IUGR/ FGR - severe for no obvious reason

[HottrampIloveyouso]

Hi there - I wondered if anyone had had experience of severe IUGR / FGR for no obvious reason (when I say no obvious reason, I mean no health or structural reasons - I know chromosomal abnormalities are a reason).

I get a growth scan every two weeks, our baby is just below 3rd centile so it is severe. I am being monitored for anything obvious like preeclampsia and am scanned twice weekly to check fluid and cord. All is coming back completely normal. I was large baby, as was my husband so unlikely to be down to that. I’m 5ft7 and my husband is 6ft so again unlikely to be caused by that.

It was noticed at a private scan at 30 weeks after movement was reduced. I’m now 34 weeks and in for daily CTGs, two weekly scans and twice weekly fluid/ cord scan. Her movement is still a bit subdued.

All I’ve read on here are women who have had an obvious reason for their IUGR/FGR I was looking to hear from anyone who otherwise presented normally but had severe FGR and what the outcome was.

Thanks.

My first pregnancy was low risk. I had undetected small for gestational age. My baby was born on the 2nd centile. She’s 25th centile now and met her milestones ahead or on time.

No real reason for her to be so small. I am tall and so is my husband so her birth weight wasn’t actually tiny (6lb) but that was very small for my height and weight.

Pregnant again and being monitored very closely with scans. Growth normal so far and I’m almost 30 weeks.

Please go to get checked at your maternity unit if the movements are slow or reduced relative to before. The midwives and doctors would rather you go in to be on the safe side.

Good luck!

Thank you @Magnoliasstreet for sharing your experience. I’m pleased to hear all was well.

We’re very concerned as there are no Doppler abnormalities nor any other super obvious reasons - we’re preparing ourselves for something developmental or chromosomal. We’re now consultant led and have my first clinic this week so that will give us an idea of our plan going forward.

I’m mindful of my movements - but it is difficult as she is now incredibly subdued. But everyone in our maternity unit know me now so have no qualms about going in if something feels different.

Thank you again and congrats on your second pregnancy.

Do you have low PAPP A?

@Nailcutee I opted for screening and were not notified of low PAPP-A.

I had similar issues to yours with my second child and the only difference was I had low PAPP A. She was born just under 5 pounds.

My DS had severe IUGR (born 0.3 centile!) and there was no known issues except that the placenta was very small in size. This we only found out after the birth. The issue was picked up at the 20w scan so quite early on. I had in excess of 20 ultrasounds and by the end I was in every day for CTG. I ended up having an emergency section at just 34w. He spent two months in hospital with an issue which delayed us but wasn't a major health concern in his case. He's totally healthy now, just still very tiny! But he's hitting all his milestones quickly and I'm so amazed how far he's come

My baby dropped centiles and stopped growing at 36 weeks. I had gestational diabetes which was under control and not thought to be related. All dopplers were normal. She was born 37 weeks by c section at 4lbs 8oz. Tiny but mighty. She is now almost one and extremely healthy and on the 25th centile. They couldn't find a reason for her low birth weight. I had a debrief and they said although the placenta was healthy it was very small, which is why she was small. Wishing you all the best. You will be in the best hands and they will do all they can x

I had IUGR and no known reason why, wasn’t picked up till a bit later it be pregnancy so wasn’t an issue until post 30weeks. No reason why, no health issues and no low hormones etc.

Induced at 37 weeks and born on the 3rd percentile. They have no issues, caught up in height and now 99th for height and 50th for weight. I have been told they are quite bright by the nursery so no development issues. Me and my partner are similar heights to you OP.

I stressed so much over it and I still don’t have an answer.

I think the plan would be continuing scans an if there is any static growth baby would be born soon, otherwise they will try to get you as close to 37wks as possible.

I had iugr with both pregnancies, both born at 37 weeks. Ds was 4lb 5oz, dd was 4lb 15. No obvious reason, although I had gestational diabetes with ds. Both born healthy, needing no special care also caught up very quickly.

That's a birth weight of 5lb 8oz - is that really regarded as severe?!!! It's not massively small! That was dc1's weight at 40 weeks and dc2 was 0.4 centile! Both adults at uni and around 25th centile. I'm just not meant to have big babies!

@titchy centiles are worked out based on lots of figures ie mother’s weight, previous pregnancies. It’s not just based upon what the baby weighs.. if that makes sense?

DD was 0.04 centile and was born at 38 weeks weighing 5lb 8, she’s 18 months now and 22lbs so has put on weight really well and is developing just fine. My first was 6lb at just shy of 40 weeks, no issues at all with him. I’m 5ft 8 and slim, I just had small babies.

OP sometimes babies are just small, I was consultant lead for both, had great care and couldn’t fault it. So many growth scans and apts I couldn’t keep track of them, but honestly it doesn’t necessarily mean that there is chorosome etc issue, some people just have small babies

@titchy lots of factors but the best way I was explained was you wouldn’t expect a 4foot11 women to have the same size baby as a 5foot11. What is an average weight for the shorter women could be an IUGR baby for the taller women

I’m going to be blunt to try and shorten my experience.

First growth scan at 28weeks,

Blood flow from placenta not great

Subsequent growth scans weekly from then

Steroids at 33 weeks with the intention for c section at 34 weeks - DD was measuring very slightly below 3rd centile.

Managed to carry on having growth scans and Dopplers until 37 weeks when DD was born weighing 4lbs 13oz.

No obvious reason for this, was bizarre for everyone, I had tests for growth disorders, toxoplasmosis, any genetic abnormalities, all clear.

I think they just put it down to my placenta being a piece of hair for no reason.

It was a really scary time, DD didn’t need any NICU time though, had jaundice and her weight dropped to 4lbs 3oz when we left the hospital as being so small her latch wasn’t great and my milk didn’t come in (turns out I was dry anyway after weeks of trying so had to switch to formula before she was hospitalised)

She came home with us 4 days after I’d recovered form my c-section.

[quote Freezeboy]@titchy lots of factors but the best way I was explained was you wouldn’t expect a 4foot11 women to have the same size baby as a 5foot11. What is an average weight for the shorter women could be an IUGR baby for the taller women[/quote]
The correlation between parental height and natal baby weight isn't that strong though. Clearly adult height should be within a range - but even at OP and her dp's height a 3rd centile height for an adult child isn't that unexpected.

I had severe iugr for no apparent reason (baby was well below the 1st centile from 20 weeks onwards). Unfortunately our outcome was not good, and afterwards we found out that placental insufficiency caused by APS was the cause. Hope things turn out better for you.

Thank you everyone for your input and sharing your experiences. We experienced a MMC with our last pregnancy and I just feel so helpless and guilty. Sometimes it is good to listen to other stories and know you aren’t alone.

I have my clinic tomorrow so will hopefully have some semblance of a plan and idea of what to expect next.

I have just been diagnosed and am driving myself mad googling the reasons. I have been booked in for checkups every Thursday with a consultant to monitor but everything feels a bit surreal at the moment