IUGR

[hsmom]

Hi,
I dont know if any of you guys are or have been in a similar spot. I am 23+1 and at my 20 week scan was told baby was measuring 2 weeks too small. I have since been to fetal medicine locally who diagnosed Symetrical IUGR + low amniotic fluid and a reverse flow on ductus venous.
I am v anxious as I lost my last baby at 21 weeks due to congenital heart disease and cant shake this permonition that it is all happening again.
Any advice, thoughts? I have booked an appointment at FMC to see Prof Nicolaides and hope he can give me some answers. At my midwife appt on monday she found a heartbeat.
Thanks for any advice or similar situations,
hsmom x

I will ask them on Monday. I have one in my green notes but they havent been plotting anything on it up to now.
Thanks for PM - I have replied.

Hello again, I am so pleased to read your news, been checking for updates! I am so glad your little one is surprising the doctors, hope she continues to grow and your pregnancy is long and dull.

Thank you! Long and dull would be great...
Will post again after scan on Monday.
xxx

Hope you are well. Should have said that the customised charts are for fundal height measurements only rather than specific biometric measures. Worth speaking to MW anyway - 30% of babies classified as under/overweight on the normal charts are actually within limits once maternal BMI and ethnicity taken into account. Good luck on Monday.

Hiya -
Hope you are ok and not climbing the walls too much!
Just back from my growth scan at birmingham. Baby continues to grow (a little). She now weighs an approx 550grams (vs 410 here 2 weeks ago) and growth is now apparently correlating to 'normal' growth patterns, although she remains v small

I have only just seen this thread.

It sounds like things are really looking up and I hope they continue to improve. Now your baby is over 500g, if they need to get her out for any reason it means she has a chance and every day she is inside you her chances go up. (generally they can't help babies under 500g as they are simply too small to be able to get lines in)

I'm not sure if you've considered contacting Bliss, the premature baby charity, or looking on their forum? If there's a chance your baby may be early it could provide you with important information and help prepare you. I also knwo there are quite a few ladies on their forums who had babies delivered early due to IUGR.

What a little fighter! That is really encouraging news. Stick to hospital with the best facilities. if you deliver earlier than 28 baby may well get transferred to the other hospital.

Hello- I am so pleased to read your news. I second Midori's suggestion about Bliss, lots of info and hand holding on the boards over there, and very useful booklets available.

I would stay at the specialist hospital. When DS was born he was about 23 week size and the consultants gave him the same sort of chance as a 23 weeker rather than the 27 weeks he was. He needed all the help he could get as the first few days were very fraught. He may well have got the same care at our more local unit but I was much happier being somewhere where they are dealing with babies that small every day.

Thinking of you and your little fighter. I hope she continues to grow.

thinking of u. Hugs

Thanks so much ladies. I will try to get them to transfer my care from local to the specialist unit when I am there next Monday.
I really cant thank you all enough though, for all your support and views. It really is so amazing to know you're not alone.
Thank you all, so much.
Will keep you posted.
ps - been on the bliss website - thanks for the info!

Hi hsmom I just saw this thread and wanted to add my story to the other encouraging ones as I know how good it is to hear them when you are going through it!

My 12wk scan with DS2 was perfectly normal, but at 20 weeks only his head measurement (barely) made it on to the chart, he seemed to be about 3 weeks behind. Dopplers were normal except for the reverse flow, which was absent, the significance of which no one seemed to be sure of at any time.

We were told the most likely explanation (by Prof Nicolaides team at Harris at KCH) was severe, early onset IUGR and the outlook was poor. His estimated weight was 120g and as you know, the target for delivery into scbu with a good outcome is 28wks and 600g....which seemed such a long way away. We had amnio, TORCH screens, achondroplasia tests done, all came back clear so we then continued to scan every two weeks (and torture ourselves with what awful conditions might be causing the growth restriction-please try not to do that too!). Like your little one, DS2 also seemed to defy expectations because he continued to grow at normal velocity, following a standard curve but right at the bottom, or below the chart. The prof suggested that maybe there had been some damage to placenta early on but that it had repaired itself..some amazing things can happen.

We made it to 37 weeks, at which point the fluid was low, so they induced me. DS was born weighing 4lbs but fine, no need for scbu, just 3 nights in hospital to
get his blood sugars up and treat a bit of jaundice with
light blanket. He is still, at 13m and approx 7kg just below the 0.4th centile but perfectly normal, developmentally on track (chatty, says mama, dada, sibling names, feeding himself, almost walking). He is the happiest baby I have ever met and so cute. Although we hope he will catch up in size, after such a stressful and seemingly never ending pregnancy we feel so lucky to have him. I really hope you have a similar story to tell soon, it sounds as if it may be heading that way . keep us posted, I will be thinking of you and wishing you well.

Hope your appointment tomorrow goes well!

Good luck tomorrow hsmom, thinking of you.

Hello ladies.
Just popped on before heading for another scan this afternoon.

Dear Sleepwhenidie - THANK YOU for such a wonderfully uplifting story. I really hope this baby does what your DS did. I am absolutely petrified that there will be something seriously wrong that will be lifechanging for us as a family (I know that sounds so selfish and to be honest I am a little ashamed of those emotions).
I am sooo delighted that your DS is doing well. Its amazing and indeed kind of echos what we are going through. Prof said exactly the same to me - placental insufficiency causing severe early onset IUGR.
Your story of getting to 37 weeks is uplifting for me. (I made it to 41+3 with my DS!!!). I have packed a hospital bag for me already (I have nothing for baby - it feels like tempting fate) as I am so afraid they will tell me to come in and deliver.
I am having a bit of a bad few days and can't get the dark feelings to go away - 27 weeks today so getting closer to that magical 28.
Can I ask you a question about your bump? Did you feel small? At school there is a woman who is 2 weeks further than me but she looks about to pop. My bump doesnt even stick out further than my boobs! Its irrational I know.....
Hey ho - thanks to everyone for your kind thoughts ref the appt this pm. Just a wellbeing scan today (so dopplers and liquor). Will let you all know how I get on.

Have a lovely day xxx

Good luck!

Your feelings are natural and don't feel guilty about how you are feeling. It is a daunting preg. and just concentrate on getting through each week.

Re bump size - this depends on mother's build and the amount of fluid, how baby is lying and size of baby. I am quite slim and have only put on a stone (now 35 weeks). Nobody can believe I am I am that far gone as bump is so small, and was in 1st preg. Baby is measuring fine though. So, don't worry too much about bump size.

Let us know how you get on.

Hi hsmom - please try not to get too down, your progress sounds very encouraging. Your little one should have a great chance of being fine if they had to deliver now-and it sounds like they are nowhere near doing that, given the growth pattern and dopplers.

In response to your question, yes I was small. Was third pg and I remember saying to DH at about 19 wks I was a bit worried that I could still fit into most of my clothes and couldn't feel movements. I never did get much movement either, I think it's because IUGR babies put all their energy into growing rather than kicking and wriggling!

If you want to pm me would be happy to chat more on phone or by email. Have to dash now but good luck for scan .

Hello all,
Quick update from my wellbeing scan yesterday.
All looking OK - phew - dopplers all 'normal', no reverse flow in the ductus and slightly more fluid than last time again considered in the range of 'normal'(deepest pool now 41.7mm). Baby was quite active and breathing a lot (took them ages to locate the ductus!).
Next appointment will be next monday for growth - and that magical 28 week milestone.
No indication of pre term labour, so as long as she keeps growing to the curve, I want her to stay IN!!

Does anyone have views on the steroid injection? My consult at the general suggested last week they give to me at 28 weeks, but consult at fetal med said he prefers to do before imminent delivery unless pre term labour is indicated. Saw some stuff on bliss site suggesting the latter is best. Thoughts?

Hope you are all OK.
sh77, I am thinking of you bored to bits at home! Take good care xxx

Hi hsmom just for info, I had almost all my scans at fmc and there was no mention of steroid injections at any point, probably because there was no point where early delivery looked imminent - which would tally with your FM consultant, so probably best advice.

Absolutely amazing! She is getting stronger and stronger by the day. Really v pleased for you.

I do research on prem babies. I would say steroids just before labour. The whole point of it is to help/mature lungs before birth. You may well carry to a longer date. Steroids is an influential predictor of survival.

I am doing well. Had my final scan today. Baby growing but will prob be smal, which is fine. I have weekly appointments until c-sec in 3 weeks. I have a few things planned and so that helps to keep my mind busy. Most of baby shopping is done.

That is great news, I am so pleased for you.

I had steroids before my son was born and I am sure they made all the difference for him, but it was only about three days before delivery. I am no expert but a few things I have read suggest that the benefits wear off over time, so the closer they are to delivery the better. But balanced against that is the fact that they like to give two doses 12 hours apart so in a true emergency situation they can't do that.

I was always small too, in fact my midwife measured me small which was the first indicator that something was wrong.

Looking forward to more good news next Monday!

What sh77 says about the steroids. I was offered them last time out at 28 weeks but was advised against them unless I showed definite signs of PTL. As it happens I had PTL at 34 weeks (had them then - right on the cusp of "usefulness" and DC2 was born at 35 weeks.

The benefits only last a week or so, so timing is critical.. BUT.. you also need enough time to get the things in, so it's a really tough call to make!

Very glad to hear all is looking good and yay for nearly 28 weeks!!

Thinking of you hsmom. Hope all is well.

Hi hsmom, did you have a scan yesterday? How did you get on? Hope all is going well.

Hi All,
Sorry I didnt get on last week. Half term madness with my 7 year old.
Yes - I had my scan last week - thanks for thinking of me. It was all OK - running on average about 3 weeks behind at 28 weeks, but I actually had some better measurements than I expected. She came up at 820grms, which seemed such a huge jump from the 560 of previous time.
Other measurements keeping track with 'appropriate' growth.
Still not decided ref the steroids. Have been seriously considering amnio as I am petrified that there is some other 'reason' for all this. Just cant decide though. I guess i would have the steroids if I were to have the amnio as a just in case.
Got another dopplers scan this afternoon, so will let you know how I get on.
Thanks a lot,
hsmom xxxx

Glad to hear the weight is still going up! I am also considering a late amnio for mine (due to bad bloodwork at 12 weeks) at 32 weeks - yes, there is a risk of PTL but I don't believe it's any higher than the risk of losing the baby earlier. However if they offer steroids to go with the amnio, take them just in case given you already have concerns!

Hopefully it is just a placenta thingy though and all is perfect with the baby :)