Any midwives/sonographer's around who can explain my notes?

[GlitteryFluff]

Background:
I'm 28 weeks and am having growth scans as last baby was 11lb7oz.
I had my first scan this week. Baby weighs approx 2lb8oz but when they plotted it on the chart they weren't happy as baby was smaller than expected. I was then sent to the maternity assessment centre who saw they had plotted the weight slightly wrong and actually baby was ok for size. Slightly under 50th centile. So nothing to worry about and sent on my way.

Question 1.
Googling tells me 2lb8oz is big for 28 weeks, average being 2lb2oz. So how comes they are plotting this baby below the 50th centile? Is it because the chart they use takes into account previous baby was massive and I'm overweight so they're expecting a larger baby but actually this time baby is more average?

Question 2.
Since coming home I've looked at my notes.
At the bottom of the report from the scan there's a section that says:

Doppler:
Umbilical artery:
PI 0.89
RI 0.61
Enddiastolic flow: positive.

The two figures come out quite low on the little chart that plots in relation to centiles.

Does anyone know what this means? I've tried having a google but am getting scary answers so would like some reassurance! Nothing was mentioned about these figures in the scan.

Question 3.
All the plots on the chart next to measurements (ie head circumference, abdominal circumference etc) are all plotting before the middle line, except for femur length with is just past the middle line.
However at my 20 week scan everything was plotting past the middle line, femur length way in front, white near the 95th centile.

Does this mean baby isn't keeping up the same pace of growing? Has growth slowed?



I will ask the midwife when I see her next but just wondered if anyone could shed any light before then?

Hopefully this all makes sense!

Thank you and sorry it's so long!

[DeadDoorpost]

I can't answer any of the first questions as I'm not a midwife, but Question 3 is nothing to worry about; the baby grows at different rates throughout, and so measurements can vary. They can also vary depending on the sonographer and they aren't as accurate as you believe them to be; it's to do with where they mark the points on the scan so they will always vary. Unless there was a significant difference, it's nothing to worry about.

(End-diastolic flow positive I believe is a good thing, but if it was reversed or absent then would be worrying but don't take my word for that, it's just something I vaguely remember from my own notes and conversations with my sonographer who was explaining everything to a very nosy me )

When is your next midwife appointment? Can you not phone them up to ask as you're a bit worried? My midwives are always happy to answer questions we have, but this might depend on areas.

[AccrualIntentions]

I am not a midwife or sonographer.

But I'm on fortnightly growth scans due to being on insulin for gestational diabetes so I'm having fecking loads of them!

At 28 weeks (plus a few days) they gave me a weight of 3lbs 2oz, which on my chart was about 60th percentile. I believe the chart in your notes is a customised chart for you, so mine assumes my baby will be a bit larger than average as I'm very tall and have a BMI just over 30. My scan yesterday showed me at the 95th percentile across the whole population but less than 90% on my chart, if that makes sense.

PI, as I understand it, is a measure of resistance for blood flowing through the placenta, and a lower number is better than a higher one. I've had values between 0.64 and 1.07, none of which the consultant has been concerned about at all. I don't know what RI is.

And I've had really varying measurements for the abdominal and femur length, at my 20 week the measurements were all below 50th percentile except for femur which was way above, at 28 weeks they'd all moved up a bit, at 32 the abdominal was much higher percentile wise than the femur length and at 34 they're both up at a high percentile again! I think the measurements can be a bit hit and miss and the baby can grow at different rates.

Definitely speak to your midwife for more information if you are concerned though.

[GlitteryFluff]

Thank you both for responding. Sorry posted before I started work and have only just got back.

dead I have a midwife appointment next week, so will definitely ask her. I'm not worried too much as I'm sure someone would have mentioned if something wasn't quite right? I think because I was expecting a whopper and this one isn't I'm feeling a little uneasy. My midwife only works part time and switches her phone off when it's not her working hours so it probably wouldn't be much quicker speaking to her before my appointment. As I say I'm not sitting here getting worked up just wondering what it all means really.
Thanks for info re flow. I wish they'd just run through these things with you before you leave. Rather than have nobody to ask when you get home. Plus they didn't even say oh everything fine baby is doing great etc because at that point they thought baby was too small so sent me off to the other department. So there wasn't any reassurance iykwim.

Accruall that makes sense about the chart being customised for me. I'm not sure why Ds was so big but I reckon because he was so unusually massive my chart is way off with what to expect and actually this baby is totally average but in comparison to an 11lb7oz-er it's tiny.
And thanks for PI info. I did read that somewhere but then read about 5 times as many websites telling me completely other things. I'm sure it's all fine because they would have said something? And the fact I was seen at scan part then at maternity assessment place that's two separate lots of people who would have picked up on it if it wasn't quite right. Well here's hoping anyway!

[Phaslosttheplot]

As a general rule, if the professionals are happy. All good, so almost certainly nothing to worry about. Weight at this stage is not so much an indicator of growth but more the measurements. So ignore the weight until it gets near delivery. As long as the measurements are between the 5th and 95th centile, that is normal. Most babies will be about the same at 20 weeks and then take on there own growth profile if the growth is measured regularly( ie along the 20th or along the 50th). Things they will watch out for is the AC (abdominal circumference) stopping growing in the case of intrauterine growth restriction or getting too big in high BMI or gestational diabetes ladies. The Doppler is measuring whether there is a continuous flow of blood to the baby through the umbilical cord and what the resistance is, there needs to be continuous flow, which the numbers show there was. Don’t panic if there is some discrepancy between scans as there is a degree of interoperator error.

Hope that helps and good luck with the rest of your pregnancy 😊

[Bez9087]

Hi @glitteryfluff not sure if it helps but when we had my son at 27 weeks he weighed 2lb 7oz so I wouldn’t say your baby was overly larger personally. I would check with your midwife at next appointment if worried though.

[confusedlittleone]

The growth charts are somewhat customised based on your BMI at booking. So someone who weighs 20 stone and someone who weighs 10stone would have a different percentile even tho baby weighs the same.

[confusedlittleone]

Also not a medical professional just gained 7 stone from pregnancy 1 until pregnancy 2 which is how I found that out!