Large Gestational Age

Presented By: Nor Ain B. Oding

Statistics of
Morbidity
 Large for gestational age is
a term used to describe
babies who are born
weighing more than the
usual amount for the
number of weeks of
Large pregnancy. LGA babies have
gestational birth weights greater than
age the 90th percentile for their
gestational age, meaning
that they weigh more than
90 percent of all babies of
the same gestational age.
 One of the primary risk
factors of LGA is poorly-
controlled diabetes, particularly
gestational diabetes (GD), as
Risk Factors well as preexisting diabetes
of LGA mellitus (DM) (preexisting type
2 is associated more with
macrosomia, while preexisting
type 1 can be associated with
microsomia).
 Nonmodifiable risk factors for
gestational diabetes include
advanced maternal age (older than
35), a family history of type 2
diabetes, increase maternal weight
and a personal history of GDM.
Modifiable risk factors include BMI,
dietary pattern, and level of
physical activity, excessive weight
gain during pregnancy. Cigarette
smoking has been identified as a
potential risk factor,
 Some babies are large
because their parents are
large; genetics does play a
part. Birthweight may also
Causes of
be related to the amount
LGA of weight a mother gains
duringpregnancy.
Excessive weight gain can
translate to increased fetal
weight.
 Prenatal care is important
in all pregnancies,
especially to monitor fetal
growth when a baby
seems to be too small or
Prevention too large. Examinations
of LGA during pregnancy that
show a large baby can
help identify a mother who
may have undetected
diabetes, or other
problems.
 Review prenatal history the determine how
gestational age assessed LMP, ultrasound
between 15 and 19 weeks, or other
Measure and record length, weight, and head
circumference on a growth curve.
Check and record HR and RR at admission,
then every 30 minutes until stable for 2
Intervention hours, then with every feeding for the first 24
hours, then every other feeding or once per
shift until discharge.
Heart rate should be between 100 and 160
bpm (may be lower during sleep and higher
with activity).
Respiratory rate should be between 30 and 60
breaths/min.
 Blood pressure mean should be
between 30 and 55, based on
gestational age or birth weight.
Contact pediatric care provider if
RR < 30 or > 60 breaths/min
Intervention when counted for one full minute.
Contact pediatric care provider if HR
< 100 or > 160 beats/min at rest.
Assess skin color for ecchymosis,
jaundice and erythema
 Impaired Gas Exchange related to altered
oxygen supply (obstruction of airways by
secretion) as evidenced by wheezes upon
auscultation
Risk altered cerebral tissue perfusion related
Nursing to inadequat e glucose supply to brain.
Care Plan Deficient knowledge regarding diabetic
condition, prognosis, and treatment needs
(diagnosis) may be related to lack of resources or
exposure to information, misinformatio n,
possibly evidenced by questions, statements
of misconceptio ns ,inaccurate follow
through of instructions, development of
preventable complications .
 Risk for disturbed maternal-fetal
dyad is possibly evidenced by risk
factors of impaired glucose
metabolism, compromised oxygen
transport changes in circulation;
treatment related side effects.
Risk for unstable glucose level is
possibly evidenced by risk factors of
pregnancy, dietary intake, lack of
diabetes management, inadequate
blood glucose monitoring.