Low fluid and reduced growth

[Twentyducks]

Has anyone had this in the last few weeks of pregnancy and what happened? It's not very badly reduced fluid and only one measure of growth is problematic. Everything else is fine. The suggestion at the moment is to look at induction at 37-38 weeks.
I'm 35+ 4 and it's only just been picked up in the last couple of weeks.

With both my DC's we had scans indicating that the growth rate was slowing down significantly, although I didn't have problems with fluid levels. The growth slow down was uniform though (all measurements) and likely due to placenta issues. I was given a c-section around 38 weeks with both if them and they were slightly larger than the scans had indicated at 5lbs 4oz and 5lbs 8oz. I imagine they will scan you again in 1 to 2 weeks and then decide what to do.

Hey twenty:) same thing happened to me at 38 weeks and picked up during a growth scan as bump was on the small side. They booked me in for an induction on my due date and dd2 was 7lbs and not on small side at all as they had feared. I was terrified at the time but they reassured me that this is totally normal during the final stages of pregnancy- good luck and congratulations:)

Thanks both. I've got another scan booked and have to have more monitoring this week so fingers crossed I can keep going a bit longer at least.

One scan is not a diagnosis. A repeat scan will detect a trend if there is one.If there was a serious concern, this would have been discussed at the time.
To take care of yourself, please pay attention to fetal movement. A well baby, with a healthy placenta will be active as usual. If the placenta stops giving the baby optimum service, the baby will conserve energy by lying quiet.
Any suspicion, go to the unit and ask them to check fetal well being.

Thanks Mayhew - sorry my op wasn't clear, there have been 2 scans but only the abdominal circumference has flattened out the head has continued to grow. Both scans showed reduced fluid but it was only after the second they started talking about induction and increased monitoring. Baby isn't small for dates and is moving around lots.

it sounds like you have been given proper advice and management. Reducing relative abdominal circumference with reduced liquor certainly merits watching. However, delivering early has risks so it all has to be balanced.

Best wishes for an undramatic birth of a healthy baby!

Thanks! I guess I'm trying to predict the unpredictable and they were a bit noncommittal when I tried to pin them down a bit which I know is understandable. I felt they weren't really expecting things to improve at the next scan and wonder what will make them decide to induce or continue monitoring. So I'm expecting them to just carry on with monitoring until I'm 37 weeks but I'm wondering what factors would make them decide on 37 or 38 weeks or whether they'll just carry on until the monitoring looks worse or I go into spontaneous labour. You seem to know what you're talking about Mayhew - are there any guidelines on this kind of thing or is it just a matter of judgement?

Hi there. I've been in your position. twice. I'm not sure that there are guidelines or not. I think they will remain non- comittal about a date for induction, they'll leave baby where it is until if gets to the stage it is safer out that in. In my case at no point would they give be a date for induction (or second time round for a CS). They just kept monitoring, at increasingly frequent intervals, until they thought it was no longer safe to delay. With DS1 I had a scan in the morning and they started induction that night. He was 5lb11 at birth at 39+1, but absolutely fine and well. With DS2 I had a scan and was booked for CS 3 days later. With DS2 I had been monitored very carefully and by the time the CS was booked I had been scanned 2 (or was it 3) times in the last 7 days. He was born at 35+5, 5lb3 (a good weight for 35 weeks), and well, apart from RDS, which was the result of the CS and almost to be expected.

Regarding early induction.... if you can, try to get a time frame from them, and some indication of how favourable your cervix is. They spent 3 days trying to induce me with DS1. Seriously, nothing happened. It was painless, but frustrating and tiring. Eventually I got very cross and insisted on a CS. At an antenatal appointment with the consultant with DS2 we had a bit of a debrief. He let slip that on looking at my notes I was totally unfavourable for induction and he would have recommended a CS instead of induction, or within 24 hours of starting induction if no progress. Obviously you will have your own feelings on this, but I can honestly say that both of my CS's (even the emergency one) were a complete walk in the park, and the recovery much the same, especially after my second when I was not so tired and drugged up to start with.

Thanks bonzo, I don't think I've very strong feelings either way though 3 days in hospital waiting for something to happen doesn't sound like much fun! Interested they waited until 39 weeks for you though the first time.

They waited because it was safe to. He was still growing, and active, the blood flow to and from the placenta was ok, and the fluid was low but ok. At 38+4 I had reduced movement during the night, went in for a ctg, which was fine but they got me back in the morning (38+5) for an extra scan, at which point they found almost no fluid, I was told to pack my bags and come back that evening to start the induction.

With DS2 I was pathologically anxious, partly because I tend to be, partly because of what happened with DS1, and partly because I had had a mmc quite recently. I'd asked to be consultant lead, and had asked for regular growth scans from 20 weeks, which they were happy to do. I think I had scheduled scans at 20, 24, 28, 30, 32, 33, 2 at 34 and 35 weeks. Plus some extras when I had a bleed at 26 weeks, and other various panics .

See above. there is no specific guideline so far as I am aware. It comes down to clinical judgement.

The earlier you are induced, the less likely your body is to co-operate, especially if it is your your first. Also, delivering before 37 weeks increases the risk of the baby suffering some complications of prematurity. That risk remains (although smaller) until 39 weeks.

This is balanced against the baby's risk of problems while it remains inside. No two cases are the same but careful watching, and quick decisions where needed, improves outcomes.

DD2 stopped growing -no change at all between fortnightly scan. She was 35+3. Fluid was low but not desperate.

The senior registrar and I disagreed on course of action. I was of the mind that as she couldn't tell me why this was happening and couldn't guarantee the safety of baby, I wanted her out. She felt watch and wait was suitable.

The consultant said both options were reasonable and as it was my baby, it was my choice. I was induced the next morning.

Thanks all :) well I'm due to see the consultant again next week so will try to pin her down a bit more then.