huge
Introduction
Huge introduction In medicine, a full-term newborn who is overweight is called a "great child." According to the definition of my domestic science, a newborn's birth weight is equal to or greater than 4000 grams, which can be called a giant child. In the 1980s, the huge children were only about 3%. With the rapid economic development in recent years, the material living standard is getting higher and higher, the average birth weight of newborns begins to increase, and the incidence of giant children is rising. At the beginning of this century, it has reached 7%-8%. In particular, the eastern coastal areas have reached 10%, and individual hospitals have reached 12.5%. basic knowledge The proportion of illness: 0.002% Susceptible people: seen in pregnant women Mode of infection: non-infectious Complications: dystocia postpartum hemorrhage uterine rupture
Cause
Giant cause
Overnutrition in pregnant women (25%):
After many people are pregnant, the elders and husbands at home hate to let pregnant women eat more good, thinking that the baby grows bigger, the better, but they did not expect the fetus to have adverse effects on pregnant women and the fetus.
Genetic (30%):
Gene chain inheritance is a phenomenon similar between biological parents and offspring, and between offspring individuals. Genetics generally refers to the phenomenon that the traits of the parent are expressed in the next generation, but genetically refers to the phenomenon that the genetic material is passed from the upper generation to the offspring.
Gestational diabetes (15%):
A small number of pregnant women have gestational diabetes, although the normal blood sugar of these pregnant women is normal, but after pregnancy, due to abnormal pancreatic function in the body, resulting in high blood sugar, these sugars enter the fetus through the placenta, the insulin secreted by the normal pancreatic tissue of the fetus will The conversion of sugar into excess fat and protein causes the weight gain of the fetus to be faster than that of a normal-born pregnant mother, and it becomes a huge child at the time of full-term delivery.
Prevention
Giant prevention
Beware of the birth of a huge child
1. Scientific intake of nutrition during pregnancy
If the average birth weight of newborns is kept at 3100 grams, this is an ideal number. The incidence of giant children can be reduced by human effort. The incidence of giant children in Japan in the 1960s was 2%-3%. However, by the end of the 1970s, the incidence of giant children rose to 4%. Due to the strengthening of nutrition education during pregnancy, by the middle and late 1980s, the incidence of giant children fell to 2%, and continues to this day. From the experience of Japan, the key It is the change of concept. The more you eat during pregnancy, the better. The more you rest, the better.
2. Strengthen nutrition education during pregnancy
Scientific intake of nutrition during pregnancy, adjusting the pace of life, this is the key to reducing the incidence of giant children. In China's big cities, the health network during pregnancy has been generally established, many hospitals have also set up a nutrition clinic during pregnancy to guide pregnant women how to choose a reasonable daily Diet, therefore, it is best to go to the doctor's nutrition guidance regularly during pregnancy.
3. Adhere to exercise during pregnancy
Pregnant women participate in appropriate exercise, such as walking, doing maternity exercises, to consume too much heat, to avoid overnutrition, and form a huge child.
4. Do diabetes screening
Every pregnant woman should do sugar screening. If gestational diabetes is found, it is necessary to follow the doctor's guidance on nutritional intake to prevent the fetus from growing too fast and to have a safe pregnancy.
Complication
Giant complication Complications, dystocia, postpartum hemorrhage, rupture
Impact on newborns
1. Prolonged childbirth
Generally, women with normal height and pelvis shape and size have a normal fetal position during childbirth. There is no problem in giving birth to a baby weighing 3,500 grams. However, if the weight of the fetus is more than 4000 grams, it is not so easy to give birth. Because the head and body of the fetus are too large to enter the birth canal, resulting in prolonged delivery, and finally have to use a forceps or fetal aspirator to assist.
2. Shoulder dystocia
Occasionally, although the fetal head is delivered but the shoulder is stuck, it is necessary to use some special midwifery methods to deliver the baby. This is called shoulder dystocia in medical conditions. The weight is 3500. It is rarely encountered in grams of newborns, and the weight of one to 4000 grams is significantly increased. If the weight of the fetus is 4,500 grams or even 5000 grams, the problem is even greater, and the delivery process will be long or even fundamental. It can't be delivered, it's tricky to handle.
3. Neural crest
The most frightening thing is that the neonatal brachial plexus spasm occurs during treatment. Severe shoulder plexus paralysis can lead to permanent disability. Of course, the worst result is neonatal death.
Damage to the mother
1. Cause laceration of the birth canal
Because the fetus is too big to be born, it is difficult to lead to long labor, dystocia and laceration of the birth canal. Not only vaginal laceration, but also uterine and bladder rupture.
2. Postpartum hemorrhage
Because the fetus is too large, the uterus often shrinks after the baby is delivered, causing postpartum hemorrhage and even death.
Symptom
Giant pediatric symptoms Common symptoms Abdominal pain, dyspnea, pillow, transverse position, into the basin
1. History: Diabetes, obesity in pregnant women, expired pregnancy and the fetus continues to grow up. In addition, the nutritional and genetic factors of pregnant women also have a certain relationship with fetal weight.
2. Symptoms: Pregnant women often have heavy abdominal, abdominal pain, difficulty breathing, etc., with rapid weight gain.
3. Signs: According to Gonggao, abdominal circumference and the first exposure level, the fetal weight 4000g may be considered as a huge child.
4. B-mode ultrasonography: determine the fetal biparietal diameter, abdominal diameter, femur length, etc. to predict fetal weight, when the fetal biparietal diameter is >10cm, the abdominal diameter/femur length is >1.385, 80%-85% is huge. .
Examine
Huge inspection
B-mode ultrasonography: fetal biparietal diameter, abdominal diameter, femur length, etc. were measured to predict fetal weight. When the fetal biparietal diameter was >10 cm and the abdominal diameter/femur length was >1.385, 80%-85% were giant children.
Diagnosis
Giant diagnosis
diagnosis
Diagnosis based on symptoms.
Differential diagnosis
1. Twins: When the twins are used, the abdominal examination is often larger than the singleton, but two or more carcasses can be touched. The fetal limbs are more, and two fetal heart sounds can be heard. B-ultrasound can confirm the diagnosis.
2. Too much amniotic fluid: Abdominal bulging is obvious when the amniotic fluid is too much, but there are more amniotic fluid in the uterus during the examination, the fetal body has a sense of floating, and the fetal heart sound is far away. The B-ultrasound can be diagnosed, and the double top diameter is mostly within the normal range, often With fetal malformations.
3. Hydrocephalus: The hydrocephalus is large and flexible, and is not proportional to the size of the carcass. The vaginal examination is large, the sacral sulcus is wide, and the skull wall is thin like a table tennis. B-ultrasound can be diagnosed.
