may have the following deviations:

• moon-like puffy face;
• wide shoulder girdle;
• short neck;
• disproportionately folded body.

As a rule, a large fetus born during childbirth has a large body, and this is due to an enlarged spleen and liver, as well as a thick subcutaneous fat layer. Also in these children there is an increase in length, discrepancy of the femur to the circumference of the abdomen and finding the length of the femur and the size of the head at the upper limits of the norm.
  As for obesity, not depending on its degree, a violation of lipid metabolism occurs in a woman’s body, which contributes to the growth of fat deposits in the fetus. By the way, one of the risk factors for large-fruited children is obesity of the child’s biological father.

Renewing causes not only the birth of a large child, but also the onset of hypoxia, that is, lack of oxygen. Renewal is of two types:

• physiological is when the pregnancy is extended for 2 weeks, while the placenta continues to fully provide the baby with all the necessary substances;
• biological is when the pregnancy is prolonged for 2 - 3 weeks, but at the same time the placenta “ages” and does not fully fulfill its functions, as a result of which the fetus has hypoxia, an increase in head volume and body length, maceration of the skin. Also biological true perenashivaniya characterized by low water with meconium impurities and the absence of the original lubricant.

Physiological pererashivanie not harmful to health and is the norm during pregnancy. When biological retouching, as a rule, doctors perform all necessary measures to speed up the opening generic activity.
  By features of the placenta understand its morphofunctional, that is, its large size, volume and thickness, which exceeds 5 cm. Due to these features, there is an increase in circulating blood, in which the fetus receives all the nutrients in large quantities, and this contributes to the fetal body weight.

In an edematous form of hemolytic disease, edema and fluid accumulation in the cavities of the fetus, an increase in the spleen and liver occurs. This disease is accompanied by Rh-conflict. In severe forms of the disease, as a result of the collision of a negative Rh factor with a positive one, anemia and jaundice occurs in the fetus. This form of the disease can cause complications of childbirth in a large fetus, the need for urgent blood transfusion to both the mother and the child is not excluded.

The following factors can also affect the formation of a large fetus:

• age (up to 20 years and after 35 years);
• violation of the menstrual cycle before pregnancy;
• transferred inflammatory diseases of the female genital organs.

How to find out about a large fruit?

Today, to find out the weight and height of the unborn child is not difficult. This can be done both on scheduled ultrasound examinations, as a rule, it is done at 11, 22, 32, 38 weeks of gestation, as well as by the traditional method that all gynecologists use when examining a woman.

Of course, ultrasound gives the most accurate results of measuring the volume of the fetus, however, it can sometimes be mistaken. During the ultrasound, the doctor pays special attention to measuring the size of the biparietal size of the head, abdominal circumference and the length of the femur of the fetus. Based on these measurements, the doctor makes conclusions about whether a large fetus or not. Indicators that are 2 weeks longer than normal for this period   pregnancy, indicate delivery with a large fetus.
  The traditional method is to measure the following parameters:

• the height of standing of the uterus above the womb, as a rule, with a large fetus, this parameter exceeds 42 cm;
• abdominal circumference at the level of the navel, which exceeds 100 cm.

Possible complications during childbirth

Natural childbirth large fruit in most cases are successful and without any complications. However, there is a possibility of their formation. The most common complications of childbirth are:

• untimely rupture of amniotic fluid;
• anomalies of labor;
• acute fetal hypoxia;
• clinical situation of narrow pelvis;
• hip dystocia;
• operative intervention;
• rupture of the uterus;
• formation of urinary and rectovaginal fistulas;
• damage to the pubic symphysis.

The situation of a clinical narrow pelvis is quite common during childbirth with a large fetus. The size of the head of the fetus may not match the size of the pelvis of the woman, which can later lead to some complications in the process of childbirth. However, if labor activity is good, then childbirth, most often, pass naturally   without surgery.

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It is hard to resist not to smile at the chubby baby: full babies always cause genuine emotion. Compared with a thin child, it looks strong and healthy. People even often say that chubby toddler is sweet, tasty or appetizing. But this very people only rarely think about the fact that in fact it is not always good. Overweight is dangerous even at this age, and problems begin in the womb ...

The birth of a child with greater weight among ordinary people is mistakenly considered to be a sign of well-being. Meanwhile, a large fruit is fraught with great risks, including for mommy.

However, one should not think that this is a problem anyway. A large fetus during pregnancy is simply a risk factor. That is why it is necessary to learn more about this in order to prevent these very risks to the maximum.

Large fetus during pregnancy - how much?

For many years in obstetrics it was considered to be a large newborn weighing more than 3,600 g. However, today this figure has been revised.

Recently, there has been a tendency to increase the body weight of newborns. A baby’s weight at birth up to 4 kg is considered to be the norm. If it exceeds 4 kg, then they talk about a large baby, more than 5 kg - about a very large, “giant” one. Every year the number of births of large children (which is called macrosomia in obstetrics) increases, as does the weight of newborns. However, in each case, a large fruit will be considered with different weight. So, if a woman has anatomical narrow pelvis   or the fetus is located buttocks down, then in this case the fetus that has reached a mass of only 3.5 kg will be considered large.

In addition, when determining whether a large fruit or not, it is necessary to take into account also its growth, as tall children are always heavier than short-growing ones.

In general, a large fetus (or macrosomia) is a child whose birth can be difficult due to its size and weight.

As far as the fetus is large, the midwife or neonatologist who delivers childbirth can actually judge at the first examination of the infant. But preliminary predictions are made long before delivery - without fail.

How to identify a large fetus during pregnancy

During visits to a pregnant gynecologist, various measurements and studies are carried out each time. Among other things, the doctor is trying to make a preliminary assessment of the weight developing fetus   (already at a later date), measuring the width of the pelvis, the height of the day of the uterus, abdominal circumference, pregnant weight and other parameters.

More accurately determine the weight and growth of the fetus during pregnancy can be ultrasound, but even in this case, these parameters can differ from the real by 10-15%.

Firstly, it gives the right to indirectly judge the well-being of the development of the baby. Secondly, in this way one can suspect the development of certain pathological conditions during pregnancy in a timely manner. Thirdly, the estimated weight with which the baby will be born is very important in the sense that it in many ways makes it possible to predict the course of the generic process itself and the presence / absence of associated hazards.

If a woman regularly visits the gynecologist during the entire pregnancy, all examinations prescribed to her are diligently carried out, then the probability of developing a large fetus is determined very simply. It is almost impossible to suspect it yourself. Yes, many discomfort during pregnancy in the case of the development of a large baby appear more pronounced, but this may be completely different reasons, and many of them. A big belly during pregnancy is not always a sign of the development of a large fetus. It is possible that a tiny baby lives in a big tummy.

The most reliable and accurate diagnosis of a large fetus during pregnancy is the passage of ultrasound. And it is worth noting that such a diagnosis is very important, because sometimes on this basis (the development of a large baby) it can be suspected that a pregnant woman has serious illnesses.

Large fetus during pregnancy: causes

Most often, the baby is gaining too much extra in the womb with her mother in connection with her way of feeding. Overweight simply contributes to weight gain. Love for flour, confectionery, sweets is poured into extra grams and kilograms. But there are also other reasons for the formation of a large fetus during pregnancy:

1. Heredity. Of course, the parents of a large build children are likely to be born too rather big. Even if you are now slim and slim, then at birth things could be different. Moreover, the size of the head of a newborn is highly dependent on genetics: if the baby's dad is also born puffy, the risks increase. Ask the grandmothers of the future baby, the children with which weight they gave birth. Most likely, the story will repeat.
2. The number of births in the past. Practice shows that every next child of the same woman is born with greater weight than the previous one. But, of course, large fruit during the first pregnancy is also often.
3. Wrong way of life. A pregnant woman who has little movement and consumes a lot of fried, fatty, carbohydrate foods will certainly gain extra pounds. And along with it, the baby is too.
4. Rhesus-conflict during pregnancy. If the Rh-negative mother bears a Rh-positive baby, then such a pregnancy carries many risks. Among other things - fluid retention in the tissues of the fetus, which affects its weight and size.
5. Disturbed metabolism (hypothyroidism, diabetes during pregnancy). Due to impaired metabolism, a lot of glucose gets into the blood of the fetus, which contributes to weight gain. Often it is a large fetus during pregnancy is the basis for testing future mom   on the level of sugar in her blood, because even if there had previously been no deviations in this indicator, now gestational diabetes may be developed.
6. Reception drugs. There is a theory that has not yet been confirmed that the fetus can lead to prolonged use of certain medications to gain weight. Among them, in particular, are means for improving uteroplacental blood flow (as, for example, Actovegin).
7. Condition and location of the placenta. There is such an opinion among obstetricians that a large, thick placenta may be one of the reasons for the formation of a large fetus during pregnancy, because in this case, the baby is fed quite intensively. A more active supply of nutrients to the fetus also contributes to the location of the placenta on the back wall of the uterus.
8. Prone pregnancy It is said that real prolongation, which may carry certain risks and dangers, if the pregnancy lasts more than 10-12 days after the period of 40 weeks. In this case, the child gains a large body weight, and also has other signs of post-aging (dry, wrinkled skin, lack of original lubricant on it, long hair and nails, hardening of the skull bones, starting to close springs).

Some doctors, and at the same time women themselves, believe that a large fetus during pregnancy and vitamins have a direct relationship. As if multivitamin complexes for pregnant women are the reason for the future child to gain extra weight. But, firstly, this theory is not scientifically proven and is based only on personal experience and observations of doctors; secondly, numerous reviews on the Internet indicate that very often when taking vitamins throughout the term of gestation, babies are born not only with average body weight, but often even with a weight below the norm. So with confidence that the vitamins for pregnant women form a large fetus, it is still impossible.

So, if it turns out that the fetus is scheduled to be large, the doctor will first of all have to establish the cause. The further management of pregnancy and preparation for childbirth will largely depend on it.

What is dangerous large fetus during pregnancy

It is not necessary that a large baby be a problem during pregnancy or during childbirth. But such a danger exists, and it is greater, the larger the fruit and the more serious the cause that led to it.

Large fetus: features of pregnancy

The larger the fruit, the more space it requires inside the womb, and therefore, the more severely the internal organs are infringed and the more stress they experience. In this regard, frequent urination, constipation, heartburn, shortness of breath may be more pronounced and frequent.

The heavier the fetus, the more pressure it exerts on the vena cava, and the stronger the load on the musculoskeletal system, especially the legs. That is why pains in ribs, back and waist, varicose veins, fainting in a supine position are normal phenomena for such a pregnancy.

Of course, the risk of the appearance of stretch marks during pregnancy with a large fetus also increases, as does the risk of increased uterine tone.

Large fetus: characteristics of childbirth

There are risks in the period of childbirth. The head of a large fetus is loose against the pelvic floor, and water may not be divided into front and rear. This means that during discharge they pour out all at once, which is worse for the condition of the baby, and may depart earlier than the prescribed time (and a long anhydrous period in labor is associated with certain risks). Together with the water in the lumen of the cervix can fall umbilical cord loop, pinching, or limbs of the fetus - in this case, you have to resort to emergency delivery.

The generic activity at birth of a large baby is often weakened, and contractions are painful. Due to the mismatch of the fetal head and the width of the mother's pelvis, it may be necessary to perform a cesarean section. If the birth takes place in a natural way, then they are often protracted, obstetricians have to dissect the tissues of the perineum or in an emergency order to resort to cesarean. Even after the birth of a large baby's head, difficulties may arise with the removal of the shoulder joints. Risk increases hypoxia   in childbirth and childbirth, in particular, intracranial hematomas are formed, and during particularly difficult births, hemorrhages in the brain can occur.

The long course of labor is fraught with infection of the birth canal and uterus.

In rare cases, the birth of a very large fetus may even cause a rupture of the uterus. Damage to the pubic bone and hip joints, muscle paresis, and neuralgic pathologies occur. Subsequently, inflammations in the urogenital tract and rectum of the woman who gave birth to the athlete are also not excluded.

Often, after the birth of a large baby, postpartum recovery requires more time, bleeding after birth goes longer, uterine bleeding can open.

A large newborn baby may require more attention and needs special care. But with its proper organization, such a baby very quickly adapts to new conditions of existence and does not lag behind other babies in anything.

If a large fetus during pregnancy: what to do?

Based on the reasons leading to the development of a large fetus, you can identify pregnant women who are at risk for this indicator. Such women should from the first days do everything possible to minimize the possible risks.

Large fetus during pregnancy: diet

The first thing to start with is to organize your meals correctly. It must certainly be complete and balanced. But with the tendency to gain weight, both the woman and the unborn child will have to exclude fatty, fried, sweet, mealy foods and foods from the diet. Emphasis should be placed on lean protein, vegetables, unsweetened fruit, and whole grains. The content in the diet of carbohydrates will need to be reduced in late pregnancy.

It is possible that, for medical reasons, the doctor will prescribe a diet for you or recommend you to spend fasting days during pregnancy. But without a medical consultation to arrange such events can not. But to limit the calorie intake will not be superfluous: do not eat for two - this is a big mistake!

If there are no contraindications for this, you should certainly move a lot and do gymnastics. It will be useful even to visit the pool or fitness for pregnant women.

But the most important thing is not to worry too much. Being under close medical supervision, a woman carrying a large fetus has very high chances to be delivered safely and with minimal risks.

Large fetus during pregnancy: how to give birth - cesarean section?

Quite a rather large percentage of pregnancies in which the fetus develops large, successfully ends by natural childbirth. They are conducted under medical supervision with tracking of fetal heartbeats. Immediately after the birth of a baby, a neonatologist must certainly inspect, and it is also necessary to conduct some research to exclude health problems in the newborn, in particular diabetes mellitus and hemolytic disease.

But it is possible that a woman will have to prepare for an operation. Large fruit is an indirect indication for cesarean section. Surgical delivery can not be avoided if, in combination with a large fruit, there are other indications for cesarean:

• narrow pelvis during pregnancy;
• high water flow;
• late preeclampsia;
• diabetes during pregnancy;
• lower blood sugar levels;
• premature discharge of amniotic fluid;
• cord entanglement;
• post-pregnancy;
• weak labor activity.

On an emergency basis cesarean section   with a large fetus, it can be carried out in case of weak labor, with prolonged labor, clinically narrow pelvis (which is already detected during the birth) or if there is a risk of uterine rupture.

In general, there is no particular reason for anxiety. Trust your doctor - and everything will go as well as possible. Do not refuse hospitalization for the last time, if you will be offered this. It is much easier and in principle correct to take delivery of a large baby with preliminary preparation and prenatal care. Medical control will significantly reduce the likely risks and prevent complications.

In the end, many women give birth to large tots not only on their own, but also without all sorts of difficulties and complications! After all, childbirth in each case is different in its own way, with individual differences and peculiarities.

And so do not be afraid - you can handle everything. Good luck to you birth! Wait for your heroes with love and impatience!

Especially for -   Larisa Nezabudkina