Re: weight loss & big baby

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• In reply to: Amy: "weight loss & big baby"

If you started a diet for gestational diabetes following your glucose screening, it is not unusual to lose some weight following. >
>2. I have gestational diabetes and at yesterday's ultrasound the baby's
>head was HUGE (2 standard deviations beyond what the radiologists chart
>registered.) His legs and arms were a little long (37-38 weeks), but
>smaller than his head. Is an extremely large head common with GD and is
>the discrepancy between his head size and his limb size anything to
>worry about now?

The measurements at this point in the pregnancy have a very large margin of error. In other words, the relationship of the leg measurements to the head measurement may be very normal for your child. >
>3. When do you (the doctors on the forum) begin considering inducing a
>mom with GD who you know has a very large baby? (EFW @3750 grams at 36w
>4d) I know the only way to tell if the baby is too big is with a trial
>of labor, but with his head so huge and him so big, I get more scared
>every day!

With that estimated fetal weight, I would keep a very close eye on the fetal growth. There is a lot of variability in management of pregnancies with suspected macrosomia. There is further debate about the timing of induction. I personally favor consideration of induction at 38-39 weeks. There is data that suggests that this sort of "early" induction does not change the outcome. Further, if the baby would get to 4500 grams estimated weight, some would just electively do a cesarean section... Lynn >
>Thank you for your input. I really appreciate it.

--
Lynn D. Montgomery, MD
Director, Maternal-Fetal Medicine
Rocky Mountain Perinatal Center
Missoula, Montana

**Note:  Opinions expressed here are for educational purposes only and, as such, do not constitute a physician-patient relationship.  This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options and/or interventions.

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• In reply to: Amy: "weight loss & big baby"