INDUCTION OF LABOUR 'BIG BABY' by https://padlet.com/LSSOG/9scvwba6cm7sf19y en-us 2023-09-12 05:55:29 UTC 2023-09-25 12:22:04 UTC hello@padlet.com What is a big baby? marisataylorclarke https://padlet.com/LSSOG/9scvwba6cm7sf19y/wish/2698970714 There is no standard definition. 
The National Institute for Health and Care Excellence (NICE) guidelines define it as growth >95th centile (at least 95% of babies are smaller) on the customised growth chart or estimated weight of >4000g on an ultrasound. ]]> 2023-09-12 05:59:26 UTC https://padlet.com/LSSOG/9scvwba6cm7sf19y/wish/2698970714 What does having a big baby mean? marisataylorclarke https://padlet.com/LSSOG/9scvwba6cm7sf19y/wish/2699000229
There is currently no evidence that the centile on which a baby’s estimated weight falls is associated with adverse outcomes (e.g., delay in labour, emergency caesarean birth, instrumental birth, shoulder dystocia (SD), perineal tears extending to the anal sphincter, or post-partum haemorrhage) unless the baby is estimated to weigh ≥4kg.

Estimated Fetal Weight of >4 or 4.5kg (called 'suspected macrosomia') is a poor predictor of shoulder dystocia but is associated with a significant incidence of obstetric intervention independent of actual fetal weight.
 

]]> 2023-09-12 06:20:11 UTC https://padlet.com/LSSOG/9scvwba6cm7sf19y/wish/2699000229 Planned Caesarean Birth marisataylorclarke https://padlet.com/LSSOG/9scvwba6cm7sf19y/wish/2699011540 There is currently no evidence that a caesarean birth improves outcomes for mothers or babies if the only concern is that the baby’s weight is estimated to be ≥4kg on USS. It is associated with a significant number of risks to mother, baby and impact on future births and it is not recommended. 

National guidance currently recommends offering caesarean section if estimated weight is >5kg in women without diabetes and >4.5kg in women with diabetes.  This is based on expert opinion rather than any studies.
]]> 2023-09-12 06:27:51 UTC https://padlet.com/LSSOG/9scvwba6cm7sf19y/wish/2699011540 Click here for more general information on the process of induction of labour marisataylorclarke https://padlet.com/LSSOG/9scvwba6cm7sf19y/wish/2699043272 2023-09-12 06:34:13 UTC https://padlet.com/LSSOG/9scvwba6cm7sf19y/wish/2699043272 How accurate is ultrasound? marisataylorclarke https://padlet.com/LSSOG/9scvwba6cm7sf19y/wish/2699045447
Ultrasound estimates of fetal weight can over or underestimate the actual birthweight of babies by 15-20%. 

So your baby's birth weight may be up to 20% bigger or 20% smaller than predicted. ]]> 2023-09-12 06:34:43 UTC https://padlet.com/LSSOG/9scvwba6cm7sf19y/wish/2699045447 Shoulder dystocia marisataylorclarke https://padlet.com/LSSOG/9scvwba6cm7sf19y/wish/2699116019 The most quoted concern is the risk of and consequences of shoulder dystocia.

This is when your baby's head is born but there is a delay in your baby's body being born.

Extra help is needed to deliver your baby's shoulders and in the majority of cases baby's are then born quickly and safely.

Shoulder dystocia is more likely in babies over 4.5kg nevertheless the majority of babies are born without any difficulty.

Half of all instances of shoulder dystocia happen in babies LESS than 4kg.]]> 2023-09-12 06:41:39 UTC https://padlet.com/LSSOG/9scvwba6cm7sf19y/wish/2699116019 marisataylorclarke https://padlet.com/LSSOG/9scvwba6cm7sf19y/wish/2699234501 You have been signposted here to help you understand :

- What is 'suspected macrosomia' or a 'big baby'
- What are risks?
- What are your options for birth?
- What are the advantages and disadvantages of induction of labour compared to waiting for labour to start naturally ('expectant management')

]]> 2023-09-12 07:10:32 UTC https://padlet.com/LSSOG/9scvwba6cm7sf19y/wish/2699234501 What are the pros and cons of induction vs expectant management? marisataylorclarke https://padlet.com/LSSOG/9scvwba6cm7sf19y/wish/2699240245 The evidence suggests that the risk of emergency Caesarean birth, nerve injury to baby and perinatal death are small and the same for both options]]> 2023-09-12 07:14:13 UTC https://padlet.com/LSSOG/9scvwba6cm7sf19y/wish/2699240245 YES! marisataylorclarke https://padlet.com/LSSOG/9scvwba6cm7sf19y/wish/2699246900 Your doctor will take to you about waiting for labour to start naturally (called 'expectant management') compared to having your labour started early (induction of labour).]]> 2023-09-12 07:18:13 UTC https://padlet.com/LSSOG/9scvwba6cm7sf19y/wish/2699246900 Other considerations marisataylorclarke https://padlet.com/LSSOG/9scvwba6cm7sf19y/wish/2699256661 Induction of labour is a medical intervention. Consider the impact of this on your birth experience and talk to your doctor or midwife about how this might impact your choices.

Consider the impact of the gestation that induction might occur at. There is evidence of longer term impact on childhood development with early induction of labour.]]> 2023-09-12 07:24:51 UTC https://padlet.com/LSSOG/9scvwba6cm7sf19y/wish/2699256661 BRAIN TOOL marisataylorclarke https://padlet.com/LSSOG/9scvwba6cm7sf19y/wish/2699258648 2023-09-12 07:26:18 UTC https://padlet.com/LSSOG/9scvwba6cm7sf19y/wish/2699258648 Link to most recent Cochrane Review Update marisataylorclarke https://padlet.com/LSSOG/9scvwba6cm7sf19y/wish/2719227075 INCLUDES LINKS FOR OTHER LANGUAGES]]> 2023-09-25 12:20:46 UTC https://padlet.com/LSSOG/9scvwba6cm7sf19y/wish/2719227075