Bad news at 36 week scan - so scared

[worried88]

I had a routine 36 week scan this morning and it picked up some problems. I've been diagnosed with polyhydramnios (deepest pool was 10.6cm). The baby's head is also measuring just above the 97th centile at 355mm, abdominal circumference just below the 97th (although this was not deemed a problem) and everything else was in the normal range. The baby appears to have fluid in the stomach and bladder which means they're swallowing, both kidneys were identified and the heartbeat was normal.

After the sonographer identified the polyhydramnios, I was given a blood test at the hospital and have now been asked to monitor my blood sugar with an AgaMatrix machine for the next three days to check for gestational diabetes.

Eight weeks ago my regular midwife detected a trace of glucose in my wee sample at my 28 week appointment, but it was all clear again at 32 weeks so I assumed it had just been a blip. My 34 week midwife appointment was cancelled due to the coronavirus and was done over the phone instead, so there was no test done at 34 weeks.

I also had a private wellbeing scan done three weeks ago and at that scan, my amniotic fluid was in the normal range. Head circumference was 319mm (compared with 355mm today). I wasn't able to give this information to the hospital today as annoyingly I didn't have my notes with me.

Following today's scan, the hospital have asked me to come in for another scan next week with a consultant at the fetal medicine unit. I'm waiting to hear back from them with a time.

In the meantime though I'm going out of my mind with worry about what all this could mean. It was such a lot to take in that I think a lot of what they were saying went completely over my head as I wasn't really thinking straight.

Has anyone experienced anything similar? I'm so frightened that something is badly wrong.

Just to say, you can start eating a gestational diabetes-friendly diet right away there's no point waiting for a diagnosis and you may even find that it controls your blood sugars perfectly well.

I was concerned about getting GD because I am overweight, and really reduced sugary things and carbs and substituted them with low-GI options. I felt great on it!

I'm a bit late to this op but to second PP, you can start a GD friendly diet straight away and get those numbers down. Have a look at the Gestational diabetes UK Facebook page, it will give you all the info. Try not to panic. It's all hormonal / placenta and nothing you've done.

I had polyhydramnios in my first pregnancy, undiagnosed, and have had GD in two subsequent pregnancies, suggesting probably did the first time too but undiagnosed, and DD was completely fine. Try not to panic, the risks are higher but you have developed it very late (I'm 22 weeks with my third and have been on medication since 7 weeks!) and your numbers suggest to me you should be able to bring them down easily with a bit of simple adjustment.

It's literally cutting right back on all carbs even complex, no white carbs, no cereals at all or most fruit, and much more higher protein and fat content in every meal. So for eg I can manage 60g of whole meal pasta, if there's lots of cheese with it. NHS advice is a bit rubbish as they still push cereal etc which sends most ladies through the roof.

I had GD with my most recent pregnancy, like you no risk factors. DD measured big at a random growth scan esp abdomen (off the scale) and I requested induction at 38 weeks - I'm sure if you do the same they'll be happy to induce early. Everything was really positive for me - DD was born (only 7lb2oz in the end compared to my 2 non-GD pregnancies of >9lb!) and is totally perfect. I actually found it reassuring in the end to be so monitored and looked after.

I had polyhydramnios in my first pregnancy, undiagnosed, and have had GD in two subsequent pregnancies, suggesting probably did the first time too but undiagnosed, and DD was completely fine.

Thank you @LimpLettice - that is so reassuring to hear.

I'm sure if you do the same they'll be happy to induce early.

Thanks @sulkysukey. The midwife this morning said they like to go to 40 weeks if possible, but will closely monitor the baby's growth and bring the birth date forward if they need to. I'm just worried that the longer the baby is inside, the more dangerous it is for them.

My 20 week scan was 2 weeks ago, baby is fine, and I'm on metformin, insulin and a very restricted diet, so again, try not to panic.

I'm actually doing the opposite and fighting early induction. I want this boy when he's ready, and with everything that's going on at the mo it might mean fighting for more monitoring to get as far as we can. They were saying 37 weeks, although I'm both old and on medication, but currently agreeing to let me go to 39 provided placenta stays healthy looking.

They will check cord flow and placenta at your coming scan and then discuss what's best for your baby. In the current climate they may prefer to let you go over a little for nice mature lungs, especially if you can get your numbers down with diet and reduce any further risk.

@LimpLettice thanks. In terms of when to induce, I guess it's trying to get the right balance between allowing the baby's lungs to mature enough but not letting them put on too much weight?

I think I'm just afraid that the longer the baby spends in there, the more in danger they are from the gestational diabetes, especially if I don't manage to control it quickly enough.

I just read the full thread and very similar happened to me with my second.
I had a big bump and they diagnosed poly followed by gd at 36 weeks.
They only difference was that they insisted I was induced at 38 weeks.
At 37 weeks you are full term and they're shouldn't be any issues with lung development at this stage.
Gd babies can put on a lot of weight in the last few weeks, if I was I your position I would be insisting on booking for induction.
I was told there is a higher risk of placental failure in the last couple of weeks with gd and also I higher chance of cord prolapse with poly.
I had a fab birth with no complications dd was 7.13 we had to stay in for 24 hours to have our sugars monitored but we were both fine and no probs since.
I have four children and only had it with her.

The worry is too much growth and possible shoulder dystocia, or restricted growth indicating placental deterioration, which is why they want to monitor you. It's natural to worry, especially as babies can put on a fair bit at the end, but yes, it's a balance and if your consultant is any good they will discuss this with you properly once they do the scan and see where the growth is going. They will want to induce if they feel there are any significant increased risks ime anyway, so you shouldn't need to insist. When is your scan?

Thanks @troppibambini for reading the full thread! It's great to hear that all was well with your DD after a similar experience.

They will want to induce if they feel there are any significant increased risks ime anyway, so you shouldn't need to insist. When is your scan?

That's good to know, thanks @LimpLettice. My scan is tomorrow afternoon - I'm so nervous.

I had a big bump and they diagnosed poly followed by gd at 36 weeks.

The midwife measured my bump today and it was normal size for 36 weeks apparently - surprising considering I have extra fluid and a bigger than average baby in there.

Good luck for tomorrow then. I'm sure you will have a plan and feel loads better after.

I just wanted to say I had undiagnosed HD-confirmed afterwards by blood tests. Gave birth at almost 43 weeks to an 11lb baby but she is and was completely fine health wise. So the fact you've been picked up at 36 weeks can only be a positive thing. Good luck.

GD

Just wanted to second the recommendation for the Gestational Diabetes UK website and Facebook group. The support and dietary advice I received here was amazing. If you're on fb, please join the group.

www.gestationaldiabetes.co.uk/

OP, do be aware that there's a 25% margin of error with late stage growth scans! Eg they might tell you that you have a big baby and then it's a perfectly normal size. Just bear that in mind when making any decisions about early induction -- baby might actually be up to 25% smaller than they think. That's why many trusts aren't keen to induce on the basis of a 'big baby' scan.

Sounds similar to my pregnancy with my now 11 year old. I was huge, had high fluid levels, measured quite a bit over size. I was found to have had CMV, Cytomegalovirus, at some point, but they didn’t have booking blood left so couldn’t tell when. My sons head measured over 100th percentile and I had a few glucose tolerance tests. I was seen by fetal medicine and closely monitored. A kidney issue was also in my son but this seemed to self remedy and by 3 weeks post birth was no longer an issue. My husband has a large head, (where as I have a tiny head that was monitored after my birth as was deemed too small!) I think some babies just have big heads generically, the rest of my baby was 90th percentile. He was born at 36 weeks perfectly healthy.

Try not to worry too much, google is not your friend at this time. Thinking of you as you won’t feel relax until your baby is here.

@Getoutofbed25 thanks - all these positive stories are so reassuring to read.

The latest with my situation is that following the 36 week scan, I had another scan three days ago with a hospital consultant.

They found the amniotic fluid level is now 8.2cm (just 2mm over the threshold), which is quite a bit lower than the 36 week scan measurement of 10.6cm. I’m not clear whether the fluid has dropped down of its own accord or whether the first scan was inaccurate - my midwife thinks the latter.

The consultant checked the brain, heart, kidneys and swallowing among other things and said all was fine. I was able to watch the baby swallowing on the monitor. He said the baby’s head is large but thinks that is probably down to genetics (large heads do run in the family) and also the gestational diabetes.

I’m now monitoring my blood sugar levels with a home testing kit four times a day, and have adjusted my diet to try and get my levels down, which I’ve managed to do so far.

A few things that are still concerning me are the fact that the baby’s head size grew so much between the 33 and 36 week scan. I mentioned this to the consultant and he wasn’t worried, but it still seems strange to me. I’ve booked another scan with the Fetal Medicine Centre to get a second opinion, but the earliest they could fit me in is the 20th, so I’m nervously waiting until then. I know it’s probably not necessary to get a second opinion but I think it will help put my mind at rest.

I’ve also read online that polyhydramnios can cause cord prolapse but no one at the hospital has mentioned this to me, which seems a bit worrying?

The cord prolapse risk was why I had to get on all fours with my bum in the air when my waters broke.

Was very relieved it happened at home and not out and about!

@Pinkflipflop85 Yes, I read that you have to do that...! I’m surprised the hospital haven’t mentioned it at all. The baby has been facing down since at least 33 weeks according to my scans - I don’t know if that means there’s less of a risk?

If the head is engaged it's fine. If not, there's a risk the cord could come out first. Nobody mentioned this to me until I was 40+14!

If the head is engaged it's fine. If not, there's a risk the cord could come out first.

The baby is head down but not engaged, so I guess they should have mentioned! I will ask about it next time I see my midwife.

I had polyhydramnios with dc4. Not sure how deep the pools were but I was measuring 10 weeks ahead at 34 weeks. Baby's head was huge too, way above the 99th centile.