ACOG's stance on fetal macrosomia

Haley.Beth

I'm seeing a lot of posts about big babies. This is a bit of a sore topic for me, I dumped an OB for telling me at 12 weeks he was going to induce by at least 38 weeks because I have a history of fetal macrosomia (my first and only was 9 lbs 3 oz) with no other evidence and wouldn't even agree to just monitor the situation. I delivered dd vaginally at 41 weeks with no complications and only a first degree tear. Her APGAR scores were both 9. I couldn't understand why in the world fetal macrosomia was suddenly a problem for this doctor when it wasn't an issue before, so I did my homework and realized the doctor is going against his own medical body's opinion on the subject.

Anyway, instead of visiting each post individually I wanted to share with you ladies the ACOG guidelines for fetal macrosomia.

http://www.aafp.org/afp/2001/0701/p169.html 

(Sorry, I can't make it clicky, dunno why)

"...the results of these reports, along with published cost-effectiveness data, do not support prophylactic cesarean delivery for suspected fetal macrosomia with estimated weights of less than 5,000 g (11 lb), although some authors agree that cesarean delivery in these situations should be considered."  (9 lb babies are NOT a reason for c-section)

"In cases of term patients with suspected fetal macrosomia, current evidence does not support early induction of labor. Results from recent reports indicate that induction of labor at least doubles the risk of cesarean delivery without reducing the risk of shoulder dystocia or newborn morbidity..." (induction doesn't actually lower the risks of delivering a large baby)

They do note that these recommendations are in the absence of gestational diabetes, which completely changes the game.