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Courtney7

Percentiles ??

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Courtney7

I'm back again for more much needed advice my dr is away for 4weeks so I've just been seeing random endos and midwives. At 28weeks I had a growth scan and baby was between the 70-75th percentile hba1c 6 baby looking fine, the last 2weeks I have been really struggling just feeling sick, tired, dizzy and crazy back pain. Today I had my second growth scan almost 33weeks) and baby is measuring at the 90th percentile my sugars haven't been too bad and other than feeling like utter **** my diabetes has been fairly managed, has anyone had a huge jump in the percebtile like this? Drs said it was "a fair jump" and recommended that I stay on control of my sugars but I have been and hba1c is still great. Any advice in growth scans, big babies and any info would be great they weren't much help at all, the said they will do another scan at 36weeks but I'm worried that bubs is going to be huge and I wonder if him being so big at only 33weeks poses a risk for him? Does he have enough room in there to keep growing at this rate? Does it mean I will go into labour early and is it possible to have a natural birth or does that also put myself and him at risk? I asked all these questions today and was told that questions like that would be answered at my 36 or 38 week appointment. :s

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Tanikit

No it doesn't matter if your baby is big and if your sugars are controlled there is nothing to be done about it anyway. How big are you because naturally some people are more predisposed to bigger babies. Diabetics tend to have bigger babies even if their sugars are perfectly controlled. As for preterm labour - it is highly unlikely that a big baby will make you go into labour early - many babies of normal women are born 2 weeks "late" and reach the same size that diabetic babies reach perhaps slightly earlier when they are born - they will not let you get to 42 weeks so don't worry!

 

The other thing you need to know is that the later in pregnancy it gets the less accurate are the growth scans because the baby gets too big and its head starts moving into your pelvis so they have to do some guess work about how big its head is. Big babies and babies of diabetics do have an increased risk of shoulder dystocia with natural birth and many gynaes advise a C-section if they are scared of this, but certainly many diabetics have given birth to big babies naturally so it will very much depend on who you are seeing. Also many diabetics are induced around the 38 week mark anyway and then it is wait and see what nature decides and if the induction works. (I had one successful induction and one that ended in a C-section as baby had a lowered heart rate but there was nothing to predict what would have happened with either and in the end all that matters is a healthy baby).

 

They do keep you in the dark til 36-38 weeks usually because they cannot answer those questions - they need to make sure the baby is the correct way around first, what your blood pressure is doing, how big they estimate the baby will be, any other issues that might arise that no one can predict and then they will tell you what your options are. If your water were to break or contractions start then get to your maternity ward for a check up, otherwise you will have to just wait it out. Three weeks sounds like a lifetime when you are pregnant with your first but it will fly by - hang in there, you'll have some answers soon.

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Lizzie G

Hi there,

 

hope you are feeling a little better. first things first though, if you arent feeling right i hope you had your bp checked and urine for protein and that babys movements are what you are used to? if at all concerned please get checked out!

 

ok with the size thing. i take it you are talking specifically "abdominal circumference"? i will answer as if you are!

 

so with the growth, elevations in blood sugar cause your blood to be extra rich & sugary for whatever length of time, this passes straight to babby and he pumps out insulin in response to metabolise all the goodies. and just like an adult, the excess calories from this rich cocktail, make fat.

 

my first pregnancy my a1c was always 5.9 or 6.0 during the first 2 trimesters. at my first growth scan i think it was 5.9. the important thing, is at that hba1c, whilst i had good overall control, and nothing crazy, there were a decent number of post prandial spikes hitting yhe 10.0/180 mark. the first scan his ab circ was towards 75th centile. i think, whilst good control overall there were just enough times where there was enough extra to make him a little chubby!. by 32 weeks my a1c was about 5.5 i think and by the end, 5.2. i accomplished this largely by avoiding post prandial spikes altogether (how i achieved that is another topic) and rarely had numbers about 7.5/150. by the later growth scans the tummy fat had gone down and he was on 50th centile and was 7 pounds 9 oz (@ 39 weeks 5 days).

 

my current pregnancy im running hba1c of 6.0. at 20 weeks he was around 75th centile again. im working on the spikes to slow his laying down of fat.

 

it is hard to avoid spikes altogether, which is why even women with good control can have a tendency to larger babies, but as i saw in my pregnancy last time (yeh ok so causality not proven but it seems fairly likely) minimising the spikes and keeping "non diabetic" numbers definitely helps.

 

please try not to worry about things though. the scans are not as accurate as you would think (i swear they hear tge word diabetes and program kn something!) just do the best you can without letting it stress you. keep being monitoted, if you can take a gentle walk after meals to minimise spikes, and be kind to yourself. you are doing very well and can only do so much. your baby im sure will be fine, but if there are indications that hes too big then make sure that plans are put in place for a safe evacuation at the right time!

 

thinking of you. try to relax and know it will be ok.

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rubidoux

Also, remember somebody has got to be in the 90th percentile. It might just be a big baby. When my second was born I was scared to death bc they estimated him to be ten pounds the day before my scheduled C. Then during the c-sec all the doctors and nurses were oooohing and ahhhhing over how insanely big he was. Well, it turned out he was 8lb13oz. I was just shy of ten pounds at birth and my mother was not diabetic. My husband was also a big baby. My little guy was normally proportioned and has been very healthy. Some babies are just bigger than others.

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2high

I was always told that baby's size has more to do with your a1c at CONCEPTION rather than during the pregnancy itself.

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Tanikit

2high I have never heard that - although I did hear that a woman who started a pregnancy on an hba1c of 12 and then controlled it all pregnancy after that did have a large baby. I thought pre conception highs were more linked to developmental problems since fat is laid down much later in the pregnancy. I don't think hba1c has all that much to do with it either since I ran so low early and late pregnancies but went high when I fixed the lows - and those spikes seem to help to make a big baby because my hba1c was alright and baby was still largish.

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2high

LOL My A1c at conception with my first was 12.7. My numbers were almost perfect the entire pregnancy, and he was 9lb 13oz delivered at 37 weeks.

This time my A1c was 8.0 at conception, I'm currently 34 weeks and his projected weight estimate for 37 weeks (according to growth scans) is 6lb 13oz. It was the obs and endo that told me, so I'm just going my what they said.

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Courtney7

Thanks for the replies so far I've been continuing to keep my levels under control abd just have my fingers crossed that at my next scan in 3 weeks time that bubs isn't over 90%. In relation to my size / partners size both if us arnt big he is tall and very thin abd I'm a shorty and moderate weight, my mum had 3 of us and I was the smallest at 5.2 so I don't think it comes from our genetics. My hba1c was 7% at pre conception and 6.5% at conception now 6% at 33weeks so over all I think I've done the best I can with my levels they arnt the 5s that everyone dreams if but I've worked very very hard to get them to abd keep them at 6 so I think it's just one if those things, I have a small glimpse of hope that the scan was out a little so fingers crossed for the one in a few weeks, I'm keeping positive abd will continue to keep my levels as controlled as u can, my main concern is my little man and as long as he is ok and the birth has no dramas then it is what it is.

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2high

Me too :) Outer North here. which hospital are you at? I'm at the Mercy (Heidelberg), and they're brilliant.

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