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Uterine Growth Development
15 replies to this topic
Posted 08 April 2012 - 11:02 PM
If a baby is born at 4kg is it considered a healthy weight? or is it only considered a healthy weight if the length is considered a healthy length?
What if that 4kg baby is 60cm long at birth - is it still considered healthy because it is 4kg, or is it considered underweight / IUGR because it does not even make the 3% on the height/weight WHO charts?
Posted 08 April 2012 - 11:46 PM
Are you talking about a girl or a boy?
60 cm long is off the charts for a newborn, and 4 kg is a great weight! Not sure where you got the 3rd percentile from.... Are you sure the baby was 60 cm at birth - 55 cm is above the 99th percentile for length....
Posted 09 April 2012 - 12:12 AM
I was certain I replied to this... *sigh*
Baby was a boy.
as you can see from the charts, not anywhere near the 3rd percentile..
So does that equate to IUGR, or not because he was 4kg?
Posted 09 April 2012 - 12:20 AM
I must admit I have never seen a baby born at 60 cms. Even the very large macrosomic babies of 5kg+ are still approx 53-56cms.
One would expect a baby of 60 cms to weigh about 6-7 kgs and be several weeks old to be on approx the 50th percentile so I can see how a newborn that was 60cms long could be viewed as growth restricted when weighing 4kg even though I haven't seen it happen and the weight alone is above average.
I probably haven't helped with your question at all...sorry.
Edited by soontobegran, 09 April 2012 - 12:24 AM.
Posted 09 April 2012 - 12:53 AM
I have heard of a number of other babies born at 57/58/59 cm, but they were all around 5kg / 11lb.
I have been researching Potassium effects on inter-uterine growth of the fetus, as there are hints that this can cause IUGR. My potassium levels were above 6.8
As I said, this baby was stillborn (my Avery). I still believe that he was not a "normal" baby.. but chromosomal tests were unable to get results.. and I have not got autopsy results back. I wonder about stroke or other issues in utero. (he had low muscle tone on the left of his body)
It appears I had "Rapidly reversible acute renal failure from ureteral obstruction in pregnancy"
thanks for taking the time to read all of this..
Posted 09 April 2012 - 09:42 AM
studiobird - I am sorry to read of your loss of Avery. My heart goes out to you.
I am not a medical professional but from my understanding of IUGR, it is based on weight. Head circumference is also taken into consideration to determine whether it is asymetric or symmetric IUGR. I have had preterm babies and 2 of my babies were not even measured for length until they were over 1 week old. Both of these babies were short for gestational age but were classed as low birth weight not IUGR as weight was higher than 3rd%ile. Length was not taken into consideration until they were older (6+mth) and then it was used to determine weight/length percentiles in diagnosing "failure to thrive". My preterm baby was beside an IUGR baby in SCN and although she was lighter than him she was quite a lot longer than him.
I am not sure if this helped at all but I hope that you find some answers.
I have heard of a number of other babies born at 57/58/59 cm, but they were all around 5kg / 11lb.
My SIL baby was in this category 57cm and 10lb10. My sister's DD was 57cm long and just under 9lb. She was not classed as IUGR. The comments from the midwives were that she was a "very long baby". Both of these babies were born 12+ days past EDD.
Posted 09 April 2012 - 09:57 AM
I wondered if you were talking about Avery. I am so sorry, he is such a beautiful baby. I have been wondering how you are doing and whether you were able to get some answers as to why he was not born alive.
Those are some really awful potassium levels Studiobird and I presume you that aside from making you very sick that they would very sadly have an effect on the intrauterine health of your little boy.
Edited by soontobegran, 09 April 2012 - 10:01 AM.
Posted 09 April 2012 - 10:20 AM
soontobegran - no, we have not had answers. I do not have the autopsy results yet.
I was in ICU after he was born. Yet, I did not feel sick at all. I am starting to believe that my uterus caused a partial bilateral blockage that affected my potassium levels and his weight development. Then when my waters broke (as he was not fully engaged) he compressed the urethra to cause a complete blockage from both kidneys causing rapidly rising potassium levels. I also believe that my high consumption of quickeze may have held some of the symptoms at bay early in the piece (the calcium and magnesium in the quickeze lessening the effects of the potassium).
They are all theories. But basically the Renal Specialists and the OBs had never seen anything like it. I was producing no urine before he was removed, and then started producing urine in theatre immediately.
All the studies I can get are old old old. it is so rare.
I am going to get my notes to get more information to try and piece it all together.
As for me...
I am OK. Good, and Bad. I had a miscarriage in January that tipped me off a cliff... but I am getting there. I spoke in front of 300 people last week about Avery and that was very cathartic.
It is just a day by day thing.
Writing, searching for answers, stepping one foot first, then the other... it all helps.
Posted 09 April 2012 - 10:29 AM
I am sorry for your loss.
Were you labouring for a long time prior to the caesarean?
Is it possible that your acute renal failure was due to true, prolonged, obstructed labour?
Acute renal failure would quickly lead to very high potassium levels.
Posted 09 April 2012 - 12:12 PM
Yes, the potassium levels were definitely caused by obstructed labour / obstructed urethra. As soon as he was removed kidneys started functioning again.
But it is also a consideration that I had prolonged pressure on the kidneys before labour started too..
Posted 09 April 2012 - 12:30 PM
Oh, the acute renal failure was caused in labour.. we know that. I guess part of it is whether there was issue in pregnancy (that could have lead to high potassium levels and subsequently affected Avery).
He was long... super long... but ONLY 4kg. which is a healthy weight - until you put it with his length...
But I do also think there may have been something wrong with him...
I have to get my records, speak to the social worker and find out about the autopsy stuff... ugh.
Posted 09 April 2012 - 12:40 PM
I know of a baby that was 60 cm and weighed 4.2 kg at birth. She's a very tall 7 y.o. now. She was born to tall parents though, so they just thought they were destined to have 'long' babies. It's the only one that I know of though.
Posted 09 April 2012 - 02:23 PM
I only had bloods done in very early pregnancy. I opted not to have others. But I did have a 20 week ultrasound / morphology scan.
My husband and I are both 160cm tall. but the boys in my side of the family are big...
Posted 09 April 2012 - 02:35 PM
If your acute renal failure was caused by obstructed labour then it would be highly unlikely to have started earlier in your pregnancy.
Acute renal failure and chronic renal failure have different pathologies and you would not have recovered from chronic renal failure as rapidly.
edited to remove other discussion related to obstructed labour. I did not mean to be insensitive.
I am so so sorry for your loss.
Edited by anotherid, 09 April 2012 - 02:56 PM.
Posted 09 April 2012 - 03:51 PM
I lost our first son Kobi 2 years ago this Wednesday and when he was born I was told that he did not look like he was growth restricted. He was almost 7 pounds and was 56cm long.
We opted for a limited autopsy based on a clotting condition I have and it was found that in fact he was growth resticted based on the measurements of his liver, kidney,and very low fat stores, for his weight and length they were undersized.
We have since had another son born prem at 34 weeks due to his growth suspected of slowing, he will be 1 in a couple of weeks and I am now also 17 weeks pregnant again. Losing a child dosen't go away and I have been a very stressed, anxious person with every pregnancy since losing Kobi but in the end we had to believe that with the right treatment and monitoring we would get there.
I hope you get the answers you are looking for we saw mulitple sepecialists before trying again because it was important to do everything we possible could to get a positive outcome. Keep asking questions if this is what you need.
Posted 09 April 2012 - 04:21 PM
The fact that your renal function recovered so promptly and has not been an issues since would infer that this was just an acute manifestation caused by the obstruction but I can understand why you are questioning whether you did have some pregnancy related renal problems as well that meant that Avery's health was compromised before you ever laboured.
I do hope you will get the answers eventually studiobird. I feel strongly that if your maternal instinct makes you believe that he was not well then you are probably right.
My heart aches for you when I look at those beautiful photos.
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