Help - AC measuring small at 32 - do I need to panic?

[strawberrycheesecake1989]

hi there,

I was referred for a growth scan today - everything is good and all measurements are within normal range EXCEPT for the AC (stomach) measurement which is at 3%. Been referred to the fetal medicine department for a scan with a consultant - has anyone ever experienced this? did all end up ok in the end? scan isn't until next week because they've got no appointments on the weekend and I just can't relax and don't know how I'm going to get through these next couple days.

Has anyone had any experience with this? x

**32 WEEKS

No personal experience but do have some knowledge of this. Sounds like baby is growth restricted - generally things will be fine but there is a chance you’ll need to deliver before term. They will have done some Doppler blood flow measurements in the cord (and possibly another couple)? That tells how baby is doing right now and if there’s any urgency. Sounds like those are probably normal otherwise they would have seen you sooner most likely.
What you can expect is much closer monitoring from now. Scans minimum two weekly but they might suggest more often to watch the Dopplers, also over time they may arrange for you to have CTG monitoring of baby’s heartbeat, and blood pressure monitoring too. Usually the delivery target is 37-38 weeks, earlier if the dopplers become very abnormal or other concerns arise. Sometimes baby might need some extra care if small at delivery - others may be able to share their experiences, usually things like a bit of help with establishing feeding, jaundice, sometimes breathing help but not usually a breathing tube. Generally all turns out well.
Most commonly growth restriction at this stage is due to the placenta. The fetal medicine scan will recheck all the measurements and make sure there’s nothing else going on - and they’ll talk you through a plan.
In the meantime if you’re worried about movements then do get things checked out earlier.
Good luck.

Can’t tell you if it’s turned out okay or not but I’m in the same boat, if that helps at all! AC measurement was showing as dropping at my 30 week growth scan and just had my 32 week one and it seems to be growing again so fingers crossed.

Everything the PP describes is what’s swung into action for me since the 30 week scan result. I have twice weekly monitoring on CTG followed by a scan on the placenta/cord in the fetal well being unit and have a scan on Monday with a specialist at the fetal medicine unit. On top of that I have fortnightly growth scans and consultant appointments. It’s a LOT. However, it’s also reassuring to know that baby is fine in there currently so I’m not complaining.

As I say, I can’t tell you this time if everything is going to be fine — obvs I hope it is and so far baby seems okay at scans — but my first was also small for gestational age but it was detected a lot later. I was induced at 37 weeks with her and she was born 5lbs and perfectly healthy.

I expect this time around I’ll be induced at 37 weeks again, I’ve made my peace with it and I’ve been there before so it doesn’t feel as daunting this time around.

Thinking of you, OP! 💐

Hi, just to say I experienced the exact same thing as you with my DD, I ended up having a growth scan at 32 weeks due to reduced movement and they picked up that she was small, especially the AC measurement. As others have described a plan was put in place, I had regular CTG monitoring and Doppler scans in between further growth scans - they can only do those every two weeks to get a clear picture of how much baby is growing. We saw a fetal medicine specialist for the growth scans up to 37 weeks which is generally how far they like to get you if they still think baby isn’t growing well - basically to full term. Then if they judge that there may be an issue with the placenta (or something else, there often isn’t a cause, there wasn’t for me) and baby would do better on the outside, they would be likely to recommend induction at that point. I know it’s scary especially as it’s a waiting game and you feel like you can’t control much - key thing is to keep an eye on movements and never feel like you shouldn’t go for monitoring, the midwives will always be happy to see you. My DD was also born at just over 37 weeks, 5lbs and healthy but just small and a bit tricky with her feeding and weight gain to begin with. Now 20 months and thriving and I’m pregnant again, will be playing the waiting game to see how this goes but feel like I will be much more prepared this time. Good luck, you will be well looked after x

Thanks so much both of you for your comments - it’s really helpful and reassuring What I’m confused about is why would only the AC be behind on the gestational growth and all other measurements fine? If there were some problem with the placenta then wouldn’t it’s growth be stunted generally? I’m so confused as to how or why only one aspect of the baby can be behind on its growth??

Thanks for your kind words and good luck to you too. I’ve been imagine all sorts so just really trying to calm down about it x

@Ellax

Thanks so much both of you for your comments - it’s really helpful and reassuring What I’m confused about is why would only the AC be behind on the gestational growth and all other measurements fine? If there were some problem with the placenta then wouldn’t it’s growth be stunted generally? I’m so confused as to how or why only one aspect of the baby can be behind on its growth??

Thanks for your kind words and good luck to you too. I’ve been imagine all sorts so just really trying to calm down about it x

So I wondered this too and asked my consultant, my understanding is that they go by the abdominal measurement to gauge the growth because it’s not a bone, whereas the head and the femur are bone measurements. So the AC gives an idea of the weight in terms of how much fat, as it were, that baby is packing on inside.

However, my sonographer also told me that the measurement can be affected by the position baby is lying in so that’s why they like to do the fortnightly growth scans in order to build up a picture of how it’s progressing rather than relying on one isolated result.

In answer to query - you can have different types of growth restriction. If it’s very early on, or another cause of the growth problem, then often you can get what you describe - baby small all over. But in later-onset growth restriction if due to placental problems, it’s almost as if the baby outgrows the supply the placenta is able to give. The head measurements will often stay on track as brain growth and development is sort of “prioritised” but the tummy growth drops off because baby isn’t getting enough to lay down fat stores - does that make sense? Another way to think about it is that if you or I aren’t getting enough nutrition, we don’t lose weight around our heads - rather around our tummy (or thighs or wherever extra fat is - those just aren’t measured for baby!). Hope that helps and glad you’ve also had some input from PP with personal stories.
@Corilee2806 congrats on new pregnancy - just thought I’d mention aspirin? Worth discussing with midwife/obstetrician if you’re under 20 weeks and not on aspirin already :)

Thank you @TenThousandSpoons0 - I did ask about aspirin when I first booked in as it was mentioned to me when I was trying to find out what happened with my first - I never really could get an answer which I know is common. I was told as there was nothing to suggest I’d need it this time, that there wouldn’t be a need to take it. I have a consultant appointment soon though so may mention it then. I hate the feeling that I can’t do much other than cross fingers!