Growth scan at 36 weeks

[gubbinsy]

Saw midwife today for 36 week check. All been straightforward so far but today measured 34cm so sending me for growth scan. Heartbeat was heard and seemed fine and still wriggling. She said it was probably nothing to worry about and it's due to new growth charts - previously she wouldn't have referred unless 4cm under but of course I am worried!
Can someone tell me this is normal?

They refer automatically now if +/- 2cm... Which frankly could easily be a measurement error or caused by baby position.

Try not to worry too much as the chances are everything is fine. Think of it as a chance to see your baby again.

Thanks - that's what I'm trying to do! Keep feeling fine then having moments of anxiety bubbling up!

Ladymedea - what is the guidance about automatic referral for a growth scan if plus/minus 2cm please? My fundal height measurement has been all over the place since 28 weeks (measuring 3cm ahead at one point with no increase over the last two visits which has brought me back down to where i should be at 34 weeks) and my midwife has not expressed concern or growth scan. The tape measure method seems like quite a blunt and not very accurate way of measuring growth so I'm surprised to hear that a difference of 2 cm would trigger an automatic scan (esp in these cash- strapped nhs times). OP - consider yourself fortunate that your midwife is keeping such a close eye on you - I would be reassured with this! Hope your scan goes well.

You should have a personalised growth chart in your notes which shows the curve the growth of your bump should be following. Certain levels of deviation from this would be investigated. The criteria in my area are on the page alongside the graph.

I agree it's a very blunt tool, but additional scans are quite reassuring - I've had two now as in measuring large, which they've discovered is due to excess fluid (polyhydramnios).

Research obsessed me pulled that out of my brain and now I'm annoyed as I can't find the source - it's not in NICE or RCOG guidelines. The latter suggest referral if any single measurement is below 10th centile or a measurement crosses an expected centile.

I hadn't heard about the personalised growth chart - it's definitely RCOG best practice as I just found the recommendation... Just a standard one in my notes which is a bit crap.

Will continue looking for where I got that info from... Now I'm starting to doubt myself and think that is the standard error range rather than referral guidelines.

Ok ignore me, I can't find it.

The key thing is if it has shown static growth they may refer... Which may be the case for OP.

Thesunrising - I was thinking the same. Mine has gone from 95th centile to 5th with no growth in a few weeks then shot back up to top line but midwife didn't seem worried at all, unlike me and dh! An automatic scan referral would have been very reassuring. OP, I wouldn't worry it sounds like this is fairly standard in most places, at least you're getting to see your lovely little one again :-) and it's reassuring your midwife is so on the ball x

Thanks all. Bump has grown still but gone from 90th febrile line on personalised growth chart to just above 50th so guess that's why. Just hoping scan date comes quick!

Febrile? Meant percentile!

I always think that having a scan is reassuring. After all, if there was any problem with growth, you would get it picked up. But at only 2cm behind, that's not the most likely option.

To give you my experience, when I was 40 weeks with DS1, I measured 34 weeks. I was sent for a growth scan like you. He was 8lb at birth.

I measured 32 weeks with DS2 at full term. After my experience with DS1, I wasn't even scanned (my hospital did 34 week scans as standard and his growth had been ok then). He was nearly 7 and a half pounds.

I have on my notes that my bumps tend to present small. Alas, the same cannot be said for my pregnancy thighs.

Hope all goes well and the rest of your pregnancy is uneventful.

Thanks Ruby - that's reassuring! Anyway, scan tomorrow so not too long to wait. The rational bit of my brain knows that it's probably all fine and just the way it's sitting and/or the way my bump is. Just keep having to sit on the anxious bit and tell myself to stop being silly! Really appreciate all your comments.

I was suddenly referred for a growth scan at 39+6 as a dr at the hospital measured me at 33cm. the day after ds was born weighing 8lb1 so while its good to be safe it can be very unpredictable (also growth scan estimated 7lb3 but he was too squished up by that point to do it properly really!)

How did it go Gubbinsy? Hope all is well.

Hope all is well I think it's just a way to pick up possible issues. I measured 32 at 32 weeks and 35 so then referred me for a scan and baby was well over 98th percentile abs weighed 8lb14oz when born so fundal height it really not an accurate measurement.

Sorry not to have updated. Scan was fine - but I managed to get myself into a right state about femur length measurement - both AC and HC around the 50th centile line - femur down at about 10%. Asked the midwife who looked at the chart and then said 'oh did you have your down's test?' at which point i had a meltdown (was a bit stressed to start with plus we're moving house this week so lots going on!). Anyway, ended up going to see the consultant yesterday to talk through all the measurements and she reassured me that it's all within normal ranges and that any risk (was low risk after quad test) hasn't changed. Said could have amnio/CVS but there was nothing there that would trigger them thinking I should and really, it was something to think about only if we'd consider terminating to which my answer was definite no!

Was all quite stressful - just wished first person I'd asked had explained as she did and said it was normal before saying anything about it being a soft marker for anything else.

Feeling much better again now and just hoping that bump has grown enough at next appt to not trigger another scan! They estimated weight at 5lb 11 at 36 weeks so a reasonable size if not massive - also bearing in mind what you've all said about the accuracy of scans anyway at this point!