28 week appointment

[PAJJ]

Afternoon All,

I'm wondering if I'm over thinking this with a lot of time of my hands, but would appreciate your thoughts.

I'm 30 weeks and in my trust you have your 32 and 34 weeks appointments at the GP surgery, these aren't happening at the moment, and any concerns I need to contact my midwife. I'm fine with this as I had my 28 week appointment where I had my blood test, urine, blood pressure, heart beat listened to, but I didn't have my bump measured. Is this normal? I have only read this is done and didn't at the time think to ask. Now I'm over thinking it, mainly because my next appointment will be 36 weeks which feels so far away.

I think it doesn't help that I was supposed to have a fetal heart scan today which was cancelled (this was a third scan due to a high nuchal fold at 12 weeks scan, CVS results negative, and it really was a precaution as the others were fine). I totally understand why this was cancelled, but I suppose just would have been a bit more peace of mind.

I think this is just a lockdown over thinking-scenario, basically my question was, should my bump have been measured at 28 weeks scan?

Thank you!

I would ring and ask your MW for her thoughts as I thought they measured every time after 24 weeks ? I have my 25 week apt next Friday where they’ve said they will start to measure . You have a lot going on though bless you so I don’t blame you for over thinking x

Hello
My midwife started measuring from 28 weeks and said it would be every couple of weeks from there
My 28 and 32 week appts are still face to face and with a midwife

If you’re worried you could just measure yourself. My mother in law who I’m living with at the moment is an ex midwife, and did a check for me measuring my bump. Seemed pretty simple, Pubic bone to belly button with a tape measure x

I'm not a midwife but I am a HCP. It's not as simple as measuring to your belly button! The midwife palpates for the fundus (top of the uterus), the position of which changes as your pregnancy advances. I think self measuring could easily give false reassurance or false worry. Definitely call your midwife and ask for advice. I'm measuring small at 28 weeks and they're slotting me in an extra appt to be measured again at 31 wks, where I wouldn't normally be seen again till 34 weeks.

Thank you all for your responses everyone. @anotherunimaginativeusername that's really helpful - my Mum is a retired midwife and said 'did she palpate for the fundus' and I honestly couldn't remember whether she touched me or it was just with the doppler (I think just getting in a bit of a tizz!).

This sounds so ridiculous as I think I'm wondering if she should have literally measured with a tape measure - but if she did have a feel for the fundus, this would be the same thing/classed as measuring?

I think the best thing to do is call, I just never want it to seem accusing that they didn't do the checks properly!

Did you have a scan at 28 weeks? If so then you don’t need a fundal height measurement too as we measure fundal height to determine whether or not you need to be referred for a growth scan. It’s not as simple as ‘measuring to your belly button’ and if you haven’t had a scan you definitely need a professional to measure you.

Importantly though you shouldn’t be going from 28 to 36 weeks without any review appointments. You should have your blood pressure and urine checked regularly too. I’d give your midwife a call and double check that this hasn’t been an error.

Actually - I'm looking through my notes and it talks about fundal heights and being measured with a tape measure. Which it definitely wasn't. I'll call and explain - I think more so because I won't be seeing any one now until 36 weeks.

Thanks again everyone!

Midwife here.

You should have your first measurement between 26-28 weeks. Are you low risk or do you have risk factors and you are on the serial scanning pathway?

You most definitely can't measure it yourself and it isn't pubic bone to belly button! And it's very irresponsible of someone to give this advice.

Where I work, we have dropped the face to face appointments at 16 and 25 weeks so our first face to face (after booking) is 28 weeks. The rationale is that 28 weeks is a key time and we need to see you for bloods and that all important first measurement.

I would call your MW and explain that it wasn't done and needs doing. And in the meantime, always be vigilant with baby's movements.

gaaaaaarlicbread 25 weeks is too early to commence measurements. The margin for error is too great. I used to work for the organisation behind the research in to fundal height measurement as a screening tool for compromised babies and their guidelines are 26-28 weeks.

And don't let the GP measure you, 99% have no clue what they are doing and haven't had a training update in 10 years 🤣

@MadameJosephine No scan, my last scan was the 20 week scan (at 21) and on the same day the last heart scan. So the 28 week appointment was quite 'standalone'.

I thought that about the gap between appointments - in my book they mark that 32/34 are to be done at the GP and I called today to clarify what I should do and they said they aren't going ahead and just to call the midwife with any problems. It's not so easy to call and say 'no problems, but I'd like my urine and blood pressure checked please'!

@Secretsout I have had two extra fetal heart scans (and an extra anomaly) because of the high nuchal fold (CVS normal) I was told after the second normal scans I wouldn't be considered high risk.

I shall call tomorrow. Thanks all.

@PAJJ in that case you definitely should have had a fundal height measurement done and recorded.

You also definitely need to be seen before 36 weeks. Asking you to self report ‘any problems’ is simply not good enough. Here’s a copy of the RCOG guideline for antenatal care during the current situation, you can refer to it if needed when you call

www.rcog.org.uk/globalassets/documents/guidelines/2020-03-30-guidance-for-antenatal-and-postnatal-services-in-the-evolving-coronavirus-covid-19-pandemic-20200331.pdf

Best of luck, hope you get sorted soon