> Can anyone say whether a very wide anterior fontanelle in a 39+ week baby,
> born following iol for (obvious) IUGR is significant in any way? The
> fontanelle doesn't bulge, and isn't tight, but there are huge gaps along
> the suture lines. The head circumference is 34cm, .5 cm larger than at
> birth, but I suspect that all these measurements are inexact. Info
> gratefully appreciated.
>
Without seeing the baby and without knowing the gestational age at birth and
therefore the number of days that this head circumference took to increase by
.5 cm, it is difficult to make a judgement.
However this information may be helpful. I have selected the mean head
circumferences of babies borns between 33 and 43 weeks of gestation in a
series of 10443 babies born in 1994. I don't suppose head circumferences
will have changed that much since! 34 cm seems bang on for 39+ weeks if the
pregnancy was to be concluded at that gestational age.
HEAD CIRCUMFERENCE AT BIRTH
GESTATIONAL AGE AT BIRTH Mean N Std. Deviation
33 27.667 15 11.859
34 29.184 31 7.904
35 32.698 49 1.426
36 32.667 165 3.914
37 33.498 522 2.926
38 33.872 1501 2.766
39 33.906 2276 3.685
40 34.238 3408 3.731
41 34.778 2055 3.269
42 34.685 370 4.301
43 35.400 10 1.125
Total 34.100 10443 3.709
However you suggest that the measurement may be inaccurate and that it is
very true. I have again taken the frequency by measurement as identified and
although you ought to have a near perfect normal distribution, some decimal
points are far more common than others. I have only taken the measurements
betwee 33 and 35 cm to demonstrate the inaccuracy.
HEAD CIRCUMFERENCE Frequency
33.0 1140
33.2 9
33.3 8
33.4 7
33.5 726
33.6 1
33.7 9
33.8 4
34.0 1886
34.1 1
34.2 10
34.3 10
34.4 12
34.5 943
34.6 4
34.7 9
34.8 5
35.0 1729
I hope that this information may be useful, or at least informative. But if
the midwife is concerned not so much with the circumference but with the
appearance of the cranium itself, I would suggest referring the baby to a
paediatrician.
Marianne Mead
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