Large baby? - possible induction 39 weeks

[snowflakeeel]

I'm 36+2
This is my third pregnancy and they discovered, through an early scan, that I have a bicornuate uterus. This didn't bother me or my consultant as I have had 2 previous full term pregnancies, however, procedure meant that I had to have additional monitoring. Therefore, at 36 weeks I was sent for a scan to ensure baby was head down, which it was. They also took measurements:
Head = fine
legs = fine
Belly = measuring at 40 weeks.
The sonographer said that my placenta had excellent blood flow and was just performing efficiently. I was sent up to speak with the consultant who said that they would give me another scan in 2 weeks to see whether baby was still growing large and if so then they would want to induce me at 39 weeks. I am on iron tablets and aspirin which I wonder might have contributed to the size - (NHS website said that if taking iron tablets this can contribute to baby putting on additional weight) who knows, just speculating.
Now I'm feeling frustrated and concerned as I did not have additional monitoring with previous 2 and they came out at 41 weeks after a speedy 2 hour labour. They could have been the same for all I know.

I'm wondering whether anyone has had a similar experience. Did you have to go through with induction and was your baby indeed the size they predicted? How accurate are these growth scans?
I know that if I do in fact have a large baby and go term with it then it could cause serious complications to me and/or baby so I don't wish to dismiss this.

I realise I am asking for anecdotes (out of curiosity) and intend to further discuss with my midwife and consultant.

Thanks

I was induced on my due date as they were worried about size and he came out a healthy 8lb 11 exactly the same as his older brother. If he'd stayed in another two weeks like my other children have tended to do he'd have been quite a whopper!

I don't think you can ever know if the other two would have been exactly the same, it's a definite head squeezer anyway.

I've had all three of mine induced and all of the labours were as different as they could possibly be! Nos 1 and 3 I was two weeks overdue, with the last one practically needing someone to go in and get him he was so stubborn coming out. No 2 on my due date was under an hour from first contraction to placenta delivered, quite possibly the most exhilarating hour I've ever experienced! So there are three completely different anecdotes to make your decision not one jot easier.

At least you will have thought it all through by the appointment in two weeks so will be well prepared to make your choice. Good luck, I am so excited for you, keep us posted.

Thanks for your lovely reply @ExCwmbranweller. It's encouraging to know that you had some good induction experiences. Thinking about it, it is probably the induction which mainly worries me. I know if it needs to be done I won't refuse but I rarely hear positive induction stories so it does have me on edge.

yes, plenty of time to think and ask my midwife and consultant lots of 'irritating' and no doubt 'irrational' questions. I should try to look at it as whatever the journey I will get the same gorgeous little outcome...even if it is monster sized.

I was induced early due to large size and ended up with an emergency C-section and a 10lb10oz baby. However, his head and limbs had always measured weeks ahead.

With just the tummy out of whack, I’d probably ask for another scan as it could just be bloating or something.

Have you been tested for gestational diabetes (that would explain a very chubby baby).

Also bear in mind that you can always refuse the induction if you feel quite confident about not having it.

Hi OP,

I created a similar thread the other day that is full of anecdotes from other posters to fill the time until you see your midwife ....

www.mumsnet.com/Talk/pregnancy/3750178-Induction-for-big-baby

In my case I have decided to hold fire on the induction to give spontaneous labour a chance. This decision was based on a combination of NICE guidelines for induction of big babies, Cochrane systematic review of evidence for inducing predicted big babies, and reading some stuff about the accuracy of predicted fetal weight.

Like you I felt a bit miffed that had I not had the growth scan at 36 weeks (because my bump was slightly smaller than expected, ironically!) I would never have known baby was predicted to be big and non of this stuff would be on the cards.

Good luck with whatever you decide.

one thing to mention though is that my baby is predicted big accross all measurements, i think things might be managed differently if the abdominal measurements are proportionately bigger than the head, length etc.

I thought that the thinking nowadays was that the size of the baby alone is not a good reason for induction unless it’s something you want? To add to the anecdotes, I had a 9.9 and a 10.6. Both about a week late, both spontaneous labour and no problems.

I thought that the thinking nowadays was that the size of the baby alone is not a good reason for induction unless it’s something you want?

When I was reading about it, it seemed to be financially driven (if my memory serves me right), ie you’d need to induce X number of patients at the cost of Y to save a certain number of mothers and newborns from sustaining permanent damage. That would cost whatever in time and money so it’s better not to generally while not necessarily in the interest of individual patients. I had an NHS consultant and consulted 2 more privately and all recommended being induced at 39 weeks.

Two different hospitals and growth scans in each were accurate for my dc.

With ds1, they told me he was 6lb at 31 weeks and would put on half a pound a week from there on. He was born at 38 weeks, my waters spontaneously broke and he was 9lb 6oz. So the estimate was very accurate.

With dc2 I switched hospitals, again baby measure ahead in size the whole way through.
At 38 weeks they told me he was 9lb and would be 10lb by 40 weeks. They wanted induction by the 40 week mark as they said 10lb would be manageable without the need for a section.
I had sweeps at 38 and 39 weeks to try and stir the baby but he didn't move. They induced me at 39+5 and he was born 10lb 12oz.
I found the whole induction process to be brilliant for me. The fact it was more or less controlled and monitored closely by the nurse and doctor meant I was more comfortable, less worries.
The labour was shorter than my spontaneous labour, the birth was easier and the recovery also.

Thanks for your story @JoJoSM2. Yes, I had the test at 28 weeks and all was clear.

Thanks @TalkingIntoTheEther. I look forward to reading these!
It looks like you have done a lot of research on this. Thankfully I have 2 weeks to hopefully clue myself up a little more on this subject.
Yes, sometimes I wish I was blissfully unaware and that I was just left to get on with it, and then, I also understand why they intervene. It's good to know I have a choice.

What centile were the tummy measurements? My DS was put at 91st centile for abdominal circumference from growth scans. Nobody batted an eyelid and they happily let me go to 42 weeks without a murmur about the size. They were also happy for me to have a home birth although I chose not to in the end. DS arrived on his own steam, 9 lb 12 oz and the birth was a dream! Turned out the growth measurement was fairly accurate. They can be way off though. DD was predicted to be 7.5 lb and came out 6 lb 6.

Hiya hun

I'm currently 39 + 4 today with my second child, I had gestational diabetes on my first and monitored for big babies, his belly was always measuring ahead and his legs was super long he come out at 8lb exact but was super small in my eyes just long legged!
This one went for a scan at 36 weeks head was fine, legs 3 weeks advanced and her belly was 8 weeks advanced which sparked being put under this possibly trial to be induced around the 38 week mark, I was induced on my first so I was feeling happy to go ahead with an induction for the safety of me and her, but they the randomise you by computer if you go ahead or stay under a consultant, which I was chose to stay under standard care.
Seen my consultant she was fine about everything quite chilled out never mind I'm more conscious as I'm "high bmi" I'm very short haha which makes me high risk on top of the chance I may have Another PPH after birth, she was happy to not let me go I've the 41 week mark, so I'm booked in for induction Friday of next week, sweeps have been booked to help.
How I feel personally about the scans and speaking to a family member who is a midwife she even says they are not accurate!! If I remember my son was measuring on above the 90th then levelled our to the 50th and was born to them on the 41st, it's a pain because all the measurements I find knock the average of it out, so that's water, legs, body & head - potential weight!
I can let you know how it all goes and what she comes out as she's currently above the 90th centile on her growth charts, noticed today after seeing my midwife that it's come down and I'm not supposed to be measured due to not an accurate reading as I'm larger mother!
It annoys you honestly!

My DS2 was overdue and we had to see the consultant on day 7 and the scan suggested he was 10lb 7 and my fundus was 48. My midwife hadn’t picked it up at all. I went for a section as I had a mmc at 22 weeks and was anxious and this boy was 11lb 5.

Yes I had this. They were predicting an 11lber - in the end he was induced at 39+6 and weighed 9lbs 4.

They do get it wrong sometimes.

Good luck, try not to let it scare you (easier said than done)!

I was induced with all three of mine
The smallest was the most overdue. 8.5 plus at 41 weeks
The other two were both induced and born at 39 +1 and were 9 lbs 8 and 9lbs respectively

I was induced as DD was measuring big. It was all sprung on me really quickly, went from 40week midwife appointment straight to triage to be induced- apparently, someone should have organised it after my growth scan 2 weeks earlier when DD was predicted 7lb 7oz at 38 weeks.

I don't know any different but the induction really isn't that bad. My first one failed but the second pessary worked after about 6 hours. My waters broke another 6 hours later, I then started on gas and air and had an epidural shortly after. I was then given the hormone drip and I dilated really quickly after that and DD came a few hours later after an hour pushing and an episiotomy, she was 8lb 5oz. The worst part of the induction for me was waiting for it to work!

Good luck OP

It just shows that measuring babies before they’re born is such an inexact science!

I had growth scans at 28, 35 and 38 weeks which suggested an increasingly huge abdominal circumference (95th centile, >95th centile, completely off the scale). I was tested for gestational diabetes twice but came back negative. Head and femur measurements/centiles seemed to vary wildly from scan to scan but abdominal circumference was consistently huge.

They suggested early delivery due to baby’s size, and I felt that I wasn’t prepared to take any risks with shoulder dystocia etc. Baby was born by elective section at 39+2. It was the right decision for me after a difficult induction and birth with first (much smaller) baby.

He was 8lbs 13oz, so a good size, but he was actually very long and slim with a big head- not at all chunky as suggested by abdominal circumference. I think it must have been his long torso all squashed up in there.

How are people defining big?

I was told by the obstetrician that my baby was “large for gestational age” because the EFW was >95th centile.

I had a growth scan at 28 weeks and baby was 'off the chart' basically, no gestational diabetes, just measuring a big tummy and head (both over the 95th centile and at 20 weeks they were at 50th). I have another scan in 2 weeks as apparently it's the rate of growth they are interested, rather than the size itself. At 28 weeks they thought he would be approx 3.5lbs.

I'd prefer to be induced if possible - which is likely because I am 40 anyhow, as I had a shoulder dystocia with my last baby and he was under 9lbs. However, I also still have a low lying placenta so c-section is a possibility right now too...

Thank you so much for all your replies. It's great to hear your experiences.

@BertandRussell. I'm still learning about this but I think it depends on the individual. This is an extract from an NHS leaflet re. LGA:
"There is no strict definition of ‘large for dates’ (macrosomia), but it is generally accepted to mean babies expected to weigh more than 4.5 kg (9 lb 14.5 oz) at birth. Whether your baby is large for you, however, will depend upon your own individual characteristics."

Pre pregnancy I am 8 and three quarter stone. At my booking app. my BMI was 22 and I am 5'5. My 1st weighted 7lbs 130z and my second was 8lb 4oz. No tears and straightforward birth. I guess these individual characteristics along with info. from my previous pregnancies would determine what is a large baby for me. This is something I will speak with my obs. about.

@seeingdots, I don't seem to have the paper that the sonographer printed off. The ward doctor had it and discussed my options then went away with my notes and it doesn't appear to have been returned to me. I will ask at my next app. Bit frustrating! But I remember the head and legs being within my centile parameters. It was the tummy circumference that was above and outside my centile.

@champagneandfromage50, you made my eyes water!

@Sar1520, yes please, I would really appreciate it if you could let me know how it goes.