Hydramnios/big baby. Should I worry?

[nurse_wannabe]

Hi, everyone. I am 32 wks. pregnant and had an U/S on Friday. I found out a couple of things that are really worrying me. I can't get in to see the doctor until Wednesday, so I wanted to get some opinions from the experts.

The U/S showed me to be 35 wks. pregnant, with a slight excess of amniotic fluid and a baby weight of 5 lbs. 6 oz. At this point the baby should weigh only 3 lbs. 12 oz. on average.

Some background info:

* I had a 1 hour glucose test at the standard time (24 wks maybe?). It was slightly high, so I had to go for a 3 hour glucose test, and those results were all normal.

* Due dates calculated using my LMP & the very first U/S were one day off, and the level of HcG was right on target at that time.

* I feel plenty of fetal movement, almost constantly while I am at rest.

Now, my questions for you guys are:

#1: The NP said that the hydramnios can signal problems with the baby. In your personal/professional experience, how often does this mean there is something wrong? What types of problems have you noted most often? Are those problems easily fixed? Have you ever seen a fetal demise with hydramnios?

#2: Have you ever heard of someone who was found to have gestational diabetes, even after her 3-hour gtt came back normal? I should add that I have all the s/sx: thirst, hunger, polyuria, blurred vision, and my mom is NIDDM.

#3: Is it possible that this is all no big deal? Maybe he is just a big baby and maybe I just have a little extra fluid?

Thank you all in advance for your help.

[Jolie, BSN]

I am so sorry for all the worry you are having to endure while waiting for your next appointment. Any OB care provider who does this to an expectant mother should be ashamed of him/herself! It is inexcusable that you weren't given more information at the time of your visit with the NP.

First of all, why was the US done? If it was to estimate the size of the baby, you should have been told that U/S at this late stage of pregnancy is only able to provide an "educated guess" as to fetal weight, with a margin of error of +/- 25%. That means that your baby's actual weight may be as little as 4 lbs., which appropriate for your gestational age. If your baby's weight is truly on the upper end of the range, then it would be large for gestational age, and further study for the possibility of gestational diabetes would be appropriate, especially since you report so many of the usual signs and symptoms. It sounds like your OB is relying only on lab work, and not taking into account your symptoms, which is very concerning to me! Please call your OB office and insist on being seen ASAP to rule out the possibility of gestational diabetes. I would not be comfortable waiting until Wednesday to get this resolved.

As for you due date. It is probably accurate, since all of the factors used to calculate it are in agreement.

As for poly-hydramnios. I am not certain if it is acceptable to diagnose poly-hydramnios based on a single U/S, or whether serial measurements are required. Your care provider should explain this to you. It can be a signal of digestive tract disorders, as the fetus usually swallows amniotic fluid, thus reducing its volume. If a baby has a blockage in the digestive tract, its ability to swallow fluid is impaired, leading to increased fluid volume. NOT ALL BABIES WITH INCREASED VOLUMES OF AMNIOTIC FLUID HAVE DIGESTIVE TRACT DISORDERS! Most of the time, an explanation is never found, and the baby is perfectly healthy. If your OB is truly concerned that you have an excessive amount of amniotic fluid, then further studies can be done to visualize the baby's digestive tract to rule out the possibility of a blockage.

Again, I am so sorry that you are spending Mother's Day worrying about this information which should have been better explained to you at the time of your visit. Please call your OB and insist on being seen ASAP to sort this all out. Let us know how things go. Happy Mother's Day to you!

[nurse_wannabe]

Jolie, thank you so much for your reply. You've really made me feel much better with the stats on the margin of error.

The U/S Friday was done because the baby was facing away from the tech the last time I had one, and my OB wanted more details than what we were able to see, i.e. facial features, etc.

I forgot to mention that on both of my last 2 ultrasounds, the tech noted that there WAS fluid in the baby's stomach and kidneys, so I think he is able to swallow okay. I hope so anyway.

[hollyster]

My thoughts and prayers are with you.