Not Grown enough - IUGR advice

[elle kay]

Hi all. I started having extra growth scans at 28 weeks due to my age (42). at 28 weeks the baby was smaller than expected according to my customized chart but at10th percentile not a concern. However 13 days later (on friday) I had another scan and baby had dropped to below 5th percentile and the abdominal circumference had not changed. Cord flow and fluid still fine.

First the dr said i would be called back for another scan in 2 weeks to see if baby catches up or if she continues to drop, but then she left the room to speak to consultant and when she came back she said actually i should
come back Monday to monitor cord and fluid and in to discuss being put on steroids for possible early delivery and another growth scan booked for next week aswell .

I will be 31 weeks on tuesday so i know the gestation is good enough to not be a huge concern but just wondered if the speed at which they are getting me back in indicates that they think the baby will need to come out sooner rather than just monitoring for a few weeks. If they are talking steroids then does that mean an imminent delivery or is it fairly standard to take them 'just in case' things take a downhill turn? I'm not keen on taking steroids simply as a precaution but of course i would if things DID go downhill and it was needed for delivery.

has anyone else had to be induced for growth slowing/stopping even when the cord blood and fluid is still good?

the baby was estimated 2lb 2 at 28 weeks2 days and 2lb 9 at 30 weeks 2 days.

Any clue as to how this might go from here?

 

[xarlenex]

I have not been in this exact situation so can't give any advice on your details you've given, but I have sat in front of consultants who have spoke at me and it's hard to take it all in and process it. My only advice is to write your questions down you need answers to before you see them again tomorrow, then even if your feeling balled over with other information you'll still remember these things too. Also if your appointment is next Monday and not tomorrow, don't sit and worry until then, call to speak to someone, midwife or consultant.

hope all goes well xx

 

[MoBaby]

Take the steroids. They are for the baby; not you. For lung maturity. If baby has a chance not to go on vent you need the steroids. Doesn’t mean babybwont need it but will have better chances with the steroids as lungs will be better.
I’d take it as a sign you’re going to deliver early if you have to come back so soon. Honestly I wouldn’t chancebit and take the steroids. Hopefully baby grows some and you can hold off.

 

[Tanikins]

My youngest was iugr. We had scans twice weekly from 31 weeks, I also had 2+ ctgs a week aswell. I had steroid shots at 31 weeks (fyi they are so painful). We were told to expect a baby at 31 weeks. Then when the scans showed he was 'ok' that moved to 32 weeks, then 34 and finally it was if we get to 36 he's coming out regardless. You have to find a line on when it's no longer safer to be inside because obviously there meant to be in for 40 weeks


The fact that there monitoring is good. They may well deliver you early but they gain may not. They will keep baby in for as long as needed. Ds2 was born 36+4 at 4lb 13oz and we had a 2 week NICU stay as he couldn't suck. During that time he dropped to 4lb 4oz.

 

[elle kay]

well i went for monitoring spent about an hour on a heartrate/movement monitor first which i hadnt expected as there have been no issues with movements , was scanned for cord and fluid which was all fine, didnt even get to sit down with a doctor, he just stuck his head round while i was on the monitor and told me that it was bad baby wasnt growing and i probably wouldnt make it to term, but that cord flow and fluid was good. no mention of steroids or any information on what might happen .. so i dont really know whats going on. After all they have only 2 growth scans to go on and arent they notoriously unreliable? I had been told i would have another growth scan later this week but today they said no, it will just be cord and liquor again. So I have to try to work out the situation from all the random bits and pieces from all the different departments and i am concluding that at the moment all is ok but they are monitoring and expecting it to become not ok at some point, but clearly must be ok for the next week and a half at least until the next growth scan

 

[Tanikins]

I had twice weekly scans for cord flow and waters. They only measured growth once a fortnight as they aren't reliable if measured too often

 

[elle kay]

so now i'm a bit concerned that they DIDNT discuss steroids yesterday, because if the next growth scan isnt for a fortnight and babys AC already didnt grow for 2 weeks, in another 2 weeks could be in quite a bad way and i wouldnt have had any steroids???

 

[MoBaby]

Can you contact them and ask about steroids?

 

[elle kay]

i'll ask when i'm in on thursday.

 

[elle kay]

too snowy to get in for my appointmenthttp://babyandbump.momtastic.com/images/smilies/doh.gif

 

[Katiedw21]

I had this as well with my last baby. Baby was not growing properly abdomen and head size were in the 4th percentile. They monitored me closely for 6 weeks but then at 34 weeks the water started to get very low so I was monitored daily until I got 36 weeks and I got to a point where I felt they were waiting for something to go wrong so they could deliver my hospital is very strict on delivering or being induced rather before 39 weeks and I didn't qualify, so I told my doctor I do not like waiting until something goes wrong and she fibbed the tests a little and was able to induce. He was born small but healthy and had no nicu stay. I think a mother's instinct is very strong and be sure to advocate for yourself if its getting to scary be sure you tell them!

 

[elle kay]

I had my monitoring today, fluid and cord were still good. baby still moving a lot. The doctor was going to give me the steroids today ahead of the growth scan on thursday. i felt a little uncomfortable to take them on the back of only 2 scans so asked if it would be taking a risk to wait to see the outcome of the scan , and he said it would not make much difference because at only 32 weeks they would not want to be rushing into anything and with the tests all being ok today it could wait. but i got the impression he didnt expect the scan to show a sudden growth spurt or anything and that i would be delivering early. So really its a waiting game til thursday, glad its not long to wait and i will take the steroids then if there hasnt been a weight increase. I do feel like the baby is fine at the moment i guess this is me following my instincts to just hold off to be sure and that there is no risk in doing that. Half of me is actually quite excited at the thought of getting to meet my baby earlier and not have that horrible last couple of weeks but of course i really dont want to have her so early that she is stuck in hospital and i'm going back and forth between my babies (i have a 16 month old who is at a very clingy phase!). I do feel quite at peace that everything will be ok , but thursday cant come quick enough for me!

 

[elle kay]

well i'm very glad i chose to hold off the steroids as baby has jumped to 25th percentile.......from below 5th, in 2 weeks? doesnt seem possible. ......but there it is, my 'significant IUGR' and suggestions i would be admitted next week , all now normal!

 

[MoBaby]

Great news!

 

[MumToEva]

Glad things are ok! With my eldest, I had scans every week from 30weeks due to restricted growth. Well she was born naturally at 36 weeks, a few days before I was due to be induced, and while she was small (5lbs), there was nothing amiss at all, and she is now a healthy 6 year old.

 

[phantomfaery1]

This is exactly what happened to me , my son wasnt on the 0.4 centile. I was induced at 37 weeks x apart from low birth weight at 4lb 10 ( below the centile chart ) he was fine x