34+5 weeks - ultrasound size estimates big baby

[BabyBumpHopeful]

I had another ultrasound today. They do them monthly because apparently they can't rely on fundal height measurements because I was overweight when I got pregnant. In all other ways my pregnancy is perfect. My weight gain/loss is on target, BP is usually on the low side, was 112/72 today. His HR was 140 at 32 weeks, and was around 138 or so today. He is head down and facing my spine, i.e. in position.

Anyway, at 30+4 weeks he was measuring 3lbs 14oz (there's a 20% error rate), 67th percentile. Today, 4 weeks and 1 day later he's measuring 7lbs 2oz, 97th percentile. His head is measuring at just over 40 weeks... in other words, big baby.

For context, I'm 5'7" with "child bearing hips" (as I've always been told :S). My DSis was in labour for 40 hours with her first and ended up needing an emergency c-section because the baby was stuck. With her second she went elective c-section. Her babies were in the high 9lb range. I was 9lb 7oz when I was born, my 3 siblings were in the 9's but I was the biggest. DH was 8lb 6oz and born about 9 days late (his mother also smoked the entire pregnancy).

My OB told me that he's likely going to be a very large baby. I'll have another ultrasound in 3-4 weeks (so 37+5/38+5 weeks). She asked me to consider a c-section as a possibility for me/us and that based on the next ultrasound they'll determine whether it might be better to induce early (or do a c-section if that's my choice and I qualify - based on his size).

Anyway, the point of this thread what would you do (if faced with induction or c-section) and why?

Sorry that's long but didn't want to drip-feed :) Thanks in advance

I would probably go for the induction. I had a large baby. Sounds like I am of similar height and build to you. He was 10lb 11 and the birth was very straight forward. It was my second baby so obviously a bit quicker but hE was born in under 2 hours. I only used gas and air and had minimal tearing. Anyway, what I'm trying to say is big baby doesn't necessarily equal a hard labour. My 8lb 12 eldest was much harder and longer and almost ended with forceps!

I've been induced. I won't do it again, so that definitely colours my view on this. Given the baby's current measurements and family history of big babies, I'd go for the c-sec.

I was measuring 'a wee bit big' throughout and a scan at 39 weeks estimated him at 8lb4oz then. I was 9lb2oz at birth (induced and forceps), my younger sister 11lb9oz (natural and Gas & air!). My husband and his sister well over 8lb and 9lb. I'm also 5'7" with fairly wide hips but smaller than my mum who's 5'10".
The sonographer sent me to a consultant after the 39 week scan, she asked what I wanted to do and I said nothing and explained the family history. Her view was that if I was relaxed she was relaxed, DS was born 6 days overdue after a straightforward 12 hour labour with a very quick 2nd stage in a pool on gas and air. Was 9lb6oz. I had a 2nd degree tear but apparently because his hand was up by his face rather than because of his size.
I'd wait and see what the estimates are showing closer to the time, if they'd been saying he was already 10lb at 39 weeks I would have acted differently.

Oh and this was 1st baby for me, I'm a bit nervous about the possible size of a 2nd!!

Sizing estimates aren't that reliable.

I was predicted a big baby. The MW helpfully reminded me while I was in labour that "this is going to be a big baby!" then when my 9lb 4oz baby was born "oh, not so big after all."

Yeah, thanks for that!

Seriously though, I was induced with my first and had the second naturally. I would be wary of the idea of induction or a Csection unless absolutely necessary. I would want to fully explore the options and understand why they wanted to take this course of action and how accurate their site and predictions are likely to be. I'd want to avoid inductions or a Csection unless I felt either was absolutely necessary.

Ah I misunderstood your post. If you have the option to avoid csec or induction I would do that. As I said, having a big baby doesn't need to be a hard labour.

I had a baby with an apparent off the chart big head. Actually it turned out smaller than my first born. Also told she was 7lb 1oz at 34+1, and had polyhydramnios. Was induced and she was born on her due date, weighing 8lb 8oz. And I had been told during my internal exam that I was 'really small' in there so you can imagine how terrified I was!
I would go for induction over c section anyway, purely for the recovery time. I've also had a pretty terrible birth with my eldest with episiotomy and ventouse etc and I'd still prefer that to a section.

I'm going through a similar dilemma but am closer to term. I would prefer a c section after I had issues with my first birth (surgery required a year later). However, they don't want to give me a c section and instead want to induce. But according to NICE guidelines and this cochrane review - www.cochrane.org/CD000938/PREG_induction-labour-or-near-end-pregnancy-babies-suspected-being-very-large-macrosomia review it isn't recommended.

Thank you everyone so far for your insight! I have a doc appointment next week and at that time my OB will tell me how she thinks it's all going (I only started gaining weight when he gained that 3lbs 4oz last month so my gain is a good guideline). I'm hoping she'll be able to "feel" him a bit through my bump and given her experience tell me if she thinks he feels chunky or "average".

I've done a fair bit of reading about macrosomia (thanks for that link too DuckWaddle) and the risks associated with c-section, induction and vaginal/natural labour. I've decided based on my research that I will definitely go c-section over an induction as it's the safer choice for me and bubs, but I will wait until my next appointment / ultrasound and ask my doctor (who isn't pro c-section, she's pro "get the baby out safe for mum and babies sake") for her opinion on whether I should wait for natural labour or do a planned c-section.

In any event, the doctors could be off with their estimates and he could be a small/average bub. I know my doctor/hospital's policy is "39 weeks, chubby cheeks" and one of the first bits of paper they gave me spoke about how unless it was an extreme emergency, they did not believe in having a baby earlier than 39 weeks, for the health of the baby... so that makes me feel more confidence that they'll wait at least until then. I'm also 100% sure of the conception date (fertility consultations had commenced) so I know he's going to actually be 39 weeks and not drastically younger due to their dates being off.

I'm just going to go with the flow. No expectations.

In other news, I ordered my breast pump yesterday so I'm hoping that's going to be available for pick-up tomorrow :D

If you do find yourself going overdue and want to hurry the baby up, apparently nipple stimulation can help things start moving along, you do need to do rather a lot of it though. I wonder if practicing on your new breast pump when the time comes might work?

Disclaimer I have no experience of this method, I'm just thinking out loud! One to look up perhaps.

Also it may sound odd but you might be surprised at the odd things you find you are willing to try if you want the baby to hurry up and make an experience!

My inductions stories are actually quite positive - was induced with all 4 DC, 2 of them were long drawn affairs to get me into established labour, despite having epidurals I delivered fine without assistance etc.

Although my first was an average 7lb 6oz my next was 10lb 6oz and I'm tiny - 5' with size 8 hips (even smaller when skinnier). I always measured small dates (yes really carrying a 10lb6oz baby I measured weeks smaller using FH) and my consultant wouldn't scan even with DC3 & 4 for size because they vary so much and are so unreliable.

Stay open minded and don't rule out induction based on all the horror stories - there are lots of positive ones out there. Post birth it was pretty much instant recovery rather than what can be a long slow recovery from a C-section.

I was induced with DD, her birth was awful.

DS was predicted to be big, induction here isn't recommended for big baby and I declined CS discussion (following DD's birth I could have had one)

He was 11lb 7oz born, forceps delivery and a much less traumatic birth than DD's (she was 7lb 7oz)

Why not consider option 3, wait for natural labour?

Have they treated you for gestational diabetes?

Flisspaps I never said I wouldn't, I just said IF it comes down to induction vs. c-section (i.e. the doctor thinks I need to go earlier due to his size) then I'd rather just go c-section because induction carries worse risks for baby (and me) if he's big enough to warrant the induction in the first place.

Anybabymakesthree no? I don't have GD, all tests were negative and my latest urine test (taken the same day as the OP mentions) is still negative for sugar.

Hello. When I was 20 I had a big baby. I'm 5"2 and was a size 6..... but during my pregnancy at the end my bump was getting rather large and my midwife measured it at 45cm at my 38week check so she booked me in for an ultrasound for the next week and said if he looks over 10lb they will offer a section.... however I went into labour the day before my ultrasound and when my baby arrived his head was twice the size of one of my thighs! He tore me badly and I needed a lot of stitches and he weighed 9lbs 12.5oz. Also on his way out he tore a muscle in his neck which we did not know about until around 8 wks later when unnoticed he could only turn his head one way. His skull was going mis Shapen because of this and he needed physio to stretch the healed muscle as it had healed too short hence the reason he could only turn his head one way and his skull went to a normal shape he's 6 now.

If I had been offered a section or induction I would take the induction before your baby gets too big. But that's only because a section terrifies me

Did you take the Glucose tolerant test at 28 weeks? To be honest with such a huge unexplained growth Im surprised they haven't redone it. You can because insulin resistance as pregnancy progresses. Urine tests not a reliable marker. Worth speaking to midwife?

My sil has big babies. Her first was 9lb6oz and she suffered an awful tear after a very difficult labour. They were talking colostomy bags at one point but fortunately she avoided that. She was rushed to theatre immediately and only saw her baby for a second. After she got back the baby had been washed and changed and she became worried it wasn't the same baby (it was). She then suffered really low iron as a result of the blood loss and was really poorly. 2nd baby was a big one, measuring big etc. The consultant recommended early induction or section. No one could promise she wouldn't tear again so she opted for the section. She went in at 38 weeks, had a very calm delivery and her 8lb15oz baby boy was kept with her the whole time. I can't quite describe just how much better she was post delivery. Not just health wise, but emotionally too. If I were you I'd go for the section. The last thing you want is to end up poorly. Early inductions are rarely straight forward. Good luck x

Also look at gentle csection. Quite a difference to traditional views of csection. Need to look at this myself as baby also large however as I have had two vaginal deliveries my consultant thinks that if induction is necessary should have good success rate.