Should I delay growth scan? Thoughts please!!

[Galmum]

Recent growth scans have shown a really big baby.
I am due for a final growth scan this Thursday pm. I will be 36+5 weeks. I've then got an appointment to see the consultant on Friday morning to see the consultant to discuss how long they'll let me go before inducing me.
It got booked at my last appointment before xmas, when I saw the registrar. I was in a bit of a state for different reasons and did n't really ask why it had to be then. It seems very early to me to be making the final decision, as she made it clear that they would do nothing before 37 weeks (at the earliest). I'm wanting to avoid really early induction if possible, without endangering the baby.
I've had 2 scans recently - one to check growth and then a further one to check some abdominal issues with a Professor. All is fine with the baby...it's just big. I'm 5ft 9" by the way and this is my second baby. My ds was 7lbs 8 at 39+2 weeks and a vaginal birth.
scan - 33+4 weeks est weight 7lbs
scan - 34+4 weeks est weight 8lbs
femur length, abdominal circumference, weight are all above 95th percentile, rest of measurements at 95th!!
I'm thinking of cancelling the scan and discussing it with the consultant on Friday. If they do feel the need to scan asap. Then they could do it early the following week. I'm hoping the growth will have slowed off and it was an early growth spurt.
At my last scan, the doctor scanning me said my best chance of delivering the baby naturally, was if I went into labour without medical intervention. She said that hopefully I cook on the early side, as she thought it extremely unlikely that I'd be allowed to go to full term.
Any thoughts? I'm going from feeling v.positive one day (as I'm making a big effort to be as prepared as possible - practising breathing, labour positions, visualisation , perineum massage, yoga, raspberry leaf tea etc!!) to be pretty terrified the next.

Why do they think you wont be able to deliver?
How do you feel?
My last DS was born at 38weeks weighing 9lbs 13. I did have a late scan, but no real concerns about delivery.
Sorry if I missed something in your post

The first thing to bear in mind is that scans to establish fetal size can be wildly inaccurate - a couple of pounds either way. Has there ever been any suggestion that you're suffering from gestational diabetes?

Did you know that the Royal College of Obstetricians and Gynaecologists/NICE guidelines do not recommend induction because of a suspected large baby when the mother is not diabetic? They say there is inconclusive evidence that it reduces problems for either mother or baby, so it might be interesting to know why your consultant thinks it would be a good idea for you, if indeed he does.

What was your first labour like? Did you have a spontaneous vaginal delivery or need forceps or ventouse? You're tall so it seems likely that you will grow big babies and be able to birth them too. Lots of people have big babies with no problems at all (I had a 10lb 13oz one last year, I know of 11 and 12lbers born naturally)

Please also be aware that there is no such thing as being 'let', 'allowed' or not 'allowed' to do anything. This is your body and your baby and it is your decision about whether to be induced early or not. Doctors can give you information and their advice, but it is not up to them to tell you what to do.

I suppose the questions with the scan is what extra information is it likely to give you? Chances are the baby is still going to measure big. I think it's a pretty poor show that you're expected to have a scan and see the consultant on different days too.

Don't worry about the scan. Before I was induced (for other reasons, not size) they gave me one and said ds would be 7.5 lbs. When he was born the next day he was 6 lbs. 1 oz.

I don't think there is a problem in you having another scan - they are wildly inaccurate and you can always bargain with the consultant for a date to deliver - you have the right to say no - they can offer their professional opinion why they should deliver you early - but they can;t force you - not being scanned or being scanned is not really the issue - you can jsut cancel it that morning, then go to the consultant appt as arranged, and then if they are desparate to scan you - they could do it that day! It seems daft to have to go to the hospital twice in one week - too much stress on the body!!!! Just play awkward! I had a scan with my last buba at 36 weeks, but they let me go full term (I have gestational diabetes) - the scan is more than likely to show a 'big' baby now as much as before - so let them do it the following week!

I have been quite bolshy with my appointments - getting them at times to suit me, etc - wouldn't have dreamt of doing that first time round - but you soon learn!

Don;t be bullied into anything - we have the power!!!

Thanks Ladies...helped confirm my feelings.

I definately do not have gestational diabetes - I've had the GTT test twice and it has been fine.

My understanding is that the concern is based on the fact that 2 separate scans at 2 different hospitals show a really large baby for age and that if the baby continues to grow at the rate it has, then I could have problems delivering it vaginally i.e. the shoulder thing. I know scans do vary widly, but I have to be honest I'm inclined to agree...I've been measuring big for ages, my bump is HUGE and my god the baby feels big - very different to when I was pregnant with my son!

I did not know that NICE guidelines don't recommend an induction for a suspected large baby. Thanks for the info. I'm definately going to cancel the scan and talk to the consultant about it. He was a lot more chilled about the whole thing than the registrar, so I think I'll end up feeling better about it all.I can have one later on if need be. On the whole I'm feeling more positive that I did a few weeks ago. I do want a natural birth if possible.

I'm not an overly anxious person, but my gorgeous son died this June of cancer, 2 years after being diagnosed. He was 3 years old. I'm an old hand at dealing with the medical world, having at points lived in hospital with my son. I've got no problem challenging or dealing with medics at any level!! We were lucky to be treated by some world class doctors and nurses. However you can imagine that having a healthy baby is the most important thing to me....much more important than getting the labour and birth I want. I know what it's like to be the 1 in a million that life goes horribly wrong for.

PS To be fair to the hospital - the ultrasound dept has a training day on Friday, which is why I can't be scanned on the same day!!

The problem is that if you have a scan and it shows (however unreliably) that the baby has grown again, you have to live with the anxiety it causes...vs the anxiety of not having a scan and wondering if you have done the right thing or not. It's such an anxious time this anyway, but for you especially, I can't imagine how much stress you must be feeling. What does dh think? People do give birth to big babies (I know more than one person who has vaginally delivered 10+lbers without assistance, and two were first timers, rather than us saggy 2nd timers ) so a big baby doesn't automatically mean curtains. I think a long talk with the consultant is a really good idea, go with your questions written down in advance! I don't know what to say about the scan, though. I can see it both ways - sorry, that's really no help is it?

Oops, sorry, x-posts

Galmum, I'm so sorry to hear about your son.

The only thing I would say, is that induction and other interventions, as I'm sure you know, do have their own risks and are no guarantee that everything will be fine. I think the key thing (in terms of induction/wait and see) is that you make a decision that you feel comfortable and happy with. You can also take things day by day, or week by week if you want, you don't have to make any final decisions now. If, for example, you say no to induction at 38 weeks, you can always see how you feel at 39 weeks or at 40 weeks. Here's hoping you go into labour spontaneously before that though!

Good luck, please let us know how you get on!

what daisy said she is tres clever, no?

You're a wise old bird yourself Lulu

Thanks Daisy and Lula,

I'm going to take it day by day and atleast by cancelling the scan and discussing it further with consultant, I'll keep buying myself more time. Going to get dh to come along on Friday.

Plan A is definately to encourage LO to come of it's own accord! I'm going to try everything ....even managed to have sex with dh today. Not an easy task with the size of my bump!

I'm going to keep thinking positive about LO arriving soon - baby was head down and anterior at last appointment, 1/5 head engaged in pelvis (I know it can pop out but better than nothing), getting slight period type pain and I got the feather duster out today with a desire to clean picture rail and behind radiator in hall - got to be a good sign!

Induction concerns me as much as having a big baby to be honest. I ended up on syntocin last time - my waters had broken with meconium in them and I was under time pressure for delivery. We fended them off as long as we could, but at 7/8cm they insisted on putting up the drip. I had been handling things fine until then. I did n't have an epidural (because I was stubborn like a mule!) , but the pain and retlentless contractions were unbearable - I ended up on my back, being monitored constantly, v.immobile and stressed. I really don't want to experience that again.

Thanks Daisy and Lula,

I'm going to take it day by day and atleast by cancelling the scan and discussing it further with consultant, I'll keep buying myself more time. Going to get dh to come along on Friday.

Plan A is definately to encourage LO to come of it's own accord! I'm going to try everything ....even managed to have sex with dh today. Not an easy task with the size of my bump!

I'm going to keep thinking positive about LO arriving soon - baby was head down and anterior at last appointment, 1/5 head engaged in pelvis (I know it can pop out but better than nothing), getting slight period type pain and I got the feather duster out today with a desire to clean picture rail and behind radiator in hall - got to be a good sign!

Induction concerns me as much as having a big baby to be honest. I ended up on syntocin last time - my waters had broken with meconium in them and I was under time pressure for delivery. We fended them off as long as we could, but at 7/8cm they insisted on putting up the drip. I had been handling things fine until then. I did n't have an epidural (because I was stubborn like a mule!) , but the pain and retlentless contractions were unbearable - I ended up on my back, being monitored constantly, v.immobile and stressed. I really don't want to experience that again.

thanks again - feel so much better!

Sorry! Double post!

Galmum,

How big was your last baby? Did you need forceps or ventouse last time?

When you say that some measurements are above 95th centile, are they above the 100th centile (ie; off the graph)? If not then rememebr that anything above the 95th, but not off the graph is NORMAL! Flipping doctors.

Its true about NICE guidelines not recommending inductions for large babies unless mum is diabetic. At my local trust they wouldn't induce early.

Only 7lbs 8 and no assistance needed.

Sorry I should have written 100th percentile not 95th - yes abdominal circumference, femur length and est weight off the graph. Others at 100th percentile.

going to talk to consultant about it on Friday - can scan again following week if needed.

Sounds a good plan to me - good luck.

Galmum,

Sorry to hear about your situation - yhe last thing any of us need is additional stress towards the end of a pregnancy. Hope everything goes ok for you though.

I hope you don't mind me asking, and feel free not to reply to this, but, I've also been tols that I'm having a big baby, but I'm a bit confused about the measurements. I don't actually know what constitutes 95th/100th percentile etc, so I can't really gauge for muself how big the baby is. I had my last growth scan at 32 weeks and am now 36+1 weeks. I was just wondering whether you'd be able to tell me the number of weeks/exact measurements/actual percentile that you are experiencing so that I can have a better idea of mine. I won't be offended if you'd rather not say!

Hi harry2007 - I feel so much better about it all today - just getting it all off my chest on MN and having a really good chat with dh has really helped. I have a memory we have talked about big babies before?? I'm due on 27th Jan and I think you're nearby as well?

I have my scan info recorded in different ways - my local hospital (where I'm having the baby) have a blue result form they have stuck in my notes and they have marked the measurements on the graphs that are part of my medical notes. You could take your results and mark up your notes to get a better idea. UCH (where I was referred to see the professor) produce a report where they include the graphs. By the way - I was referred to see the Prof because the baby's liver looked large and my son had a childhood liver cancer, not because of the size of the baby.

I hope this helps rather than confuses!

33+4 weeks
Head circumference - 333mm
abdominal circum - 350mm
femur length - 71mm
biparietal diameter - 86mm - don't know what it means

34+4 weeks
head circumference 335.5mm
abdominal circum - 361mm
femur length - 74mm
biparietal diameter - 92mm
est weight - 3664g

I don't have specific percentile for each measurement - just when it's plotted on the graph you can see it in relation to what I'm assuming is either the 0/50th/100th percentile lines or the 5th/50th/95th percentile lines - the lines are not labelled.

Has this helped in any way??? I'm going to ask the consultant to clarify the percentile thing on Friday. Can let you know.

Just to add - the ouside lines on your graphs will be the 5th and 95th percentile respectively. The freakish way statistics are worked out means that they would never be able to show the 100th or 0th percentiles. It's still worth remembering that this means that 5 in every 100 babies (and there are hundreds of thousands born each year)will measure greater than the 95th percentile. Obviously the further your measurement is away from the line the more unusual the baby's measurements are but factor in the 25% error rate too. A baby measuring 10bs by scan measurements could actually be between 8lbs and 12lbs. Looking at your actual measurements in mm Galmum you can see that the increase in every dimension is far less than 25% - this means that the difference might well be down to the scan machine and operator error (which is not the same as incompetence) and also the slight differences in the way the baby will have been lying at the times of your two scans. Ultimately the scan will only be a guide - one which will help a skilled clinician make a judgement about the likelihood of you birthing your baby vaginally. They'll need to consider your build and fitness levels as well. My own thoughts would be to go for the scan - otherwise the consultant will be trying to make a decision and advise you missing some of the information they need.

Thanks for replying Galmum.

At 32 weeks, my measurements were as follows:

Head circumference - 330mm
Femur length - 64mm
Abdominal circumference - 320mm
BPD - 87mm (don't know what it means either!)

If th top line demonstrates the 95th centile, then my measurements are truly massive!

I'm due on the 28th but I have a Consultant appointment on Monday to scedule a CS due to severe SPD - can only part my knees 9cm and with this whopper of a baby, I don't think that'll be wide enough for some reason!

Harry - just had a look at the charts - I think you beat me on a few measurements! Go girl! Has made me feel better than someone else out there looks like they have a whopper! Sounds v.sensible to be having a cs.

Can't imagine how you are managing with a big baby and severe SPD - I'm sure it's not helping. Sending all my sympathies!

Thanks ForgottenFreeTime - you dron't have to reveal your true identity, but you sound very much in the know! Possible a medic or close relationship to one me thinks! You make absolute sense. I've got no doubts about the skills of the scanners and totally understand how these things are only estimates and how things can legitimately vary. They have been really good to me - one was a consultant and one a clinical fellow with prof in the room. I can't get better care than that. Having been in the hospital system with my son for the last 2 years - we always used to see the differences in blood results between different labs.

I'm not going to the scan on Thursday - (cancelled already as I wanted to give the dept time to fill slot) because I feel it's too early to be making the final call. I would only be 36+4 weeks. I do want another scan, but post 37 weeks seems more sensible. I've seen the consultant once and he seemed really nice. He actually fully read my notes before walking in the room, so he knew that my son had died in June of cancer. I know it may mean he has to see me again the following Friday, but I hope that in my circumstances he'll understand and be sympathetic. I am a bit of a medical Mum - I've been totally involved at every stage with my son and used to discussing everything from changes in medication to when to best time to do surgery. I'm sure they'll understand if I've interferred a bit. I'm big on being nice, polite and empathetic to medical staff - it comes from having spent so much time in hospital!

Thanks for clearing up the percentile thing for me & Harry.

Harry - keep us posted - on here or on the antenatal thread on your planned cs date. Can't wait to see how big these babies actually are! My Mum brought down baby clothes for 3-6 months yesterday because it's a big baby. Thanks Mum - it's big but not that BIG - she's a complete nutter!

Harry - meant to say - I realise that you're having a cs, due to severe SPD not big baby.

Just wanted to let you all know - saw consultant today. Lovely friendly kind man.

He was happy that I cancelled the scan and does n't feel the need to do one at this stage.

He's not going to induce me before atleast 40 weeks + a few days. In fact he took the time to explain how studies have shown that early induction of supected large babies does not make labour or the outcome any better for women or the babies!

He wants me to go into labour spontaneously and is confident I can deliver a big baby. I'm seeing him weekly from now on. He'll review the situation each week and if anything crops up, we'll discuss it then.

Totally different experience from seeing the Registrar last time, who was friendly, but scared the shit out of me with talk of possible early induction at 38 weeks, cs or being allowed to go to term, but then there would be concerns about the shoulders getting stuck.

His attitude had made me feel soooo happy and positive about this birth. It really has lifted a big weight off my shoulders. I feel that I can do this now.

Yay, sounds like a great consultant! I'm so glad that you're feeling more relaxed and confident about it all.

Glad you had a positive experience with your Consultant Galmum. Mine was excellent the last time I saw him too - just hope things will go as well on Monday when I see him about booking CS.

I've had the same experience as you with Registrars though - they do tend to be over cautious IYKWIM. They don't like to give a definitive answer, they just give all the options, including the worst case scenario. Probably because they don't have the auhtority to make the final decision anyway.

Can't wait for it all to be over now TBH. Really excited about seeing the LO. I have no idea what size clothes to take into hospital for the baby though. I know he's expected to be huge, but how much difference will it make if he comes at 38 weeks instead of 40 weeks? Anyone have any suggestions?