Re: big baby--More questions
From: Amy (anonymous@obgyn.net)
Wed, 16 Aug 2000 12:09:44 -0500 (CDT)
I have a couple more questions: Is there any way to keep the baby from
getting bigger--does controlling blood sugars really help?
How much of a margin of error is there in EFW? I am terrified of having
a 13 pound baby. My blood sugars are not extremely high--Most of them
are fine (maybe 1 a day is around 130), but the baby has gained an
estimated 3 pounds in 3 weeks.
Does prednisone make babies bigger by itself?
One more, Why do GD babies have more respiratory problems? Will the
prednisone I've been on the entire pregnancy help this or is the baby
stuck?
At Tue, 15 Aug 2000, anonymous@obgyn.net wrote:
>
>At Tue, 15 Aug 2000, AP wrote:
>>
>>I am 33.5 weeks and have gestational diabetes. The EFW today of our
>>baby was 7.5 pounds. I have a couple of questions. First: does GD make
>>babies big all over or just fat? Our little one measured greater than
>>the 95% percentile in EVERY way (leg measurements, arms, head, abdomen,
>>etc.) Is this common with GD or is our baby just genetically meant to be
>>huge?
>
>This is very common with GD. Actually, they are not just big, but they
>have a characteristic pattern of fat distribution (think of the Michelin
>man).
>
>>Second, what's the standard practice for anticpating labor and delivery
>>when the baby is as big as mine looks like it's going to be? Induce
>>early, if so when? Let labor come when it may and if problems arise do a
>>C-Section? If I go to term and the baby is <4.5kg schedle a C-Section?
>
>This is a very difficult problem. You can't induce too early, as
>another problem with GD is that the fetal lungs have delayed maturity,
>and even near term babies can have respiratory problems. There is are
>also difficulties with accurate measurements in GD babies, and the
>estimated fetal weight (EFW) is unreliable. There is also little data
>to prove that planned C/S improves fetal outcome. Some practitioners
>have a cut-off point (4 or 4.5 kilos most commonly), but this is not the
>standard of care. For my own patients, I feel that every mother and
>child have the right to a trial of labor, but with anticipated very
>large babies, they have to stay right on the labor curve. If the labor
>begins to lag, I am quicker to go to C/S than for a baby of average
>size.
>
>>Third, if I went into labor now would they still try to stop me? I have
>>been on prednisone the entire pregnancy and as I understand it the
>>baby's lungs have a good chance of being developed?
>
>It would depend on the circumstances, but I suspect that they would try
>to stop you at this point, at least for another half week or so.
>
>--
>William D. McIntosh, MD, FACOG
>Clarksville, TN
>
>This is for educational purposes only, and is not intended to be replacement
>or substitute for consultation and examination by an appropriate medical
>professional. Due to time constraints, private e-mails cannot be answered.
>
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