Re: Uterus large for gestational age???

Posted By Kimberly on April 21, 1999 at 17:17:55
I am 28 years old and approximately 13 weeks pregnant (LMP Jan. 21/99) with my first pregnancy. Yesterday I had my first prenatal exam. During the exam my midwife commented that my uterus was definently large for my current stage in pregnancy. When I asked the midwife what would be the cause of a large for age uterus she replied that there are 3 potential causes. 1) Incorrect date of conception 2) increased amniotic fluid/large uterus for unknown reason 3) multiple pregnancy. My comments / questions on each:
1) Due to infertility problems (endometriosis)I am aware down to the hour my time and date of conception. (I have been very carefully tracking my cycles, and had used this particular month both BBT, and an OPK). Pls Note: I have not had any fertility treatment - with the exception of a laproscopy to remove endometriosis deposits in Nov. 98. I have not taken any fertility drugs i.e.: Clomid.
2) What would cause an increase in amniotic fluid or enlarged uterus? What is the name of this condition, and could it be a sign that the baby is not healthy?
3) Relating to multiple pregnancy - I have no known predispostion to this condition. I have a grandfather (my father's father) who was a set of identical twins - but I understand that this is not typically a genetic condition.
I am really worried, and want to understand what the implications of an enlarged uterus might be. Based on the information above, what are the odds that I am carrying twins? If I am carrying twins, why has my pregnancy been so easy (no morning sickness)? I am scheduled for an ultrasound in 5 weeks, is this the only way that I will be able to confirm whether I am carrying a single (or multiple) healthy fetus?
I am very confused right now, and would appreciate any assurances.
Thank you very much!
Kimberly

[hfhsmdrcs]

Posted By hfhs.md.rcs on April 22, 1999 at 09:41:37
Dear Kimberly:
Twins occur during 1/90 pregnancies. Although fertility drugs and family history are associated with twins, most multiple gestations occur without such an history.
Some pregnancies have lots of symptom changes; others do not. Symptoms do not tell us if a woman has a twin pregnancy.
Increased amniotic fluid is called olyhydramnios. If can occur without explanation; it can be a sign that the pregnancy development is not normal; it can reflect issues such as diabetes in mother. At 13 weeks' gestation, the observation is that the "pregnancy seems large": the causes must now be evaluated.

I have great respect for and work with midwives. When a pregnancy abnormality is detected, CNMs usually consult with an OB/Gyn to consider testing that might be logical (materal serum alphafeto protein and hCG level; ultrasound at 16 weeks in a unit where an amniocentesis can be performed to study fetal karyotype).
Keywords: Uterus larger than dates
This information is provided for education purposes and is not a medical consultation. If you have specific questions, please speak with your healthcare provider.

[Andrew__0]

Posted By Andrew on April 30, 1999 at 15:48:42
Kimberly,
I came to this site because my wife is also experiencing the same problem and we wanted some more information.  Her uterus is a full 4 weeks larger than the gestational age would indicate.  
We just met with a Maternal Fetal Medicine Expert yesterday.  A sophisticated ultrasound was conducted and the following is a summary of the information we received.  Please keep in mind that I am a lay person and nervous father to be.  If you haven't already I highly recommend visiting your OB/Gyn.
Via her 20 week ultrasound, it was determined that there is a build-up of excess amniotic fluid.  As the previous person had indicated, it can be an indication of gestational diabetes.  This can be tested quite easily with your doctor.  
My wife also experienced a rash on her face and arms, along with the build-up of fluid the doctors wanted to test for the Parva virus also known as Fifths Disease.  If contracted by the fetus, Fifths Disease can cause complications and close monitoring is recommended.  Two blood tests need to be taken within two to three weeks of each other to detect your immunity to or a presence of the Parva virus.
A build-up of fluid can also be an indication of genetic issues.  My wife is 35 and she had a amniocentesis, so most genetic issues have been ruled out.
Build-up can also indicate: a cleft lip or palette - the fetus would then have problems swallowing the fluid; abnormal opening between esophogus and windpipe; or digestive problems.  A sophisticated ultrasound ruled out all the above.
Finally, it can mean nothing at all and you can deliver a very normal baby.
As you can imagine we're still a bit unnerved and don't feel like we have the answers we need.  As I had mentioned, I am in no way and expert and hope you have visited your doctor and have some more answers than we do.
Best of luck and please e-mail me if you have any information that varies or is additional to the above.
Andy
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