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Preterm "Macrosomia"From: Dr. Lynn Montgomery (lmontgomery@communitymed.org)Fri Dec 29 15:34:46 2000
I have to say, I have never encountered this circumstance in my obstetric career. Any Suggestions? 38 G2 P1, currently at 29.5 weeks gestational age based on three first trimester ultrasounds, referred for preterm labor, possible macrosomia and polyhydramnios. On initial evaluation, has a fundal height of 42 cm and cervix is fgt/80%/soft. Ultrasound gives an estimated fetal weight of 5# 9oz and an AFI just above the upper limit of normal at 25. Despite having had three scans in the first trimester verifying dates, I don't believe them, thinking that she is actually at least a month further along and I amnio her for maturity. The FLM comes back at 6 (mature is 55). In other words, the dates are likely correct. Monitored blood glucose values for a solid week with great values-no evidence of occult diabetes. So, now I have basically a 6 pound baby at 30 weeks gestation. I am stopping preterm labor for what seems to be primarily macrosomia. Usually worrying about the smallness of a premie. In this case, I am concerned we are going to have the true "original bubba". Lynn
-- Lynn D. Montgomery, M.D. Director, Maternal-Fetal Medicine Rocky Mountain Perinatal Center 2825 Fort Missoula Rd, Suite 130 Missoula, Montana, 59804 406-327-4094 fax: 406-327-4154 e-mail: lmontgomery@communitymed.org website: http://www.communitymed.org/rmpc/
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