dr concerned with how big babies are

I had my second growth u/s today and the dr that did it said he was concerned with how big the babies have gotten since my last growth u/s 4 wks ago. I failed my 3 hr glucose test lastweek so on friday they told me I have gestational diabetis..guess its really coming into play now. 4 wks ago baby A was 2.5 lbs and baby B was 3 lbs which was right on target. I'll be 31 wks on turkey day, at today's u/s baby A weighs 4 lbs 3 ozs and baby B weighs 4 lbs 14 ozs. I asked the dr if those #'s were high and he said yes, so he scheduled me to come back in 4 weeks for another growth u/s he said thats if I'm still pregnant. I asked him if they would take the babies sooner then my scheduled c-section at 38 wks and he said if they keep growing at this rate and with me having gestational diabetis they would try to get me to 36 wks then probably take the girls because the longer they're in there with me having GD the more harm it can do them..so now I'm worried.

Afterwards I had to meet with my nurse to have her show me how to test my levels 4x a day and give me some info on the types of foods I have to eat etc, when I told her about the weights of the babies she was also really concerned. I have to go back tomorrow for my 31 wk appt with my OB and I have to update her with the results of todays u/s and see what she says. The dr talked about possibly having me coming in starting nextweek for weekly NST's.

Has anyone else had GD that caused the babies to pack on the pounds very quickly? do those weights seem really high for me being 31 wks? the u/s tech had the babies listed as being almost 34 weeks already. If I follow the food list they gave me and watch my carbs will this help to slow down the weight gain of the babies?

 

I passed my 3 hr test- and was not diagnosed with GD. At about 31 weeks 5 days the girls were 4 lbs 5 ozs, and 4 lbs 11 ozs. This week they were up to 5 lbs 2 ozs and 5 lbs 3 ozs. I know I am a bit ahead of you, but my doc has not said anything other than I have big babies, which is a good thing at this point because we are waiting for labor to kick in any day now (I am 5 cm dilated). Did they say how they are measuring for their gestational age- are they measuring further along than what they should? I do know diabetes can make them measure big, but I am not sure what effects they end up having if carried to term.

 

I did not have GD, neither one of my pregnancies. My oldest was over 9lbs. My twins weights were pretty similar to yours ... I measured 2 weeks ahead consistently.

26w: 2lbs6oz and 2lbs5oz
30w: 4lbs6oz and 4lbs5oz
34w: 6lbs1oz and 6lbs15oz (but they said baby B measured too big, they expected lower 6lbs range ... they were right)
38w2d: 7lbs11oz and 7lbs10oz

There is no reason why you can't deliver 7 or 8lbs twins. Absolutely no reason. I have no experience with GD, however I would be very careful to deliver these twins prematurely, and that's what 36 weeks is. Size wise they may be OK, but their lungs may not be, including other medical issues. Again ... you're measuring very very similar to what I did, and no doctor was ever concerned. They always said that they were hoping for 7lbs babies. But I did not have GD. And ... u/s can be 15% off ... especially estimated large size twins are not always as large as they think, making an early c/s or induction even more risky in my opinion.

I think you have to talk to your doc about the risk of GD (and larger size babies) and the risk of prematurity. Size itself is not an issue, in my opinion. There are several women on this board who delivered 7lbs, 8lbs sets of twins.

 

thank you both for putting my mind at ease. It was nice to hear that neither of you had GD but your babies measured around the same my girls are right now. I guess I have a history of big babies, my almost 3 yr old dd was 9 lbs they induced me at 39 wks.

I'd prefer to keep them in there as long as possible regardless of their weights, so tomorrow when I meet with my OB, I'm going to express my concerns and see what she has to say about it.

 

I don't have GD- passed my one hour test.

At 31 weeks- Baby A was 4'3 and Baby B was 4'2. They were measuring at 33 weeks each. The dr.s are not concerned at all.

 

At 31 weeks my Drew weighed 4'4 and Livi 3'6 and the doctors were concerned that Livi was too small. Remember too that the u/s is just a guestimate, they can be as much as a pound off. I wouldn't let them induce early unless there was a really good reason for them to, hang in there.

 

I do'nt know much about GD as I've never had it before (and hoping I don't have it this time around) but those weights do sound big for 31 weeks (keep in mind though, those growth scans are not always accurate). My Baby A was measuring 4lb. 8oz at 34 weeks (the day before I delivered) but since she was a "tall" baby, she only came out weighing 3 lb. 14 oz. By her bone measurements, they estimated her to be bigger.

At 34w1d (when mine were delivered) they were 3 lbs. 14 oz. (however, this was SMALL for 34 weeks - she wasn't on the growth chart) and the other was 4 lb. 8 oz.

 

I don't think the concern is so much the size of the babies as the effect of the diabetes on the babies. This is from the American Diabetes Association.

How gestational diabetes can affect your baby

Gestational diabetes affects the mother in late pregnancy, after the baby's body has been formed, but while the baby is busy growing. Because of this, gestational diabetes does not cause the kinds of birth defects sometimes seen in babies whose mothers had diabetes before pregnancy.

However, untreated or poorly controlled gestational diabetes can hurt your baby. When you have gestational diabetes, your pancreas works overtime to produce insulin, but the insulin does not lower your blood glucose levels. Although insulin does not cross the placenta, glucose and other nutrients do. So extra blood glucose goes through the placenta, giving the baby high blood glucose levels. This causes the baby's pancreas to make extra insulin to get rid of the blood glucose. Since the baby is getting more energy than it needs to grow and develop, the extra energy is stored as fat.

This can lead to macrosomia, or a "fat" baby. Babies with macrosomia face health problems of their own, including damage to their shoulders during birth. Because of the extra insulin made by the baby's pancreas, newborns may have very low blood glucose levels at birth and are also at higher risk for breathing problems. Babies with excess insulin become children who are at risk for obesity and adults who are at risk for type 2 diabetes.


I hope you can get the GD under control.

 

GD babies also tend to have under developed lungs.

 

When I saw a dietitian last week, she said that in twin pregnancies, there's no sense trying to control GD just by counting carbs, since it's still really important for you to get enough calories for the babies. I'm surprised that you're not on insulin -- that should control the GD and allow the babies to stay inside long enough to be mature!

 

coming from a regular diabetic (on an insulin pump) the best thing you can do for yourself (and your babies) is to get yourself to an experienced endocrinologist - your OB/GYN and Peri may be great people but you REALLY need an endo to help you control your sugar (even if its through insulin)...

I went 36w with my twins, I had a completely complication free pregnancy - I developed pre-e which was why I had to deliver early but those kids were happy where they were!

if you have any insulin questions PM me...

 

I just checked my stats & my girls weighed 4lbs14oz each at 33 Weeks. My doctor never freaked out. Hang in there- that GD diet works.

 

I'm curious about this too as I didn't pass my 1 hr. Dr. gave me wrong test (12 hour fasting) instead of the 3 hr and I had to do the 3 hour a few days ago... I'm waiting on hearing back from them. I didn't have GD with my DD, but with twins - and being overweight, and family history, etc... so I'm just basically waiting to hear back that I do.

My SIL had GD with her last baby and she did the diet, and yet her baby came weighing almost 13 lbs (almost the same as her other baby that she didn't have GD with - her DH is BIG.) but she ended up in NICU with blood sugar issues that needed time and attention to get regulated.

 

I did not have GD. My boys were born at 31w exactly and one weighed 4lb 7oz (the other was 3 lb 11 oz). The nurses commented that they were "big" for their gestation, but not worrisome big.