20 week scan - head circumference and femur on the 5th

[Marmitepeanutbutterandhoney]

I had my 20 week scan yesterday.

The baby’s head circumference was measuring 155mm and I understand that puts her on the 5th percentile. Her abdominal measurement was normal at the 50th, but her femurs were also small, again around the 5th.

I am feeling extremely panicked. I got bitten by mosquitoes in a Zika country at 5 weeks pregnant so really paranoid that this has affected the baby.

The sonographer got a colleague to repeat the scan and measurements and they sounded concerned. I was in there an hour and a half, but left feeling really unsettled.

They have invited me back for a growth scan but said it doesn’t need to be until 26 weeks. That’s six weeks of worry for me - it feels way too long.

Please could anywhere share there similar stories? I am very emotional and feel so depressed. We have already lost two babies this year.

Thanks

I have no experience with this I'm afraid my baby is measuring bigger than smaller but I just wanted to say could you arrange to see your midwife and discuss the scan results properly or just give her a call to try and ease your mind so your not sitting around worrying for weeks. X

I had a similar experience at my 20 week scan earlier in the year - head circumference was measuring on the 5th centile. I was under midwife led care and contacted them the following week, explained the situation and that I couldn’t wait another 8 weeks and they arranged a scan that day for me! Maybe try contacting your midwife unit? Totally agree that 6 weeks is far too long to wait!

Thank you for your replies -

I will call the midwife this morning.

Tef- do you mind me asking the outcome of your situation?

I’m just waiting a call back from the midwife. I have been crying since I posted - I’m just so worried

What a worrying time for you. Hope you don’t have to wait too long for a call back. The first thing I would say is that it sounds as though you have a baby who is small overall. That is not what happens with Zika, so please try to let that thought go.
Babies range in size as adults do, so your little one may just be supposed to be small. What sort of size are you & baby’s father?
Did you have the combined test & if so have you got the detailed result report? One of the hormones (PAPP-A) is of interest because it can give clues about placental function. If you don’t have that report ask the midwife when you speak to her.
I would hope that your midwife will arrange for you to see a fetal medicine consultant to review you.
I am happy to look at the report & discuss more by PM if you would like me to.
Sending love x

Nan what a lovely message thank you. I’ll go and take a picture of the report now and work out how to PM to you.

No call yet from midwife, they are usually very good at getting back so I’m hoping it won’t be too long.

My husband has a small head. I am fairly small - - size 8-10 and 165cm.

We are both just so worried

Did you get a call back from your midwife?

Yes, she said she’d chat with the consultant...

My baby (DD2) measured small from 19 weeks onwards. She had a small head and a small abdomen. The percentile varied from 7 to 12. Had a scan every two weeks from then on and she continued to measure small until the 35. week or so. And then on the due date the abdominal circumference was too small again so they wanted to induce the next day, luckily she was born that same evening, weighing 3240g and was 53cm long. That pregnancy was the
worst time of my life, I was so worried. As it turned out, for absolutely nothing. She is 6 months old now.
If the consultant couldn't find anything wrong, that is a good sign. Could you also be a week out?

Thank you for your message tinn and congratulations on your healthy LO!

I’m definitely correct with my dates so not sure what is happening.

I had a call back to say that the consultant will see me in two weeks time. I feel relieved I don’t have to wait the original six.

Glad that they’re bringing forward the appointment!! At my follow up scan babies head was on the 20th centile, and the reasoning behind the original result was thought to be the position she was in. Hoping for a similar and positive outcome for you, too xx

Hi @Marmitepeanutbutterandhoney, just a quick bit of reassurance for you, at my anomaly scan I was told my baby’s head was measuring under the 10th centile so got referred to fetal medicine. Because I’m a huge worrier, I paid for a private consultant scan who put babies head on the 3rd centile. Long story short, I saw the nhs consultant who was happy and didn’t want to see me I til 33 weeks again, in that time her head had grown and was around the 25th centile. I wouldn’t worry too much! Then her abdomen measured small, long story short I was induced at 37 weeks and her head measured 33cm, now at 6 weeks her head is over 37cm and on the 50th centile. Sometimes they just grow a bit out of sync xxx

Hi OP, have you had your second scan yet?

Hi - yes I had a second scan this week. Our little girl has now dropped to the 3rd centile, everything else is looking normal apart from a small heart defect (a hole) which they hope will disappear on its own.

We have been offered an amnio... I feel so down and in despair. It’s a huge rollercoaster as part of me thinks that’s she just small and the next I’m envisaging the most horrific things.

I would have the amnio. If you don't you'll be stressed to the max until the birth. The heart defect will most likely disappear so I wouldn't worry about that at all.
Sending you and your little girl lots of strength!

Thank you for your message, I’m just really concerned the amnio in itself will cause a problem. I’m also rhesus negative which makes things a little more complicated.

I couldn’t live with myself if something happened..

@Marmitepeanutbutterandhoney, bless you! I can completely understand how worried you must be. The fact that everything looks normal on the scans is a good thing, that means no soft markers for any serious conditions.

Is baby over all measuring small? Completely get why you don’t want an amnio due to the miscarriage risk. To reassure you though, it’s a really small risk. When I was going through my baby measuring small, the consultant didn’t see the need to an amnio as we already had NIPT testing that came back low risk for everything. Could NIPT testing be an option for you? They can also do a TORCH screen for infections.

Xx

I would also recommend NIPT and TORCH if amnio is too scary. But as the PP said, the risk of the amnio is very small and it gives you a more definite answer compared to a NIPT test.

Interesting - I’ve never heard of the TORCH test before. I’ll ask the midwife today.

Is NIPT the same as Harmony? We had the harmony test during the first trimester and it came back low, so that side of things looked positive. I also had the NHS screening - also low.

I do have group B strep and resus negative blood group, but otherwise I’m not aware of anything.. I have had two D&C’s this year, but not sure that could cause any difficulties?

I’m pretty adamant about the amnio.. I just don’t think I can go ahead with it.

Harmony is NIPT testing, from my understanding though and I could be wrong, Harmony checks for downs, Edwards and pataus only. I had panorama which is another NIPT test and it checks for more conditions such as turners syndrome and some others. That being said though the other ‘rarer’ conditions that Panorama screens for, I’m sure would be picked up on a scan, especially a consultant scan.

The torch screening is for any infections that you could have picked up, I don’t think it tests for zika though.

Is baby measuring small overall? Xxx

Yes baby is small over all...

To echo what another poster said it’s very unlikely to be zika or any other form of microcephaly as that is a disproportionately small head. As I said before, I was super worried about microcephaly as DD head measured under 10th centile at 20 week scan so paid for a private consultant scan who reassured me. From what you said it just sounds like you’ve got a small baby- but small doesn’t mean unhealthy or weak.

When are you seeing the consultant again? Have they done an arterial doppler scan to check the blood flow from the placenta? How the fluid around baby looking? Sorry a million questions.

I was in a similar situation myself, head small consultant referral, 10 week wait saw consultant at 32 weeks and baby on 5th centile in terms of EFW, saw consultant again 2 weeks later and baby on 10th centile, came back for a clinic follow up and baby back down to 5th and consultant wanted to induce me the next week. Long story short, induction went well and baby was just constitutionally small. Had an Apgar score of 9 and was stronger than most chunky babies. One of the midwives put it to me that ‘a fish grows to the size of its tank, and it’s the same with babies’. So if you are petite that may well be why. 😊

I agree that it probably isn’t Zika related as the baby is small all over, but small baby plus hole in the heart can (unless you are of specific racial backgrounds) be a sign of something else. The amnio is a good start - remember the risk of anything going wrong with an amnio is less than 1%. You have more of a chance of getting hit by a bus!

No experience of this sorry just wishing positive thoughts

Just an update.

Baby is now off the chart HC wise. She went from 5 centile (20 week scan) 3rd centile (22week scan) and now not on the chart (24 week scan).

Other measurements are small but within normal realms. The BPD is now under normal. They say that she is growing - she’s hasnt stopped - but obviously we are very very worried.

They are not pushing amnio as they said the gestation to do it is the worst it could be. They have suggested an MRI of baby’s brain but not until 30-something weeks. We can also revisit invasive testing at that time.

I feel like a mess. So overwhelmed and worried. I keep just praying that she’s just small, but maybe that feels further away now...