Large abdominal circumference

[Kittyswhiskers]

I had a scan yesterday and the baby’s abdominal circumference was off the scale (big rather than small) but everything else was within range. Estimated to be around 9lbs at birth.
They didn’t tell me much else except to say see a consultant next week. Has anyone else had anything similar?
I’m trying to stay away from Google as I’ve terrified myself. This is my third baby and my other two weighed around 8lbs at birth.

Im 24 weeks and had the same situation as you at 20 weeks. All measurements were 30-50th centile and abdominal circumference 93rd I've been referred for gestational diabetes glucose tolerance test at 28 weeks.

Midwife seemed pretty relaxed about it at my last appointment.

All of my measurements were fine at 20 weeks but not today. Everything was between 20/50th centile apart from abdominal circumference which was off the scale. They talked about induction, more scans and another diabetes check next week, but I have no
Solid plan yet. Not knowing is hard.

Same here. Nobody said anything at all really - Just that I'll need another growth scan in two weeks time and a scan next week to check fluid levels as I was borderline high (polyhydramnios) Ive already had my GTT test and numerous urine tests and all come back clear so not sure why. Baby is measuring huge anyway (93rd centile at 29 weeks) sorry I can't be more help. But you're not alone

Thank you for replying anyway!

I hope it all turns out fine for you.

I’m really edgy as I tend to give birth around 39 weeks and I don’t feel I have much time to come up with a plan.

I’m also terrified of shoulder dystocia which I’ve read can be linked to large abdominal circumference.

I had this at my 32 & 36 week scans. Baby measured fine but abdominal measurements off the scale. Consultant made me redo my GTT test, which came back negative as I knew it would, it’s just how I grow my babies! I had an awful lot of pressure from the first consultant to book in for a planned c section (was hoping for a VBAC) citing issues such as shoulder distocia, birth injuries to me etc. The second consultant was much more chilled about it and suggested early sweeps and induction at 39 weeks in the hope I would give birth early and baby wouldn’t be quite as big as predicted. Interestingly my community midwife was advocating a planned section very hard mostly due to me trying to birth a large baby. Just make sure you have done some research on shoulder distocia, and other risks, so that if you do get any scare mongering you can make an informed decision. I requested a different consultant after my 32 week scan to ensure that I got a balanced viewpoint, and I’m glad that I did.

In the end I had a planned section for other reasons, and my baby did indeed have a rather large abdomen!

@Helporhindrance07 I think I would prefer a planned section given my previous births, speed of them etc. Do you know if this is something I can request due to risk of shoulder dystocia? Is shoulder dystocia more common in abdominal circumference? Google suggests it is but it’s hard to know what to read and what’s credible etc.

You can request a planned c section for any reason you like, it’s in the NICE guidelines I had a planned section and it was lovely and calm, I was aware I was having one beforehand so was able to prep for not being able to get out of bed for a day (peppermint capsules, paracetamol and your stuff arranged so you can reach everything!) but it is easier for me to say this because a repeat section was always a higher possibility for me because of how my first birth went (failure to progress resulting in unplanned CS).

I’m not a doctor but this is what I found through researching and chatting to my midwife etc. Shoulder distocia is rare but my midwife told me that it often is more to do with the position of baby rather than size, and almost half of all SD cases are in smaller babies so size doesn’t play as big a part as some doctors would have you believe. But yes I think the larger abdominal measurements can increase the risk a little bit. There is lots they can do for SD to help move baby along and in most cases it’s brief and easily fixed.

I had this too; noticed at 24wks abdomen in 97th percentile! Obstetrician made me do the diabetes test; came back negative, thinks it’a just his natural body shape as he is 50th-70th percentile for all others. Midwife however is convinced it’s because I’m ‘eating too much sugar’ and every appointment is fixated by my weight and his abdomen measurement… I think I eat fine, yes I’m not sugar free 100% but my BMI is fine & I wasn’t overweight before pregnancy so I’ve chosen to pretty much ignore midwife! Obstetrician has assured me some babies (like everyone!) are rounder in some places than others. If diabetes isn’t an issue & growth pattern is harmonious she’s not too worried xo

Is it too late for me to request one now? Would I literally just say due to baby’s abdominal circumference and personal choice I want a section? I’m really scared of shoulder dystocia after I googled and then a friend told me she had a section as her baby’s tummy measured large too. I think I’m more terrified as I already have 2 children who need me and I’m so scared of dying (yes this is my anxiety speaking!)

Oh just to say I’ve done the diabetes test once, my bmi is on the lower end of normal and I have to repeat the diabetes test again, however I do think it’s not diabetes!! I had a private 4d scan at 32 weeks ish - and the AC was measuring large back then. Now though, it’s not even plottable on the graph.

How many weeks are you? I “requested” a planned c section at 35+5 and they didn’t have any trouble booking me in yes so you need to say you’ve done research and thought about it and due to personal choice and baby’s measurements you want to request a c section. If the doctor refuses they have to refer you to someone who will agree so don’t let them fob you off! There might be other options though, like maybe an early induction with a very low tolerance for moving to a c section? If you can get a friendly doctor they will be able to chat you through the different options

I had a scan Monday and they found an off the scale abdominal circumference. Diagnosed with gestational diabetes on Wednesday and needed to start insulin today.

I’m 37 weeks
I get a diabetes check on Tuesday followed by an appt with the consultant (same day)
I had a problem in my previous pregnancy and the consultant was AWFUL and made me feel like a total idiot so I’m terrified the same will happen again!!

Hopeful bump for the daytime crew x

Hey I'm following as I could've written this! I'm planning to request C-section on Monday (and am worried I'm incredibly late to do so) will be 38w on Monday.

Was tested for GD and my results were normal.

How are you getting on OP?

I’m okay thank you. How are you?

Are you requesting a section based on just the large AC or are there any other reasons for you? Have you just had the one scan where the AC has been large? Do you mind me asking where on the scale you were?

I had an OGTT at 28 weeks and I’m having a fasting blood test this week. I don’t think I’m diabetic though. What’s your consultant like if you’ve already met them?

@Kittyswhiskers

I’m okay thank you. How are you?

Are you requesting a section based on just the large AC or are there any other reasons for you? Have you just had the one scan where the AC has been large? Do you mind me asking where on the scale you were?

I had an OGTT at 28 weeks and I’m having a fasting blood test this week. I don’t think I’m diabetic though. What’s your consultant like if you’ve already met them?

I'm good thank you just nervous this is my first baby so worried about pretty much everything.

The main reason for the request is the large AC, was measuring 97th centile and est to be around 9lb on my due date, so if I went over it would be even more. 😞 this has been the case on my last 3 scans.

To be honest, I've met my actual consultant once and not only could I not really understand her, but I also only got about 2 minutes of semi-conversation out of her. I have an appointment with her on Monday (I think) so will update on how that goes.

I would be happy with trying a sweep at 38w to try start things naturally whilst he is estimated weighing a little less (hopefully around 8lb at 38w) however that all depends on how much they estimate him on Monday.

If any more than this at that point or failed sweep I will request that it is a c-section. You are allowed to request a c-section, it's just some trusts aren't very good at accepting that request! I have been suffering with PGP also, but am unsure if that's enough grounds to request one on. X

Ahh that’s a shame I’m sorry your consultant isn’t more forth Coming. I haven’t even met mine yet. I’ve only had one scan and I guess they might scan me again. I have severe pgp too - this is my third pregnancy and I’m sorry to say it’s got progressively worse!! My husband is going with me to the appt on Tuesday and I suppose I need to be assertive. My
Problem is I’ve read that a large Ac Is related to shoulder dystocia which I am terrified of as I already have a super stiff pelvis and should probably be using crutches - I also have very fast labours (3 or 4 hours) and I’m worried the speed of things could potentially end in an emergency section anyway. I might just go in and say ‘I want to request an elective section please’ and see where I get.

My baby’s ac wasn’t even on the centile it was way above the top one. Google has terrified me with lots of potential reasons for this.

How were your previous births? If you’ve had 8lbers before likelihood is a 9lb baby would be fine. I had a scan at 36 weeks that showed a big baby (all over not just AC) and estimated to be 9lbs at term. They were pushing c section etc based on the size/dystocia risk but my first child was just under 9lb (although 2 weeks late) so I knew I could do it. I had an easy waterbirth day before my due date. I really didn’t want a section because would have impacted my ability to look after my older child.

Oh and baby was 9lb - exactly as predicted.

My previous births were OK. The second was hardest as I have fairly severe pgp and was made to lie in an reclining position which has damaged my back even 3 years later. I don’t think they’ll allow me a water birth or even a monitoring free birth based on these scan findings. Husband can WFH so not too worried about the recovery from a section, I’ve already been crippled the last 3/4 months with pgp which has meant I can’t lift my children etc. It’s not so much the Weight that worries me. Just the risk of shoulder dystocia which I’ve read is linked to large AC.

@Kittyswhiskers

Ahh that’s a shame I’m sorry your consultant isn’t more forth Coming. I haven’t even met mine yet. I’ve only had one scan and I guess they might scan me again. I have severe pgp too - this is my third pregnancy and I’m sorry to say it’s got progressively worse!! My husband is going with me to the appt on Tuesday and I suppose I need to be assertive. My Problem is I’ve read that a large Ac Is related to shoulder dystocia which I am terrified of as I already have a super stiff pelvis and should probably be using crutches - I also have very fast labours (3 or 4 hours) and I’m worried the speed of things could potentially end in an emergency section anyway. I might just go in and say ‘I want to request an elective section please’ and see where I get.

My baby’s ac wasn’t even on the centile it was way above the top one. Google has terrified me with lots of potential reasons for this.

Absolutely. Put your foot down! It's your body and you should be able to make the choice at the end of the day!

I'd avoid google as majority of these types of things aren't usually picked up due to lack of scanning etc, so majority of stuff you may find on google could just be worst case scenarios etc. I've been avoiding googling things for this reason.

When you request your c-section just let them know that you've read the pros and cons of both CS and VB, (if you have) and refer to the NICE guidelines. Link below

https://www.nice.org.uk/guidance/ng192/resources/2021-exceptional-surveillance-of-caesarean-birth-maternal-request-nice-guideline-ng192-9191145133/chapter/Surveillance-decision?tab=evidence

Sections

1.2.30
If a vaginal birth is still not an acceptable option after discussion of the benefits and risks and offer of support (including perinatal mental health support if appropriate; see recommendation 1.2.28), offer a planned caesarean birth for women requesting a caesarean birth. [2011, amended 2021]

1.2.31
If a woman requests a caesarean birth but her current healthcare team are unwilling to offer this, refer the woman to an obstetrician willing to perform a caesarean birth. [2011, amended 2021]

Elective sections booked for baby’s position, medical reasons etc are booked late all the time. Go in with confidence that you got new information last week that means you think a elcs is a good idea for the two of you.