Baby measuring very small at 32-week scan

[BeeBread]

I've just come back from my 32-week scan, which was all generally fine (heart, brain, kidneys, blood flow in good working order etc) except that the doctor said at the end that he wanted to book me in for another growth scan in 4 weeks because the baby's abdominal circumference and estimated weight were on the 7th centile.

Looking back at the 22-week scan, he was around the 20th centile for weight I'd say. So he has never been big but seems to be dropping down.

The baby's femur length is almost on the 50th centile so he's not particularly petite, length wise. His weight is out of proportion to his length - ie he's very skinny.

I feel at a bit of a loss as to the implications of this - the doctor didn't seem too worried, which obviously is good, but equally he didn't give me any advice beyond the basic statistical information.

I don't know whether I should be doing anything different? Is there anything I can do to help the baby put on weight? I am eating lots and have put on plenty of weight myself, so don't think that's the issue. If he's still small (or smaller) at the 36-week scan, what will they do about it?

Sorry - bumping because I'm worried.

Bump. Anyone around?????

I would say firstly, that if the doctor didn't seem worried, then I wouldn't worry. Could you call your MW to see what they tell you - they might be able to put your mind at rest.

My thoughts (non-medical!) are that some babies will be on the 1st centile, others on the 99th. Babies, like other children and adults, grow at different rates which is why scans for dating are not completely reliable after about 12 weeks (the point babies stop growing at the same rate). Some are born squat and chubby, others long and skinny (like DD)

I don't think there's anything you can do to make the baby gain weight. See what they say at 36 weeks - however at that time you'll only be a week off full term, so if they do have concerns for any reason then at least you'll be at a point where you can discuss doing something if necessary (eg induction, extra monitoring)

What was the reason for you having a scan at 32 weeks, as that's not routine - was that due to concerns over the baby's size based on fundal measurement?

I have heard that sonographers can be inaccurate 20% of the time. Measuring the abdominal circumferance is never going to give the perfect weight, and measuring it in the womb on a moving baby, one snapshot in time probably explains why there are mistakes or errors made.

There are plenty of stories of people being told they are having big/small babies and it not being the case.

Thanks for the replies. I'm so unused to this because DS came out at 8lb1 and has always been extremely chunky - this is all very alien territory for me. I know that it could just be that the baby is naturally a little tiddler (which is fine by me as I'm only 5ft 1) but I'm not doing brilliantly at being rational about it...

The 32-week scan is now routine at King's in London, so there were no previous indicators; I hadn't even noticed (or thought it was significant) that the baby was on the light side at the 22 week scan.

I've been reading a bit about intrauterine growth restriction which apparently applies to foetal weights under the 10th centile. Most of the potential causes don't apply to me - I don't drink, smoke, haven't got high blood pressure or diabetes, and the scans haven't revealed any congenital conditions which would cause the baby to be small.

The remaining possibility is that the placenta/cord aren't great, which may mean that the baby is ok now, but could be at quite serious risk if that gets worse. Whilst I'm glad on a number of levels that the doctor was relaxed, I'm also a bit that I'll be left unmonitored for another 4-weeks.

My midwife only works Tuesdays so I might try to see my GP before then in case she can put my mind at rest.

DS1 was said to be ~98th percentile at the 32 week scan. That was based on crown & tummy circumfs, iirc.
They kept saying how I was "tall" or "fit", hence why my bump didn't look very big.
Only MW looked puzzled a few days later, "He doesn't feel that big" she said.
He was born on the 9th percentile at 39 wks gestation.
I don't have a lot of faith in scans, can you tell!!?

there is a link between IGR and pre-eclampsia - for me the drop in growth came before pre-eclampsia - but obviously not in all cases - just make sure if any headaches that don't go away with painkillers, visual disturbances etc you go and get your BP checked asap! As the told me when the weight first drop on scans babies often catch up again if they scan in 4 weeks, so might be nothing at all just babies position etc!
x

DD was 75th centile at her 32 week scan, and 2nd centile at the 36 week scan. Nobody seemed worried as her proportions had stayed vaguely the same. I think they only worry if, for example, the body remains small but the head suddenly grows huge, or the stomach grows out of proportion to the body etc.

By the way, she was born at 41 weeks weighing 10lb 5oz, putting her on the 99th centile. So I don't think they are particularly accurate.

Sounds a bit like my scans, especially the first - I tend to have long thin babies.

As well as measuring the growth, did the scan do blood flow - looks like lots of bright colours blobbing around on the scan (technical term!). This looks (I think) at the condition of hte placenta and the blood flow through the cord.

Oh - and each time I have a growth scan for a baby I get told the accuracy level - around +/- 50%, so its indicative I guess rather than accurate. What they are after is the general trend in growth and not a snapshot image, hence the additional scan. Our first was IUGR but like you had non of the possible causes - sometimes it just happens and he was fine when he appeared (apgar of 9). Everything about that pg was small - baby, placenta, fluid. All healthy though.

hth and it goes well at the next scan.

I do like the idea that the scan might be wildly inaccurate and this could all be something about nothing! Cuppa I think yours takes the - from 2nd centile to the 99th, wow! All of this does make me feel a bit better.

They did check the blood flow to the placenta and that was okay too, so I've no specific reason to think that that is the problem - I'm just grasping at straws a bit.

The pre-eclampsia point is interesting. My DM had quite severe pre-eclampsia with both me and my brother, and so I watch out for it but actually my blood pressure has been pretty low (around 100/60) for much of the pregnancy.

However, at today's appointment and when I saw my midwife on Tuesday it had gone up to 120-something/75, which by itself is fine but a bit of a jump, so I will dig out my blood pressure cuff and keep an eye on it I think.