Growth scan after shambolic midwife appt

[Kitcat159]

I have just had my 36 week midwife appt and my normal midwife is off sick.
I was left with a trainee and a student...
Both took the measurements, one got 32, one got 34. Both low.
Now I have to go for a growth scan.
Thing is. I know they measured from a different point compared to my normal midwife.
They also tried to get me to have my 28 week bloods done as they were not done. Despite me saying they were. Eventually they agreed that they were already done.

I asked if it was normal for the skin on my bump to be a mottled pinky red colour? May just be the heat. When they looked they saw that i was covered in tiny scratches, bump gets really itchy particularly at night so now I'm being sent for blood tests to test my liver.

1- I don't feel particularly confident in what they have said so made me somewhat uncomfortable
2- does anyone know how long roughly a growth scan takes? Are we talking an hour? Whole day with monitoring?
3- does anyone else's bump get red patches particularly in the morning?

Thanks. I'm a bit all over the place after that appointment.

Itching in pregnancy is a sign of liver failure. it’s called obstetric choliosis and it’s really serious. They’re not being shambolic, they’re doing their job.

Not sure about the skin but I have been for 2 growth scans. Both literally in and out, so half hour tops, no monitoring or anything just scan then done

Insisting I needed my 28 week bloods done repeatedly even though I said I had them 8 weeks ago and it says in my notes I had them is shambolic.
Both measuring from different points and getting different readings is shambolic.
I don't think it's unreasonable to expect one of them to know where to measure from!

I just had a growth scan at 37 weeks after midwife saying it was fine 5 days earlier st 36 week appointment. Was in hospital and consultant said that I was measuring quite small. Was livid as no one had me up anything about bump size and I’ve had several prenatal appointments.

Anyway, the scan took ten minutes max. I got it the next day and I am pleased to say my baby is a completely average size. Middle of all the growth charts. Bump size is completely down to your individual body, how you carry, if it’s your first baby etc try not to worry.

Good luck with all the other stuff. Hope bloods come back ok.

Growth scan could depend on your area. Mine took a while morning. Waiting in clinic to see one of the consultants minions to measure. Then for her to decide they'd done it wrong. Then more waiting for the scan. Then another long wait back in the clinic to see the minion again. Big faff. But better to b safe than sorry. But goes to show the inconsistency that can happen when different people measure

Sounds like they've done nothing wrong. They're sending you for an additional scan which means you're being taken care of. The sonographer will likely check your placental blood flow, fluid round the baby, head circumference, femur length and abdominal circumference. These measurements will be used to give an estimate of your baby's weight at this stage. Nothing to worry about and takes ten minutes. A bit longer if you need a CTG trace for heart rate and movements. Be thankful. They've done the right thing by you and your baby.

It does sound like they were a bit all over the place but I'd be happy that they were over cautious rather than blasé. I wouldn't worry if you can help it xx

Measurements are so hard, but if they both measured smaller then they have to send you really. It is hard to understand why they wanted you to do bloods that are already done and I'm sure that didn't fill you with confidence but honestly it's better to be over cautious.

Your scan shouldn't really take any longer than your 20 week (maybe less). It just depends on the waiting times. Did they book one there and then or will you get one through the post?

Abdominal measurement is known to be very inaccurate specifically for this reason, not everyone will measure from the same spot as it's very subjective. If there is any doubt the safest thing to do is send for a growth scan which it sounds like they have done. Maybe they weren't familiar with the system if they were covering for a colleague who is off sick and that's how they got confused about the bloods. Either way it sounds like they have erred on the side of caution, which if I was seen by someone who didn't know me, is they way I would prefer it.

I got sent for a growth scan twice once because I was measuring small then at another hospital I was measuring larger! depending on the positioning of the baby it’s really hard for them to tell and they are often wrong, but better safe than sorry.

As for the itching, yes, this can be a sign of a liver problem, but also is normal in pregnancy because of the stretching of the skin too. I itched like mad and am fine

Im having extra scans bc I’m apparently old (I’m 37), baby has come up slightly accelerated on the last one so I was there for ages waiting for Doctors to discuss and decide next steps (GTT - negative thankfully). I was there 3 hours but the actual scan - 30 mins including a wait beforehand.
I appreciate it’s probably a bit annoying, especially as you feel there’s no need for it but you’ll get a chance to see baby! That in itself is lovely, my one was playing peek a boo and stretching arms out, was so cute and I’ve loved seeing the progression. If nothing else that has been worth all the extra time and parking fees!

Incidentally, my midwife has messed up my bloods a couple of times by writing wrong dates on. I have very awkward veins so I’ve ended up with several unnecessary bruises and numerous people attempting to get blood out of me! It’s annoying but she’s only human and other than that I’ve had great support.
Hope all goes well with your tests and scan!

I'm 37 weeks on Friday and keep having to have additional growth scans due to midwives being unhappy with measurements of bump and fears my bump isn't big enough.

Every time I have been for the scan we have been reassured that the bump is growing perfectly and is precisely where it needs to be.

The scans have taken no longer than any other scans I've had during pregnancy and to be fair it's quite nice to have the reassurance. Rather be safe than sorry.

Also. Itching. I've had severe and awful itching for the past week that started originally on my bump but has now spread to my legs and arms.

I believe it's probably PUPPS as there's a rash to go with it.

My bump looks the same as what you have described due to my subconsciously itching in the night!

It's pretty agonising actually all this itching.

I don't have an issue getting scanned etc. I would rather get it checked.
I think the pure haphazard-ness of the appointment made me feel really uneasy about it. Like their lack of confidence made me uneasy - rather than take my blood pressure they said "I need to do your blood pressure is that ok?" Are you happy for me to put the cuff on you now" "Are you happy for me to proceed?" When they said about taking the blood pressure I said sure and held out my arm ready.
It's my first baby so obv I'm going to be concerned when they say the size has dropped off the chart.
I would rather be safe than sorry of course.
And any chance to see my LO is welcomed.
I tend to panic when people mention needles.

rather than take my blood pressure they said "I need to do your blood pressure is that ok?" Are you happy for me to put the cuff on you now" "Are you happy for me to proceed?" When they said about taking the blood pressure I said sure and held out my arm ready.

To be fair, that's almost certainly how they've been (recently) trained - to ask for patient consent at every stage. Most experienced HCPs stop doing it constantly because it gets a bit burdensome, but the idea behind it is sound - they should ask you for permission before doing things, even very routine ones - even if it was implemented a bit over-earnestly.

I think you need to be kinder, sorry.

Asking permission is a big deal in healthcare nowadays; they were just following their training.

The fundal height measurements are not very good but protocol sadly. I had two midwives do mine. One measured 40 weeks and the other 35 (I was 34). Last pregnancy I was sent for countless growth scans which were all fine and quite reassuring.

Just try to understand that they are doing the best they can, whilst following the “book” and don’t worry. Always ask if something is worrying you.

All the best x

The person with the student would have certainly been a midwife, not a trainee. I'm a midwife, you are either a student midwife or a qualified midwife. Trainee doesn't exist. They asked consent to take your blood pressure, yep that's normal. Two people measuring fundal height will get different results, unfortunately it's not very accurate especially when done by several different people.

Think you need to relax a bit. They've referred you for a scan. If your not happy with your care then book in with your normal midwife for another appointment.

Another midwife here and totally echoing what @Dreamingofkfc has said

Yes there's a lot of research out there saying fundal height is subjective. One study got 40 experienced midwives to each take a measurement and there was a 7cm difference in the range!

The consent asking at every stage is by the book modern training in many places. The midwife is probably trying to set the student a good example. One of them would have been qualified even if newly so.

You are aware that you have a right to refuse students treating you on the NHS including for maternity care? So if you are anxious about any treatment including when you are in labour you can request this.

Personally I like students in the room, taking a history of whatever especially ones who ask their trainer awkward questions.

Where I am everybody gets a routine growth and position scan at 36 weeks. It's a quick, 10/15 minute appointment. They estimated my DS's weight wrong by 2lbs though so not particularly useful.

You sound like you're being really unfair and moaning about stuff that isn't really a big issue.

They checked you were okay with your blood pressure being taken - not an issue. They will have been trained to ask in a certain way.

They may not be 100% on your measurements but it could be that your baby had changed position etc. One week I measured massive but she had her bum stuck up in the air - so they are getting you a scan to check everything is ok - again not an issue.

They weren't sure about your 28 week bloods so instead of just going oh well never mind they were going to do them again to be on the safe side - again really not an issue.

They spotted symptoms that could potentially be really dangerous and are responding to that in appropriate way - again really not a problem.

You're essentially moaning about nothing really.

I echo what other midwives have said. Can I also add that it’s really difficult covering someone else’s clinic, especially last minute, when the computer system could be entirely different, their way of measuring may be different, the equipment is difficult to find, you end up running late etc. And whilst none of these would be an excuse for poor care, it sounds like the ladies looking after you were in fact erring on the side of caution in your case which is always the way to go and shows that they were being professional and working within their spehere of practise.

You can often get a better check up from newly trained midwives than more experienced ones. All midwives should be asking / explaining everything to you before they do anything.

OP I had many growth scans and they are normally 10-15 mins.

Obstetric cholestasis does have itching as a symptom but it's normally elsewhere not just the bump. It is v common to have an itchy bump at 36w due to the size! But it cannot hurt to have your bloods done.

Of course they should ask consent re BP checks. Don't you know lots of patients get "white coat syndrome" and feel v anxious having their BP done? It's quite right to check you are okay. If you read childbirth threads you will see there are still sadly some HCP who think it is okay to do internals and such without proper consent ("I'll just...."). Much much better they have consent drummed in.

I’ve had plenty of growth scans and they take no longer than any other scan.

Plus they’re more accurate than the bump measuring thing.