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Followup To
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I am 39 weeks pregnant. My last u/s at 29 weeks showed the baby's weight to be 3 1/2 lbs. I know this can be a bit off. My baby's head hasn't dropped yet and it's my 1st pregnancy and i'm concerned that the baby is too large. My OB doesn't feel another u/s is necessary and if it's a large baby and vag. delivery won't work, we'll cross that bridge when we get there? I am frustrated, i'd rather know than to go through a long labor and then c-section. Should I push for another u/s to check baby's weight or see what happens? My OB is old fashioned and doesn't induce until 42 weeks.Don't babies gain approx 1/2 lb per week in 3rd tri?
Answer -
At 39 wees gestation, the estimated fetal weight is usually around 6-7 lbs. If the baby appears very large, and a sonogram shows an estimated fetal weight of over 9.5lbs, we recommend cesarean section. If the EFW is less than that, you can try for a vaginal delivery. Your weight of only 3.5lbs is very small. I agree with your doctor that another sonogram is not necessary. If you do not go into labor by 40 weeks, a non stress test will be done and you can safely wait until 42 weeks if fetal surveillance is good. Soon, you will start to have irregular contractions. When you get regular contractions at the level of your belly button that come every 3 minutes (from the start of one contraction to the start of the next) and each contractions lasts (remains hard) for at least 45 seconds, you should be checked. When your cervix is dilated to greater than 3cm, you will be admitted to the hospital. Once you reach 5cm dilation, you usually will dilate 1cm per hour until full dilatation. Give yourself a chance. Don't worry.
another question, sorry!
You had mentioned the baby was small? and I was a bit confused because at 29 weeks, they told me 3 1/2 lbs was in the 90% percentile, so I was trying to figure what the baby may weigh now 10 weeks later. Wouldn't that put the baby around 9-9 1/2 lbs? does an ob usually wait until you're in labor and if no progress is made due to large baby, take the baby c-section? So if the baby may be around 9- 9 1/2 lbs, should I ask for another u/s? I have an appointment tomorrow. thanks in advance for your reply.
Answerwe usually assess the size of the baby at around 40 weeks. If it appears large, we can perform a sonogram to assess estimated fetal weight, as I mentioned before. There is no way to predict how large the baby will be based on the EFW at 29 weeks. If you appear very large, you certainly cah have a sonogram and get an estimated fetal weight. If it is more than 9.5lbs, your doctor can decide whether you allow you to have a trial of labor or to proceed to cesarean section due to "macrosomia". HOwever, we usually give you a trial of labor and see if there is progress in labor. I would just ask your doctor if the baby appears excessively large. If not, you should give yourself a chance in labor.
