Large fruit
Last reviewed: 23.04.2024
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A large fetus is a fetus with a birth weight of 4000 g and more (up to 5000 g). With a body weight of more than 5000 g, the fruit is called gigantic. A large fetus occurs in 8-10% of cases. Giant fruits are extremely rare (one case for 3000-5000 births).
The high birth rate of large children can be caused genetically, and also is associated with excessive consumption of carbohydrates. Often there is a multiple birth of large children from the same woman.
The group of risk of the birth of a large fetus includes many-pregnant women, pregnant women weighing more than 70 kg and growing over 170 cm, with abnormal weight gain during pregnancy (more than 15 kg).
Large children can be born due to overweighting, obesity, edematous form of hemolytic disease of the fetus.
Especially large fetal body mass is observed in diabetes maternal, which is determined by a metabolic disorder in the fetus.
How to recognize a large fruit?
Diagnosis of a large fetus is based on the features of the history and data of objective examination.
Collecting anamnesis, find out the growth and physique of the spouse, the patient's body weight at birth (hereditary factor), the body weight of the newborn in previous births. Find out whether the patient is suffering from diabetes mellitus, endocrine disorders.
With an objective examination, there is an enlarged abdominal circumference (over 100 cm) and a height of standing of the uterine fundus above the womb (more than 40 cm). A particularly accurate indication of these values are in the absence of pronounced edema and obesity. The size of the head during palpation usually exceeds the norm. To clarify the presence of a large fetus is possible with ultrasound, which allows you to determine its size and calculate the estimated weight of its body. Important indicators of fetometry are the biparietal size of the head, the circumference of the head and abdomen, the length of the femur of the fetus, which exceed the individual normal fluctuations of the corresponding gestational age. Antenatal diagnosis of a large fetus with ultrasound is possible already from the middle of the third trimester. A large fetus is also characterized by an increase in the thickness of the placenta.
Conducting births with large fetuses
The course of pregnancy with large and giant fruits is characterized by some features. Pregnant women are twice as likely to have swelling, late gestosis, 1.5 times more often - polyhydramnios, crooked. Sometimes, due to high diaphragm standing, dyspnea may appear.
The birth of a large fetus due to overgrowth of the uterus and the appearance of an incommensurability of the fetal head and pelvis of a woman in childbirth is often complicated by the late discharge of amniotic fluid, the primary and secondary weakness of the ancestral forces. The biomechanism of childbirth with a large fetus is carried out in the same way as with a uniformly constricted pelvis.
In case of incompatibility of the pelvis of the mother and the head of the fetus, the birth proceeds as in a clinically narrow pelvis. In connection with squeezing a large head with the bone base of the birth canal in the second stage of labor, fetal hypoxia or intracranial injury is possible.
After the birth of the head, a difficult birth of the shoulders is often observed, especially in the case of diabetes in the mother, when the shoulder girdle is much larger than the head.
In the postpartum and postpartum period, complications associated with overgrowing of the uterus: violations of the placenta, hypotonic bleeding. At birth, a large fetus increases the frequency of injuries of the soft tissues of the birth canal, uterus, vagina, perineum.
In connection with this, in recent years, the indications for delivery by cesarean section in a large fetus have been expanded (in the case of a combination of this pathology with the elderly woman's age, pelvic presentation of the fetus, pregnancy overpinning, anatomically narrowed pelvis). Rh until resolution by caesarean section is performed when a birth in a clinical mismatch between the size of the fetal head and pelvis of the woman in childbirth, or the persistent weakness of labor.
Prevention of large fetuses
A large fetus is difficult to prevent. Prophylaxis of complications for the mother and fetus at large sizes is a thorough assessment of the obstetric situation. In the case of additional complications, a planned cesarean section is indicated.
When conducting labor through the natural birth canal, it is necessary to reveal in a timely manner the disparity of the pelvis of the mother and the head of the fetus.