Posts Tagged ‘macrosomia’

What is a maternal-fetal medicine specialist?

Friday, March 15th, 2013

A maternal-fetal medicine specialist is an obstetrician who concentrates on the care of pregnant women and babies in high-risk situations. Another name for this doctor is a perinatologist.

A maternal-fetal medicine specialist treats women with a number of conditions. Complications with mom’s health, include:
• A history of multiple miscarriages or premature birth
• Diabetes (gestational or preexisting)
• Hypertension (high blood pressure)
• Preeclampsia
• Infectious disease (toxoplasmosis, parvovirus, HIV/AIDS, etc.) or chronic illness
• Rh disease
• A family history of heart, kidney, or other disease

A maternal-fetal medicine specialist often treat pregnant women who are carrying multiples (twins, triplets or more) as the risk for preterm birth is significantly increased.

This doctor also specializes in the care of women whose baby is known to have:
• Abnormal fetal growth
• A known birth defect or suspected genetic disorder, such as Down syndrome, Trisomy 13 or Trisomy 18
• A baby with macrosomia (too large)
• A baby with fetal growth restriction (too small)

If you find yourself in a position where the risk of complications is higher than the average pregnancy, ask your current health care provider for a referral to a maternal-fetal medicine specialist. You may or may not need the extra care, but it will be good to get a second opinion.

Mom’s weight and baby’s health

Thursday, January 3rd, 2013

Overweight and obesity during pregnancy can cause health problems for your baby. You know that it’s not great for your health, but it can affect your baby’s well being, too. While most babies of overweight and obese women are born healthy, problems can include:
• birth defects, including neural tube defects (NTDs) which are defects of the brain and spine
• preterm birth
• injury, like shoulder dystocia, during birth because the baby is large
• Death after birth
• Being obese during childhood

Dr. Patrick M. Catalano, a highly renowned obstetrician, professor and researcher has focused on nutrition and metabolic conditions before and during pregnancy and how those conditions affect a fetus’ growth and how much body fat it gains. His research has shown that infants born to obese mothers and mothers who have diabetes are heavier at birth and have a higher risk of developing metabolic disorders, including insulin resistance, a precursor to diabetes.

Dr. Kathleen Maher Rasmussen and her students broke new ground in understanding the threat being overweight at conception has on successful breastfeeding.  We know that breast milk is the best food for babies during the first year of life. It helps them grow healthy and strong. Dr. Rasmussen’s work on over-nutrition found that there is delayed onset of milk secretion and shorter breastfeeding in women who were significantly overweight.

If a woman starts pregnancy at a healthy weight, it can not only lower the risk of preterm birth and birth defects, but can give her baby a healthier start that can have life-long benefits.

Macrosomia

Tuesday, October 26th, 2010

babyfaceMacrosomia is a term that describes an unusually large baby, weighing more than 9 pounds 15 ounces.  Aside from genetic factors (others in the family are really big), one of the main causes of macorsomia is poorly controlled diabetes during pregnancy.  Increased maternal plasma glucose levels, as well as insulin, stimulate the baby’s growth.  Pregnant women who are obese are at increased risk of having an overly large baby.  If a baby goes way past its due date, it may be overly large.  Interestingly, more male babies are macrosomic than girls, and if you have had one overly large baby you may be at increased risk of having another large baby in a future pregnancy.  I know a guy who is one of four boys, each of whom weighed over 14 pounds!  I kid you not.

With a really big baby, there is the chance of having a difficult birth.  The mother may experience perineal tearing, significant blood loss, and even damage to her tailbone.  The baby’s shoulder may get caught behind the mother’s pubic bone causing a dangerous situation and a threat to both the mother and baby, including possible infant death.
 
Some doctors will plan a cesarean delivery if a woman appears to be carrying a very large baby.  Unfortunately, late third trimester ultrasounds are not particularly accurate at measuring the baby’s size and many planned, cautionary cesarean deliveries turn out to be unnecessary.  It is always important to go over the risks and benefits to both mom and baby when discussing a planned cesarean delivery.

If you are planning for a baby in you future, now is the time to get your weight under control.  If you have diabetes, be sure to manage it carefully so that it is as controlled as possible during your pregnancy.  If you have recently had a very large baby and had gestational diabetes, make sure your doctor tests you for diabetes a few months after delivery.  Up to 20% of women who had gestational diabetes end up with postpartum diabetes and will need to manage it.