IUGR@24 weeks-Going against doctor's advice?

[BabyBlueStar]

Oh dear I'm terrified posting this..

Hello!
I'm currently 25 weeks and 4 days today carrying a little(very little) boy!
At my 24 week scan they saw he was measuring really small (about 480 gram putting him at 22 weeks).. further prodding around during the ultrasound revealed absent end diastolic flow in the umbilical artery and I believe some reverse as well but it was on and off, sometimes it was good others it wasn't.

At 24w6d I was sent to another hospital where the ob checked again and then we had a talk with one of the neontologists there.
He basically told me everything that can happen when a preemie is born at a certain gestation, what can happen in the NICU, etc.. all very much doom scenarios or horrible outcomes. I understand you should be informed about everything that can go wrong but it got me to think "is it worth risking all of this and delivering him early or wait and risk stillbirth?".

I had another scan at 25w3d and ultrasound revealed nothing much has changed. She checked the artery in the liver that connects the placenta to the baby and the flow there was fine (she said as long as that's fine he doesn't need to come out).
This thursday I need to go in for a check up again and then we'll talk with a neontologist again this time to discuss when to intervene and when to let nature have its way..

It's a very difficult matter and a bit of a controversial one too, where one would deliver at 28 weeks, others won't..
I was wondering if there was anybody who has chosen not to deliver when advised and what their set limits were (gestational weeks and weight).

I found this article too which really reassured me in a way that there's a choice even when they say "he needs to be delivered now" but I'm afraid they'll look down on me or will try to persuade me to have it their way.
[[I need 10 posts before I'm able to post the like but the title of the article is "When Is It Right To Let Your Unborn Baby Die?" by Eugenie Samuel Reich]]

I feel him kicking a lot and his fluids are good so I'm staying positive but I'm prepared too.

 

[mummy3]

Hi. First off congrats on your pregnancy, I know this is a few days after your post so I hope all is stable still?

Not entirely sure what you are asking, I'm thinking you want to keep him in when the doctors decide it's time to deliver?

First off every day he is inside of you is a day for development. From my experience with my preemies (last one was born at 27+3 with waters breaking at 26+5), even though they may be smaller it's the gestation that matters the most. The neonatal doctors are right to explain all the risks and yes it's very, very hard to hear. On the other hand there are equally high risks from remaining pregnant at a stage where the pros start to outweigh the cons. As a parent you do have the right to educate yourself and make decisions for you and your baby.

I went the other way and pushed to deliver, very long story but her arm came out, then went back in, the perinatologist examined me and the arm was back in but after insisting on another exam I was found to be right and she was born by C section that afternoon. She had E coli pneumonia and sepsis from her arm coming out, sometimes we know our bodies better.

Have you had steroids? Those and mag sulphate for brain development help a lot. 28 weeks is a milestone gestation, that was my aim, anything after that a bonus. It's where the risk of mortality and morbidity drop dramatically.

Take it day by day and reassess when you reach different gestations, the pros and cons change daily/weekly.

Good luck x

For what it's worth my little girl is 22m old and the only thing really going on is a speech delay.

 

[BSelck24]

Hi there!

Just seeing your post now, but wanted to add some advice!

First and foremost, this is your baby and you decide what happens. I personally would take the doctors advice as much as possible because they see these scenarios very often.

I wasn't sure if you said they were concerned about the blood flow in the umbilical cord or whether or not the baby was getting enough nutrients since he stopped growing? If he could gain a little more to help his chances outside of the womb that would be great, but it is important to remember that if he is not being nutritionally supported properly in the womb, the doctors can give him a feeding tube (with IV fluids and vitamins to start, and then formula once he can handle it) to bulk him up.
I agree with the previous poster to get your steroid shots to help with lung development.

Just remember the baby may not be getting what he needs in the womb and the best option might be delivery if he has stopped growing.

 

[DandJ]

My IUGR baby was delivered 36+4, and they began monitoring me at 32 weeks because of my preeclampsyia. The blood flow from the umbilical cord was ok, she was just small. Had lots of NST done to make sure baby was ok... ultimately I had an emergency C-section because of my pre-e and failing liver. If those weren't an issue, she could have stayed in longer but still be on the small side. She was measuring 3 weeks behind... but completely healthy despite her small size. She was in NICU for 10 days only to make sure she could feed via bottle and regulate her body temp. She is a happy baby!

 

[Radiance]

You get the final say but please listen very carefully and make an informed decision. You should also be monitored more closely, especially if you decide to go against the suggestions. I was unfortunately on the other side of this. My OB pushed my sons IUGR off to the side and it resulted in his death.