Obstetricians and sonographers must keep careful track of the baby’s growth throughout the pregnancy. A baby who is developing too slowly or growing too quickly may need intervention in order to prevent serious medical complications. The medical term for a baby who is larger than she should be is macrosomia, also known as “big baby syndrome.” A large baby can present more challenges during pregnancy, labor, and delivery than an average sized one. Excessive birth weight is associated with increased risk of injury to both the mother and child.
At The Becker Law Firm, our Ohio birth injury attorneys understand the risks associated with a large baby and the standards of care obstetrical caregivers must meet in managing a pregnancy, labor, and delivery involving a suspected large fetus.
Contact us today if your child suffered birth injuries as a result of macrosomia. We can be reached online or by phone at (440) 252-4399.
Estimating the Size of the Fetus
The size of the fetus is estimated from ultrasound images taken at various stages during pregnancy. Malpractice can occur if obstetrical caregivers fail to properly interpret ultrasound tests or fail to properly estimate fetal weight based on the ultrasound.
There is a large range of error in estimating fetal weight by ultrasound alone. Doctors must also consider other factors, including the mother’s height and weight, obstetrical history, size of the maternal pelvis, and the presence of gestational diabetes.
There are several warning signs that should put careful obstetricians on notice that a baby may be macrosomic:
- Gestational diabetes
- Pre-pregnancy diabetes
- Obese mother (BMI > 30 or over 198 lbs.)
- Rapid/excessive pregnancy weight gain
- Prior delivery of a “large for gestational age” baby or macrosomic baby
- Post-term pregnancies (those that go beyond 42 weeks)
- Advanced maternal age
- Multiple gestations
- Male baby
When any of these warning signs are present, obstetricians should check to see if macrosomia is a true concern. Doctors can check the baby’s size by pushing on the mother’s stomach using a technique known as Leopold’s maneuver. If large enough, an ultrasound will be used to determine the baby’s size, though these scans may be off by as much as fifteen percent. Obstetricians and sonographers should double-check the date of conception to ensure an accurate calculation.
Treatment of Suspected Large Fetus
The underlying cause of macrosomia frequently must be managed, particularly in the case of diabetes. Obese women should be instructed to gain less weight and may require referral to a dietician or nutritionist.
Some doctors choose a cesarean section or induction for babies who are large for gestational age (before they become macrosomic), but that runs the risk of injuries caused by prematurity and underdeveloped lung function. If the pregnancy is allowed to run its course or if induction is attempted, the doctor should be prepared to deal with a shoulder dystocia situation and should be prepared to deliver by cesarean section in the event of an emergency.
Risks of Macrosomia
Macrosomic babies are at risk for the following medical complications and injuries:
- Birth trauma, including cerebral palsy
- Cesarean section
- Shoulder dystocia
- Brachial plexus injuries
Mothers of macrosomic babies have a greater than normal risk of postpartum hemorrhage and complications resulting from a cesarean section.