Worried about ultrasound measurements at 29 weeks

[LilysMom2016]

Hi all

Am currently 29 weeks pregnant and have been through the wringer in the past 8 weeks. Coupled with lockdown and ongoing possible complications (NIPT for DS, pre-eclampsia causing assymetrical IUGRs), this pregnancy has just been a complete balls-up. I'm sure I'm not alone, and that there are those worse off than me but being pregnant this time has just been about anxiety, stress, guilt and feelings of failure. Having to go to every scan/appt by myself due to COVID-19 and hearing bad news alone has been pretty traumatic. Apologies for a long post- guess I'm just looking to see if anyone else has had similar experiences with ultrasound measurements:(

Background:
In terms of big ultrasounds only I went for the 20w scan around 21 weeks, and the Fetal Medicine Dr was concerned that the femurs were measuring behind (can't remember how far- panicked preggie brain) so he suggested doing the Panorama NIPT test to rule out DS, which later came back fine. Everything at 12w scan was fine in any case, but he wanted to be sure and he wanted to see me again around 27/28 weeks to look at growth again.
I went back to my usual OBGYN in the meantime at 24 weeks and weekly since to check growth and she has checked me for IUGR, placental insufficiency and early-onset pre-eclampsia- and all bloods and Dopplers have been fine. I have been on Aldomet since 24 weeks, and Ecotrin since 12 weeks too.
She also sent me for other bloods, including the TORCH screen, full blood counts, kidney and liver function- all fine/ negative for anything. She has been seeing me weekly for scans, and sending me to a colleague for second opinions and the measurements have differed a bit so I went back to the Fetal Medicine Dr on Monday. He checked the femur and humerus measurements and they are both super small, but he couldn't commit to achondroplasia, or baby just being small. I am losing my mind with worry and a host of other feelings.

I don't have a breakdown of his latest measurements, but the ones from a scan I did at 28 weeks are:
BPD- 66mm (GA26w5d +-15d)
HC-242mm (GA26w3d +-14d)
AC-194mm (GA24w1d +-15d)
FL-40mm (I know his measurement for this one was 42mm) (GA23wd +-13d)
HUM-37mm (GA23w0d +-20d)
TIB-34mm (GA23w1d +-21d)

If I look at the adjusted gestational age next to each measurement, they all seem small or am I just clutching at straws? I'm clinging to the hope that kiddo is just small, especially if IUGR looks less likely, and the odds of baby having achondroplasia are quite low really. One of the scanners suggested that my placenta had a bit of calcification, but usual OBGYN hasn't said anything.Nobody has been concerned about make-up of organs or facial bones etc. No doctors can confirm anything at this stage. Any thoughts or similar stories? Thank you for reading, hope you all stay safe.

xx

[TenThousandSpoons0]

I’m sorry you’re having a tough time. It’s difficult to comment much without having a lot more Info but on surface it sounds like baby is growth restricted rather than just small (AC and long bones and HC are all under 1st centile, BPD at 6th centile). The medications you mention made me wonder whether you have other medical problems, or risk factors for pre eclampsia - that can go hand in hand with growth restriction. If your blood pressure isn’t raised outside of pregnancy, then the high blood pressure and small baby now would probably most fit with a placental cause of growth restriction, rather than something”wrong” with baby - but sometimes it can be pretty unclear for a while. It sounds like they’re doing a good job exploring all the possibilities for you and keeping a close eye on things -I know it’s really stressful. With Covid on top of it all it’s not surprising you’re finding it really hard- please reach out to someone for extra support if you need it - the fetal medicine team will often have a midwife or a counsellor attached to their service who can help you. Good luck x

[LilysMom2016]

@TenThousandSpoons0 Thank you so much for your response, I really appreciate it. I should've said that I developed pre-eclampsia in my first pregnancy and my OBGYN was v keen to ward it off as much as possible this time, and the aspirin was meant to help placental blood flow issues if I remember correctly. l I don't have high BP otherwise. I have felt like I need to speak to someone before things get out of hand so that is something I'm going to sort out before this much-wanted kiddo arrives. Thanks again xx