IUGR baby

[user1487941567]

I am 28 weeks pregnant with DC3. Very short gap between DC2 & DC3, I got pregnant when DC2 was just under 6 months which the literature seems to suggest might be a factor.

I have been scanned a lot due to previous preeclampsia and DC2 being a very big baby. Everything has been fine until 24 weeks when I was told baby was measuring very small, 5th centile but it might be an error and positioning so I went back yesterday. Told again that it was 5th centile and as this was the second time I'd measured that way it was now a suspected IUGR. Sent to MDU, had the trace, more scans booked etc. Am seeing the consultant in 3 weeks.

I've scoured the internet - medical papers and RCGP fact sheets so that I am armed with the facts for the consultant meeting - and it seems to say that it could be anything from chromosomal disorders to infections to me being short (5ft 3 - although partner is 6ft 4).

I just have a feeling that it's the placenta, because of the previous preeclampsia although I feel perfectly well this time.

So what I'm really asking is, is there anything at all that I can do to help the baby grow? Supplements, spinach smoothies, anything that I can take, I will. It sounds like these babies are usually delivered early and go to neonatal, which I have taken as the most the most likely outcome and anything better than that will be a god send.

Anyone with experience, I would love to hear from you. Any questions I should ask at the consultant meeting etc, just any advice at all really.

Thanks

The Doppler scan (booked due to the preeclampsia) looked fine by the way so there is no reason why it should be the placenta other than my instinct!

If it was 5th centile at 24w and still 5th centile at 28 then that's steady growth. I would have thought they will keep monitoring with scans and plan delivery if growth slows.

They are, that is the plan, but is there anything I can do to help baby catch up?

I'm going through similar but its my first and I've managed to reach 36 weeks, another scan on Monday to review growth and discuss plan. Ive been repeatedly told there's nothing I can do differently, as long as I'm avoiding smoking, alcohol, excess caffeine and not losing weight. Mine has been bobbing around the 10th centile, but the concern is she was on the 50th and growth rate seems to have declined as my pregnancy has progressed. The consultant scanned me to see if there were any clear signs of chromosomal abnormalities and seemed quite certain this wasn't the case.
Hopefully your baby will continue to track along the same centile user and you can get further on with your pregnancy. they need to weigh up the risks of getting the baby out prematurely versus keeping them in if there's an issue in utero.
I can only suggest having vit B12, haemoglobin and ferrritin blood tests to make sure you dont need any supplements, having regular BP monitoring and religiously monitoring movements. Other than that try not to worry (obviously a lot easier said than done), my baby seems to go really quiet when I'm stressed so I know its better for her if I can stay calm.

I've never smoked but I didn't know I was pregnant till 3 months as I was breastfeeding DC2, so had a little tipple at Christmas and then got a BFP on the day after Boxing Day. Ive done nothing differently from the last pregnancy and DC2 was over 10lbs.

Well done on getting to 36 weeks muggle, I am really hoping we can get that far. Lots of people are telling me "oh I was told baby was small and they were 8+lbs etc" but none of that takes the worry away! Hope it works out for you.

no unfortunately nothing takes the worry away user :(

I havent really discussed it with many people in real life because I dont know anyone who was specifically monitored for IUGR and everyone else just seems to say 'oh but you dont look small' or 'the scans are usually wrong'. I know people are trying to be helpful but it just feels dismissive when the consultants are clearly monitoring for a reason and that there is a risk even if small.

Good luck for your consultant meeting! Do get in touch with the department if you have any concerns/questions in the meantime as the waiting is hard going!

I was induced on the 15th May (40+1) due to baby measuring small. Growth scans started from 28 weeks. As previously said she was bobbing on and just below 10th centile but growing along her own curve hence no early induction.

All scans were fine etc. I am not a smoker, was eating properly and taking vitamins etc., etc.

It was very worrying and the only thing I could do is to monitor movements which I did to the extent that my midwife said that they should have a chair for me at my local MAU.

I was also googling like crazy and because there are so many stories out there that those scans are so incorrect I was hoping that was my case too.

But they were quite spot on with the scan sizes and my DD2 was born full term at 6lb1oz.

She is perfect and had an Apgar score of 9.

I asked midwife to check my placenta and the first thing she asked me was if I smoked during pregnancy which I found a little bit offensive.

My placenta was small in size ( something they can't tell when scanning I think ) and gritty. MW said it looked like smokers placenta. Sometimes that means that placenta had aged a lot sooner and can gradually become insufficient but not necessarily. It can still provide enough for a baby to grow healthily.

I was very upset by the induction and almost considered refusing it but now I think it was the right decision. There are still so many things scans cannot pick up such as size or quality of placenta.

I would listen to what doctors say and if induction is offered take it.

Hope it all works out OK for you and the little one.

Xxx

Not read all the replies as am at work - but I had regular growth scans and towards the end was monitored every other day and then Induced at 37w. Baby was 5lb 8oz and totally fine ! I think they tend to suspect IUGR as they can't tell until the baby is out, so better to assume / suspect so you get the best treatment

passthebiscuit what centile were you on when they induced at 37 weeks? Was your baby on a similar centile throughout pregnancy?
Congratulations on your healthy baby!

My IUGR baby was picked up at a private scan at 28 weeks. Not sure if the NHS would have noticed as I wasn't due another scan and I was measuring ok. At that point she was estimated at 3rd percentile. However, the NHS were brilliant once it was picked up and I had constant monitoring and scans up until 36 weeks when they got her out by elective c section. It looked like a blood pressure / placenta issue. She was 4lb 2 and spent a week in SCBU (one of the biggest in there!) for jaundice and blood sugars but didn't need help breathing. Quite honestly, I think it was mainly that she's a dainty little thing. I'm not sure what percentile she was born on, but everything in her red book shows her consistently tracking the 9th percentile for the last 14 months. Also, growth scans are notoriously unreliable - they thought she would be over 5lbs when born.

feelingforsnow thanks for sharing. Was your baby suspected to be on the 10th centile at induction? It's so difficult isn't it, I'm unsure whether to be induced if it's suggested and baby stays at 10th centile. I've no idea of the risks though, so will be discussing it on Monday at my 36 week scan.

Congratulations on your perfect little girl

Sorry for hijacking OP!

Sorry you are going through this worrying time. My girl was born in 2012 at 37 weeks weighing 4lb10. Iugr was diagnosed at about 24 weeks as she was small for dates at 20 weeks and didn't really pick up. I was petrified that there was something seriously wrong but the consultants were very reassuring. We were told she may have been one of a multiple at conception - they're programmed to be small - or it was just one of those things. Neither my husband nor I are small, rather the taller side of average. What they were more interested in was the pattern of growth. If the iugr was symmetrical - i.e. head, femur and body all roughly the same small size then we were told there was unlikely to be anything medically wrong. With placental deficiency or other problems the blood is directed towards the brain and the head then grows at the expense of the legs and body. I was told there was absolutely nothing I could do to improve growth. They would just be more cautious and monitor very closely. I had fortnightly growth scans and fortnightly dopplers (so every wk at hospital from 28 wks) and although growth slowed right down, there was a minute amount of growth so she stayed put. All was fine until 37 weeks when the fluid seemed to have disappeared. I was induced the next day and unfortunately due to the cord being round her neck, ended up with an emergency section. These complications weren't due to the iugr but because of it, the medics were more cautious.

The best advice I can give you is to plan to finish work before 37 weeks, earlier if it looks like baby will come earlier. I ended up with 2 days of maternity leave before she came which was psychologically tough - I hadn't accepted she would come early. Also be prepared for lots of feeding when babe arrives! We were on a two hourly schedule - bf, formula top-up, express for at least 2 months, although I couldn't keep up the expressing after the first few weeks. I was shocked when the midwife asked which formula I was going to give her as I wanted to bf, but given her weight they were most insistent. I successfully mix fed for 9 months. My husband did a bottle feed at midnight so that I could go to bed after the 10pm feed and sleep till 2am. It was brutal, but we got through it. She was continually asleep and didn't cry for the first fortnight so feeding was hard, but the infant feeding coordinator was a marvellous help.

By 6 months old she had gone from the 0.04th centile (4 in 1000 babies as small) to the 50th - average. At 4 years old she is one of the taller children in her class, despite being summer born.

Good luck and try not to worry. Resting and looking after yourself - body and mind - is all you can do x

When pregnant with my tiny IUGR baby I was advised (by leading consultant) to watch my salt intake. Other than that - diet won't make any difference. If you're taking aspirin or other meds, there's possibly a benefit to taking them in the evening rather than morning.

@PretendingToBeAMuggle
Yes, she was expected to be max on the 10th centile. Her head was on the 5th. She was born on 2.8th centile at the end.

I was very unsure of induction as well and thought exactly like you that if she is growing steadily then although sh might be small there is no need to induce if she is otherwise alright.

I think the problem is that even if there are genetically small babies and most small babies are alright there is a reason why they are small. And another problem is that they do not always know why they are small and if it is dangerous or not.

And because of all that NHS will not take any chances given that the rate of still birth in the U.K. is the highest amongst developed countries.

You can always refuse it and if you do they will have to offer you daily monitoring of your baby.

I was very stressed through out my pregnancy. Not a few hours went passed without me considering to go or not to go to my MAU.

When I arrived for the induction I was 0cm dialated and my cervix was not favourable. For all I know I could have had 2 more weeks to go and that would have been extremely stressful even with daily CTGs.

I know it was a right decision for me at the end even though I did not feel like it when it all kicked off.

Interesting point about the aspirin, I am on it due to the preeclampsia and was last time, I take it in the morning. Will switch to evening. I watch my salt very closely as the preeclampsia was so severe with DC1 that I was on statins for almost 6 months after.

All measurements have been in proportion so I guess that is a good sign. I never returned to work as I found out about this baby whilst still on mat leave and I never planned on returning anyway. So I just look after the baby and my eldest all day.

I just feel like I'm letting her down, I am just hoping my body can just keep her healthy until it's safe to be induced. I wish that a consultant had seen me the same day to be honest because it might have made me feel less helpless. Took DC1 to the cinema this afternoon and spent the whole time thinking "was that a kick?" I'm going to be on tenterhooks for the next 3 weeks till the scan.

Thanks for sharing everyone

Agree with those above re: frequent feeding. I did manage to breastfeed once I got her home (expressed every 3 hours round the clock to establish supply while she was in SCBU) but she fed every 90 minutes for a good few months really.

I am surprised so many were induced. I was offered induction but they weren't very keen as apparently small babies don't always cope very well. Plus not great success rates with a baby who doesn't really want to come out for a few more weeks!

Hi I had this with my DS can't remember what centile he was on but when he was born was just below 0.4th centile. I had high blood pressure before getting pregnant and had Obstetric Cholestasis quite early around 20/22 weeks and that was when growth was also picked up.
I had regular growth scans because of the os I had regular monitoring anyway. At the end was going in twice a week.

I ended up having a c section as my blood pressure had gone up at 36wks DS born 3lb11 was in Scbu for 2 weeks didn't need oxegen and is a happy health 3yr old.

user please ring the hospital if you're getting really stressed about the wait. I was told around 28 weeks that i needed to be scanned by the consultant due to concerns re genetic abnormalities but that it wouldnt happen for 2 weeks. I got so upset and worked up I rang the hospital the next day and spoke to the lead midwife in pregnancy assessment. She was brilliant and arranged for me to be scanned earlier at another local hospital and told me to go in every day for a trace and doppler if I was at all concerned. There was nothing new in terms of growth on the scan but it was reassuring to know that I'd been scanned by an obstetrician and that no abnormalities were detected other than the decline in growth weight and low estimated foetal weight.

Thanks so much for replying @feeling I have an anterior placenta so don't feel a huge amount of movements and consequently have been stressed about movements throughout my pregnancy. I think you're right, if I turned down an induction it would hugely play on mind as to what is happening. Fingers crossed she's had a massive growth spurt by Monday and I can keep her safe inside a little longer

I had iugr too.

At my 20 week scan the baby was normal size but there was a possible issue with blood flow through the placenta so they recommended a 28 week scan. By that point the blood flow issue had not resolved itself and she'd dropped off the bottom of the growth charts. I was then very closely monitored. By 33 weeks the blood flow issue had become critical so they wanted to get her out as soon as a nicu cot was available. They refused to let me try induction as they said she wouldn't cope. She was delivered at 34+0 weighing 3lb6. She was in nicu/Scbu for just over three weeks.

It was a hugely stressful time but she got here safe and sound and is now a petite but typical 2 year old.

All was fine at my 20 week appt too and growth has just tailed off, although the last two were consistently 5th centile so I am just praying she is "constitutionally small" which may be the case but as our last was so big I am thinking probably not. Even with severe preeclampsia and 3 weeks early our first made it to 6lbs 4. If I have to have her early I am prepared for it, just want to be fully prepped for the meeting in June so that I don't get sidelined - our trust isn't exactly on the ball and I think that's adding to my worry.

This is useful for questions to ask at your appointment user

My ds had iudr and was born on the 0.4th centile at 33 weeks due to preeclampsia. But the great news is that even though he is still tiny at age 1 (3 - 6 month clothes) he is perfectly formed. My point is try not to dwell on it too much, you'll only stress yourself. Be glad your baby is otherwise happy and healthy.