The Large Baby

Question 1

Considered a large baby if symphyseal fundal height is consistently above which centile on a customised chart?

Answer 1

90th centile

Question 2

Considered a large baby id symphyseal fundal height is over ___ cm for gestational age?

Answer 2

2cm

Question 3

As parity increases, the size of baby increases. True or false?

Answer 3

True

Question 4

Causes? (name 3)

Answer 4

Gestational diabetes
Polyhydramnios
Foetal macrosomia

Question 5

Foetal macrosomia - diagnosis

Answer 5

US estimated foetal weight over 90th centile

Question 6

Foetal macrosomia - risks

Answer 6

Maternal anxiety

Obstructed labour

Question 7

Foetal macrosomia - management

Answer 7

Exclude gestational diabetes
Reassure mother
Conservative vs IOL vs Caesarean section

Question 8

Polyhydramnios - definition

Answer 8

Excess amniotic fluid around the baby during pregnancy

Question 9

Polyhydramnios - maternal causes

Answer 9

Diabetes

Question 10

Polyhydramnios - clinical features

Answer 10

Abdominal discomfort
Pre-labour rupture of membranes
Pre-term labour
Cord prolapse

Question 11

Polyhydramnios - examination signs

Answer 11

Baby large for dates
Tense, shiny abdomen
Inability to feel foetal parts (due to excess fluid)

Question 12

Polyhydramnios - diagnosis

Answer 12

US confirmation

• amniotic fluid index > 25 cm
• Deepest pool > 8 cm

Question 13

What test can be done to exclude diabetes?

Answer 13

Oral GTT

Question 14

Polyhydramnios - management

Answer 14

Induction of labour by week 40

Question 15

Polyhydramnios - labour risks

Answer 15

Risk of malpresentation
Risk of cord prolapse
Risk of preterm labour