Reliability of fundal measurements and growth scans

[Flutterby8]

Hi all,

Im currently 35 weeks pregnant with baby number 1 and I am not sure if I should be worried or not!

I had a growth scan at 29 weeks after a trip to triage where baby measured bang in the middle of my growth chart on the 50th centile. Estimated weight was 3lb 6oz on the day. Sonographer was happy and off I went.

My next midwife appointment raised a couple of concerns. I was told baby was measuring almost on the 90th centile and that the presentation was breech. I was told to do some exercises to encourage baby to move and return 3 weeks later.
Which I have.
Ive had my 34 week appointment and I have had 3 midwives examine/measure me. All 3 of them feel I am measuring just below the 97th centile and none of them could determine the position of the baby.
They are referring me for an urgent growth scan.
They also told me that I need to get my birth plan in place asap!

Im not very tall (5ft 1in) and I do have a very pronounced bump. I am struggling in pregnancy now to be honest.
If baby is really measuring that big and is either breech or transverse, what happens next?
Would they suggest early induction or c-section? And if so, how early?
Midwife didnt seem to want to commit to anything when I asked, just mentioned my pain relief options for birth and birthing positions.
I suddenly feel a bit out of control and a bit worried about what could happen so any reassurance would be fab!

Friendly bump?

Hi, I’m currently having growth scans and have done in my previous pregnancy. I look at them as a bonus that not only is growth being checked but also general well-being of the baby and everything around it at each scan. It’s a good reassurance.

I wouldn’t be alarmed about the birth options/pain relief conversation as that is routine at this stage of pregnancy anyway and something they need to tick off on notes that they have discussed with you, not something I think is alarming, even though you may have thought it was spurred on by the growth scan conversations.

They are often slightly out with the scans size wise but it’s good they will be able to confirm babies position for birth, but at your next scan if they think any decisions need to be made, you will have a meeting with a doctor after to discuss options. Many people birth bigger babies on the higher percentiles with no problems though, so it’s not a reason to always opt for intervention, so it won’t be forced upon you and will be a decision you can make, as long as baby is showing no signs of distress on the inside.

Wishing you a happy and healthy rest of your pregnancy x

Thank you for your reply @Catherine1210.
Im glad to have a growth scan to be honest. It is a long time to wait from the normal 20 week scan until birth so I like the fact things are being checked for me.
I just feel a bit worried that Im going to go in to the scan feeling ok and then be told that we have to make a decision on an early birth quite quickly.
This may not be the case but the midwives didnt fill me with joy despite trying to reassire me that this was normal protocol.
Ive heard horror stories about inductions and I think im just worrying myself now.

Sorry to take this thread a bit off topic… but what would trigger a growth scan to be recommended? I’m in week 25 but I had my midwife appointment last week due to her being away this week, so I’ve not had any fundal measurements done yet. Is it the case that they check those measurements and then if you seem bigger or smaller than expected then you get a referral?

20 weeks til birth without a scan is such a long time. I feel like I just want someone to reassure me again in a few weeks that everything is ok 😅

I was sent for a growth scan as bump had dropped off a little, traces of protein in urine and high blood pressure.

Growth scan showed baby between 3rd and 10th percentile at 35 weeks (bump measuring between 50th and 90th). Going this week for another growth scan to determine eviction plan. Because my baby is measuring smaller than expected I'll be going in for early induction.

Midwife said pack your bag just in case. Doctor and consultant at the hospital both said o need to give birth a certain way so whatever I had on my birth plan isn't allowed. A little disappointed, but equally so I'd rather know now than on the day l.

@Dipsydoodlenoodle thanknyou for your reply. Sorry for the questions. Did you get referred to a doctor/consultant on the day of your growth scan or were you asked to return for a seperate appointment?
I assume youre then booked in for more regular consultant led monitoring based on the results of the scan?

@glasspaw my growth scans so far have been recommended firstly because Id been seen twice out of hours in triage due to reduced movements and now because of my fundal measurement and position.
Fundal measurements normally start from 26 weeks I believe, or at least mine did.

Was just sent for a growth scan...she then said my blood pressure was too high, so I had to wait for monitoring and to speak to the 'general' maternity doctor on the same day. Had all been OK, I'm sure I'd have just been sent straight home.

I then got a phone appointment with the consultant the following week (they do their clinics on a specific day) but she couldn't say much until the next growth scan.

As for the next growth scan (Tuesday) I have the scan and appointment with the consultant on the same day - but this time they specifically know baby is measuring small rather than just a random growth scan.

Scans are more accurate than fundal height but can still be off due to operator and position of baby. They say there’s a 15% error of margin with scans.

I can’t comment on how accurate the growth scans were for me yet, I’m also 35 weeks. However, at 20 weeks baby was over 97% percentile. I had fundal height measured at 24 weeks and was measuring 3 weeks ahead so referred for a growth scan. Growth scan showed baby about 70th percentile. Next growth scan at 28 weeks showed baby back just below 97th percentile. Fundal height measurements were still 3 weeks ahead. At my last growth scan at 32 weeks, baby was back down to approx 70th percentile. But by my 34 week midwife appointment, fundal height was 5 weeks ahead. My next growth scan is in a week and they’ll decide what the plan of action is then.

Some trusts like to recommend early induction for big babies but NICE guidelines say that big baby alone is not a reason for induction. If baby is transverse or breech, they might try to manually move them into position. I’ve already made peace with an early induction (and I’m ready for pregnancy to be over with) but I’m reading positive induction stories to try and help me prepare.

Thank you for your replies @Dipsydoodlenoodle and @InTheNightWeWillWish.
Over the weekend I have been thinking about worst case scenario which in reality would be early induction or c-section.
If im honest, the sooner baby is born the better at the moment because the symptoms im having are starting to really get me down now.
Although id much prefer for baby to go full term to give the best start, im begining to feel drained and very uncomfortable.
I still dont think baby is head down but im happy to be proved wrong at my scan appointment!
I have been reading up on inductions too. They dont seem all that great, depending where you read obviously. Seems many people suggest an epidural with an induction, which is something I was hoping to avoid.

@Flutterby8

Thank you for your replies *@Dipsydoodlenoodle and @InTheNightWeWillWish*. Over the weekend I have been thinking about worst case scenario which in reality would be early induction or c-section. If im honest, the sooner baby is born the better at the moment because the symptoms im having are starting to really get me down now. Although id much prefer for baby to go full term to give the best start, im begining to feel drained and very uncomfortable. I still dont think baby is head down but im happy to be proved wrong at my scan appointment! I have been reading up on inductions too. They dont seem all that great, depending where you read obviously. Seems many people suggest an epidural with an induction, which is something I was hoping to avoid.

No problems.

I'd also heard epidurals might be best with induction. I'd wanted water birth, but they said baby would continuously be monitored do I couldn't do that