Inconsistency In Growth At Scans?

[midori1999]

I am at risk of fetal growth problems due to a number of complications. I also have GD.

At 29 weeks I had a scan which said baby weighed approx. 1.6KG. Then at 31 weeks 1.9KG, still a good weight for gestational age, but dropped from 75th to 50th centile roughly.

Then at 33 weeks the scan showed baby weighed approx. 2.5KG, with a BPD of 86mm and AC of 311mm.

Yesterday ( 34+5) I went to the DAU as I had had reduced movement for a day or so. Typically baby started moving loads as soon as I got there although they did a trace which was fine, lots of movement and heart rate rising during the movements, which is what they like to see apparently. However, they also did a scan and I noticed the number of weeks given for the measurements was less than at the previous scan, BPD was 85.7mm and AC was 308.5mm. I queried it and the doctor says 'the EFW is 2.8KG is that the same as before?' I said, no, the EFW had gone up.

I know scan measurements are just an estimate and I am not too worried, obviously the baby can't have shrunk, even by a tiny bit in 11 days. However, I am confused that the EFW given was higher although the measurements were smaller?

I am a little concerned that even allowing for errors etc baby may not have grown much. My blood pressure has gone up slightly (from 120/80 to 135/90) and there was trace protein in my urine last night. Doppler scan was fine and AFV was fine last night and at last appointment. I am going to query it on Weds at my appointment, and they'll scan me again then anyway, but I can't help but worry a bit, although not overly so, baby is moving as normal now (which is lots!) and it's only a couple of days to wait.

Has anyone has similar though or can anyone offer any advice please?

Hi midori, from what I've been led to believe, growth scans can be (scarily) quite inaccurate - we had one at 28w (as I have renal hypertension making me at higher risk of pre-eclampsia) where the sonographer recorded measurements prompting the Consultant to worry and request another at 30w as he would need to see if the growth had slowed / stopped pretty quickly.

When we went at 30w, the measurements appeared to have caught up by 6w gestation in the 2w period, obviously impossible to have caught up by so much in so little time. The Consultant now thinks the 28w measurements were wrong after we had another at 34w showing good measurements.

As long as your LO is moving well I think you should try not to worry (as this will increase your bp) & relax, hoping you find out more on Wednesday.x

Thanks for replying.

It seems so stupid they rely on scans to diagnose growth problems when they can be so innacurate. Trying hard not to worry, my appointment is tomorrow, so will see what they say then.

Hi midori, how did it go?

Hope it went well for you.x

Just to emphasise the inaccuracy of growth scans - my LO was measuring 2.5kg (5lb 8oz) estimated fetal weight at our 34 week scan, he was born on Wednesday at 37+2 weighing exactly that!

Yes, I am worried about growth myself. I am under consultant care for having preeclampsia with my first (born at 36 weeks, weighing 5lbs though estimated almost 7lb).

My baby's growth had slowed from 50th centile at 23 weeks to 20th at 28 weeks and now I'm due a scan in a week to check for placental insufficiency. My pressure is fine and dopplers were fine.

She said not to worry 'yet'. Yeah....

I have definitely got bigger (I am skinny this pregnancy compared to fat with the last, and people's comments about how small I am have made me paranoid) in the past week and have put on two pounds and it's not on my body so I'm hoping she has caught up.

Very best of luck. It's given me some perspective reading the replies.

wiiunfit, congratulations on the birth of your baby!

otchayaniye, how do they check for placental insufficiency, other than doing a doppler? I hope things are OK with you.

I have given up on growth scans a bit, tbh. On my normal appointment following my DOU appointment, it showed that growth in fact hadn't changed since my scan two weeks prior. Everything else seemed absolutely fine so they sent me away to be re-scanned a week later (last wednesday) and said try not to worry. Last Wednesday's scan showed baby weighing approx. 6lb 13oz, which would have meant a gain of approx. 1lb 3oz in a week! My blood pressure was astill a bit high, so they sent me to the midwife on the Thurs, when she sent me to the DOA again as baby's heartbeat seemed a bit slow with a hand held 'thingy' and all was fine. They scanned me in the DOU again on Saturday and did a doppler, CTG etc and all was fine and baby weighed approx. 7lb, which ties in with the scan 4 days previously.

I just don't believe my baby didn't gain for two weeks and then gained 1lb3oz in a week. The obs themselves have said the scans can be 'way out' so I am taking them with a pinch of salt. A big one!

"otchayaniye, how do they check for placental insufficiency, other than doing a doppler? I hope things are OK with you"

Thanks, and I hope it all goes well for you -- obviously you are further along and your baby is a good weight. I am worried as at 28 weeks baby was just over a kilo so wondered if my placenta starts to knacker,

Yes, they use a doppler but consultant implied that she expects this could be the start of placental insufficiency. Obviously I am a bit worried and hope I can keep the baby in for at least 6 weeks. Having a baby at 33 weeks and having a baby at 36 weeks is often a completely different thing. My first was born at 36 weeks and it was fine. Breastfeeding fine, no special care apart from lights and went home in 48 hours.

My main worry is breastfeeding a very small baby. It's one reason I am continuing feeding my toddler. So I have milk in as I am a lousy expresser.

All the best. I think even if you gave birth now it would be ok.

And yes, of course there is going to be some inconsistency. They reckoned my daughter was 2.7 kg at 36 weeks and she was 2.5 kg at birth.

I'm worried about the risk of complications, but I am 37 weeks tomorrow, so not at all worried about having a baby now. In fact, having had twisn at 23+5 last year, 28 weeks would have seemed wonderful to me at the time! (obviously it's not wonderful, but compared to 23...)

I think around 1Kg is average for 28 weeks though? Certainly a friend's baby was born at 28 weeks weighing just under 2lbs and she is absolutely fine. (she had placental abruption at 24 weeks) I know that doesn't really help though when you're in your situation. Hopefully it'll turn out to be a false alarm and baby will stay in and thrive until term, but I do know it's extremely hard to think of that if there's any chance at all something will go wrong, especially if you've reason to worry.

Are you on asprin?

Thanks Midori - no not on aspirin (should I be? Shall I ask?) And yes, I have got my head round having a baby now (I'm a fan of worst-case-scenariorising) and yes it would be ok, as you say.

The weight is ok for 28 weeks, it's more that it has slipped down the centiles. Which is why I was interested in this thread as it could simply be down to the inconsistency of scanning to gauge exact growth.

I guess I'm just expecting placenta insufficiency as my dopplers early in pregnancy tipped me for it with a 30 percent risk. That coupled with the dropping of growth levels I think has made me accept it may be happening, and the way the consultant spoke about it made it almost seem a done deal. She wouldn't be drawn on how long I could keep her in. It's all wait and see. Which as you'll know is tedious and worrying when you think you have got over the hump and should be lying on a sofa necking violet creams reading magazines (well, actually I have a toddler, so dream on...) instead of continually schlepping to hospitals and peeing in 5 litre canisters.

But I'm grateful they are looking after us and can't fault the NHS care (had my first abroad privately by a really outstanding doc)

All the very, very best to you.

This baby went from 75th/80th centile to 30th, and is now back on the 75th again, so hopefully the next scan will be more encouraging for you. Be interesting to see how big baby actually is when born (I am booked for induction on 24th June) compared to what the scans say. Also, they are only estimating from BPD and AC with me, I know it is a lot more accurate if they also measure HC and FL as well.

I don't know whether you should be on asprin, but I have been on it from the start. That is due to a blood clotting disorder I have and for that asprin improves the chances of a positive outcome to a pregnancy from 20% to 80-%, but I asprin is though to improve placental efficiency and is certainly used often in ladies with recurrent miscarriages where there is no apparent reason because of this. I think clots are a common cause of problems too, even with no clotting disorder. As far as I know, there are no negatie side effects known at all, so it might be worth discussing with your consultant as it might be that you have nothing to lose by taking it, even if there is no obvious reason to?

Ah, interesting you say blood clotting disorder. I have never had one I know about but the midwives always ask if I'm on aspirin as my blood flows a lot and takes ages to stop when I am tested.

Again, all the best!

Sorry ladies, just catching up! Thank you for the congratulations, I still can't believe he's here & he's sooo perfect, currently fast asleep next to also fast asleep DP!

otchayaniye, yes - ask about Aspirin asap, it thins the blood and makes things a little easier on the placenta iirc. I was on 75mg (the "baby dose") until 34 weeks.

midori, my LO's femur length was taken into account & was measuring behind by a few weeks at the last growth scan we had, his weight was still overestimated so I'm not sure if I'm honest!

I think it's important for you both to try to think like I did - the Drs know you have this potential problem so you're not going to be forgotten about & they will be keeping a very close eye on you.

Best of luck to you both. :) Lots of Un-MN type hugs.x

Oh, hugest congratulations wiiunfit