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Large fruit
Last reviewed: 08.07.2025
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A large fetus is a fetus with a birth weight of 4000 g or more (up to 5000 g). If the body weight is more than 5000 g, the fetus is called giant. A large fetus occurs in 8-10% of cases. Giant fetuses are extremely rare (one case per 3000-5000 births).
The high frequency of large babies may be genetically determined and may also be related to excessive carbohydrate consumption. It is not uncommon for the same woman to give birth to large babies more than once.
The risk group for the birth of a large fetus includes women who have given birth to multiple babies, pregnant women with a body weight of more than 70 kg and a height of over 170 cm, and those with pathological weight gain during pregnancy (more than 15 kg).
Large babies can be born as a result of postmaturity, obesity, or edematous form of hemolytic disease of the fetus.
A particularly large fetal body weight is observed in cases of maternal diabetes, which is determined by metabolic disorders in the fetus.
How to recognize a large fruit?
Diagnosis of a large fetus is based on the characteristics of the anamnesis and objective examination data.
When collecting anamnesis, they find out the height and build of the spouse, the patient's birth weight (hereditary factor), the body weight of the newborn in previous births. They find out whether the patient suffers from diabetes mellitus or endocrine disorders.
An objective examination reveals an increased abdominal circumference (over 100 cm) and the height of the fundus above the pubis (over 40 cm). These values are a particularly accurate sign in the absence of pronounced edema and obesity. The size of the head during palpation usually exceeds the norm. It is possible to clarify the presence of a large fetus using ultrasound, which allows you to determine its size and calculate the estimated weight of its body. Important fetometry indicators are the biparietal size of the head, the circumference of the head and abdomen, the length of the femur of the fetus, which exceed individual normal fluctuations of the corresponding gestational age. Antenatal diagnosis of a large fetus using ultrasound is possible as early as the middle of the third trimester. A large fetus is also characterized by an increase in the thickness of the placenta.
Management of labor with a large fetus
The course of pregnancy with large and giant fetuses is characterized by some features. Pregnant women experience edema, late gestosis 2 times more often, polyhydramnios, distortion 1.5 times more often. Sometimes, due to the high position of the diaphragm, shortness of breath may appear.
Childbirth with a large fetus, due to overstretching of the uterus and the occurrence of disproportion between the fetal head and the mother's pelvis, is often complicated by untimely rupture of amniotic fluid, primary and secondary weakness of the labor forces. The biomechanism of childbirth with a large fetus is carried out in the same way as with a generally uniformly narrowed pelvis.
In case of disproportion between the pelvis of the mother and the head of the fetus, labor proceeds as with a clinically narrow pelvis. Due to the compression of the large head by the bony base of the birth canal in the second stage of labor, fetal hypoxia or intracranial trauma is possible.
After the birth of the head, difficult birth of the shoulders is often observed, especially often in cases of diabetes in the mother, when the shoulder girdle is significantly larger than the size of the head.
In the afterbirth and postpartum period, complications associated with overstretching of the uterus are possible: placental separation disorders, hypotonic bleeding. During childbirth with a large fetus, the frequency of injuries to the soft tissues of the birth canal, uterus, vagina, and perineum increases.
In this regard, in recent years, indications for delivery by caesarean section for large fetuses have been expanded (in the case of a combination of this pathology with an advanced age of the mother, breech presentation of the fetus, post-term pregnancy, anatomically narrowed pelvis). Delivery by caesarean section is performed when a clinical discrepancy between the sizes of the fetus's head and the mother's pelvis or persistent weakness of labor occurs during labor.
[ Prevention of large fetus
A large fetus is difficult to prevent. Prevention of complications for the mother and fetus in case of its large size consists of a thorough assessment of the obstetric situation. In case of additional complications, a planned cesarean section is indicated.
When delivering a baby through the natural birth canal, it is necessary to promptly identify the disproportion between the mother's pelvis and the fetus's head.