Potential IUGR

[EllieJai44]

32 weeks pregnant, having regular growth scans (every 2 weeks so far).

-28 weeks scan baby was on 50th percentile
-30 weeks scan baby was in-between 25th and 50th percentile
-32 weeks scan baby is now at 10th percentile

Had my next consultant appointment brought forward because of the decline in growth and my next scan brought forward from 3 weeks time to 2 weeks time (expected this one).

I have no idea what the consultants will say or do and I have another week to find out!

Has anyone had anything similar? I've had two previous babies who were on slightly smaller size when born, both in 6lb range, both also had growth tail off a bit towards end but not this early or this dramatic on the graphs.

Both previous two were induced at 37 weeks for growth and movements, but was going to opt for c-section this time due to traumatic induction that ended in emergency c-section last time!

Sonographer mentioned possible IUGR even though baby weight relatively okay, just a little small but it's the growth in between scans they are worried about....

If you had IUGR or suspected IUGR what plan was put into place and when did you deliver?

I had IUGR with my first DS. I developed PE so had been admitted to hospital at 33 weeks. When they scanned, they found that he hadn't grown at all since the scan two weeks previously. The decision was made the next morning to deliver him that day by c-section. He was 3lb 15oz and spent a month in SCBU. He's now 20 and nearly 6'4". I didn't have the same issue with DS2, he was actually a week late but was still only 6lb 4oz.

Hi, I’m still in it so can’t talk about delivery but I can share the plan that’s been put in place for me.

My 12 week blood tests flagged low Papp-a which can cause iugr, so I was booked in for routine scans at 28, 32 and 36 weeks. Between 28 and 32 he fell from average to below the 5th percentile.

They then moved to fortnightly growth scans (you can’t measure growth more frequently) and a well-being scan on the alternate weeks. This is to check on the health of the placenta and umbilical cord.

If they have concerns you will be moved to more frequent monitoring. My Doppler measurements have become abnormal at 35 weeks so I’m now likely to have them checked every 2-3 days.

If they confirm that it’s IUGR then likely the plan will be as simple as a constant watching to decide if the baby is better out or in. If they are not growing at all and/or other checks suggest distress or the placenta is failing it tips the balance towards early delivery. The more cause for concern they have the more regularly they will monitor you. You will be advised to monitor your movements extra closely. Growth is the first thing babies slow down on if they’re not getting the support they need from the placenta. If the stress gets worse then eventually they will conserve energy and stop moving - that’s when you really have to get them out.

They will likely want to get you to 37 weeks as that is term, but the benefits of staying in beyond that diminish quickly.

I recommend you ask your consultant whether they think an induction or c section is likely. They often don’t like induction for iugr babies as it can be too stressful for them.

Also ask them about steroids. My hospital tries to avoid steroids (which help the lungs develop) from about 36 weeks, but others seem to favour them.

If you want to breastfeed speak to your midwife about colostrum harvesting. Your baby will need to put on weight but might be too young to suckle. You can collect colostrum pre and after birth to give them via syringe.

Because it seems very certain that I will not get beyond 37 weeks I moved my maternity leave forward.

I have been told that a stay in nicu/scbu is not inevitable. It depends on how your baby is when they’re born. I’ve also been told that for true IUGR (E.g it’s something about the placenta causing the problem) they catch up really quickly after being born.

It’s really stressful and I cried a lot when it all first emerged, and felt frustrated that my body couldn’t grow a decent placenta. But I am extremely confident that no one is going to miss anything that actually puts him in danger. Your baby will be fine but be kind to yourself as the watching and waiting is stressful.

@Moancup thank you for your reply! You sound like you're very close to meeting baby! Have you been told yet if it will be a section or induction?

I'm hoping for a section over induction because my son who was born on 2nd percentile didnt deal with the induction and ended up an emergency c-section and then he ended up in NICU for 5 days, however he was a champ at feeding so he did start catching up fairly quickly! I breastfed both my previous 2 so felt lucky to be able to do that still, hoping same for this one!

I speak to a consultant next Wednesday but they have already moved my next scan forward to 2 weeks time and I think although a plan will be put into place next week, they will see what baby does on next scan too- just worried if they drop growth again what will happen from that.....

I can't imagine I would go much past 37 weeks either considering I've delivered at 37 weeks twice previously for similar situations- just wasn't picked up till 36ish weeks

My consultant is very pro section for small babies and would say your previous experience is very typical. I’d like to try for an induction (the ignorance of a first timer!). We’re going to have a final discussion about it when she decides to move to delivery but she has told me to mentally prepare for a section.

In your circumstances I’d assume there’d be no objection to a c section but definitely put int on the list of questions for your next appointment. My guess would be they’ll want to take you beyond 34 weeks if it’s safe for baby to stay in.

@Moancup my first was induction and was a dream! So I don't think you have unrealistic expectations!

I'll be 34 weeks at next scan so yeah will be past that at least!

Good luck with your delivery!

Hi I just saw this and wanted to join for some moral support, hope that’s ok. 34+3 currently. At 28/30 weeks fundal measurements I was told I was small, 32 weeks fundal I got some concerned comments, and at the same week had a growth scan which resulted in hospital admission for a combination of low amniotic fluid and IUGR measuring 3.5% for stomach. His head and legs are still around 25%. At 20 weeks he was around 25% all over and I really thought this would be a full term healthy pregnancy, so the 32 week hospital stay took menu complete surprise. My DD, now 2.5 years old was SGA, born at 35 weeks and 4lbs 14oz. She spent 18 days in the NICU with breathing and eating issues, at 24 hours out one of her lungs collapsed. Knowing my son is going straight there assuming he’s even ok is crushing me, I’m basically an emotional mess. I’m getting twice weekly non stress tests + amniotic fluid levels checks and once weekly scans for measurements and Doppler for placenta blood flow. The doctors think the issues are being caused by placental insufficiency which likely also happened in my last pregnancy. Fridays are the measure days (the one that really matters) so this will be our 3rd since we found out we had IUGR. 32 weeks he was 4lbs 7oz, 33 weeks 4lbs 9oz and now I’m just crossing anything for growth to expedite the nicu stay or by some miracle avoid it entirely (however unlikely). Every now and then I imagine the birth and him being 5lbs and not going there, but I know it’s not going to happen now growth has stalled. Hoping to keep him in me till 36-37 weeks, but fluids keep going down. I’ll likely be a c section as he’s also breech! Anyway, I’m sorry others are going through this, but I’m really glad to not be alone. Hope you’re all doing ok, and are feeling better, I know this is a very stressful time.

@Moancup i just reread above, your post was so helpful. I snuck a look at the growth scan last week so saw the weight, but my consultant said they don’t look at the weight more than every 2-3 weeks as there’s too much error, so you’re definitely right there. Just wanted to clarify the comment I had. They gave me the steroids at 32 weeks due to my admission to hospital then and my DD being a spontaneous early labour. My doctor has talked up the merits of a c section but keeps saying we need to wait to see, and “the first paves the way for the second” meaning I delivered quickly naturally, but he’s breech and low fluids mean he's not showing signs of turning. I had planned an induction and natural birth, but after the nicu stay with my DD I wonder if a c section would have been a better move. I’m also terrified of a c section, a toddler and recovery with having to drive to the nicu when I won’t be able to/my husband will likely want to take paternity later to save it. There’s just so much unknown and now throw Covid exploding in the mix. Id love to be able to know an outcome or control any part of this, hopefully you guys understand how out of reach this feels right now? 2-3 weeks feels like a very long time from where I am!

My first dc had iugr,, discovered at 35 weeks with a section at 36 weeks, he weighed 3lb 14. He's just finished his gcses and is around 5.9. I was under consultant care during second pregnancy and took aspirin from 20 weeks, second dc was 7lb 10.

@madeleine85 are you the madeline on the FB group I was talking to on my post on there? If so then 👋 haha

You're more than welcome to join for support too! It's such a hard time not knowing what's going on and what to predict!
You say Fridays are your measure days, that mean you get another today? Keep us updated on babies weight! Ours weigh very similar for the 32 week scans also! It's just the growth in between that's the issue!
We gained 250g (estimated) in 2 weeks, when apparently it should be way more than that?

I'm just trying to make it to my next scan with no information still, feels so long till next Wednesday when I speak to a doctor and I don't even know what they will decide!

Holding out till that 37 weeks too, it's so close! Literally touching distance but these babies do their own thing so who knows!

Hi, both my kids were IUGR due to pre eclampsia and placental failure.
Delivered at 37 weeks by section.

5lbs each.
Fed hourly (BF) for several weeks to catch up which they did quickly.

If it helps, fast forward and my now teenage eldest is nearly 6ft with his head stuck in the fridge looking for food about to drive to his first job having passed his driving test.

I could hold his whole little body in one cupped hand when he was born. Can’t quite believe it now!

My son was growth restricted also due to pre eclampsia. He was born by c section at 35+6 weighing 4lbs9. I had a growth scan the day before which estimated him at exactly that, so sometimes they are accurate! They had told us that he would almost certainly have to have a spell in the NICU but he came out yelling and, though TINY, was completely fine, no NICU needed. He couldn’t really latch at that size but I managed to feed via a combination of nipple shields and pumping, and when he was 4 weeks old he started to latch on properly. He did catch up really quickly on weight.

For those worrying about c sections, I found mine an unbelievably calm and nice experience and recovery much better than I anticipated. It seriously hurts to move about for a few days but I became totally mobile again very quickly. I would have needed lifting help with a toddler though! My consultant was very keen that I have a section and knowing after delivery just how bad my placenta had really got, plus how ill I personally was, the thought of trying to be induced is actually quite scary in retrospect.

@Crossornot glad your son did well and nice to know he didn't need any NICU time either! Makes it a possibility!

I'm eager for a section even though I know for the first 5 or so days they do hurt alot! Another induction scares me because of how my sons induction went and we ended up in an emergency section and him ending up in NICU!
The recovery from a section worries me slightly as I have 2 other children at home, one which is only 18 months old- however my OH will be off for 3 weeks and then my mum will help us so hopefully won't be too bad!

No NICU for either! In fact we were home after my section with my 5lb teeny in less than 24 hours then pushing the pram through the snow by day 8 post section.( my youngest)
I had to take my other child to school.
i couldn’t do my coat up as I was still huge and swollen but that cold fresh air was divine!

I’ve had 3 babies, (BGB) - I think I’m not very good at growing boy babies as they were both monitored for growth as small throughout the pregnancies from 20 weeks. Last baby was much more alarming, not even on the chart at 20 weeks and lots of frankly horrifying speculation from medics about what might be the reason. They didn’t expect him to make it, thought growth would drop off - but it didn’t, he just grew below the line but following a normal curve. Induction at 37 wks after scan at 36wks showed that fluid had dropped. He was on 0.4th centile, just under 4lbs, but other than a little jaundice requiring light blanket he was totally fine. Turns out he had growth hormone deficiency and from 5yo has had daily growth hormone injections (he’s now 12). Please try not to worry, you are nearly there, even if there were to be a decision to deliver now (highly unlikely), the chance of a good outcome would be high. I’m sure your baby will catch up - good luck

@EllieJai44 yes, that’s me from theFB group. How are you getting on? How many weeks now? My scan isn’t till later today but nst is now. I live at the hospital these days more or less 😂. Hoping for good news this afternoon. I feel massive despite the fluids dropping so either my bump is growing or I’m just getting fat from all the food I’m eating to try make him grow 🤷‍♀️. I’ll send an update after the consultant today. Thanks to everyone with positive stories, it’s really helping me feel a little more positive.

@madeleine85 nearly 33 weeks so a while still, just trying to get through to Wednesday when I get to talk to the consultant!

Hopefully you do get good news! Keeping everything crossed for you 🤞

@madeleine85 I’m sorry you’re going through this too, it’s very stressful.

I had the steroids today as the consultant I saw definitely thinks I won’t make it to 37 weeks (next week is 36). My dopplers have worsened over the past two days so I’m back in for a CTG tomorrow but can’t get another doppler check until Tuesday.

@Moancup sorry to hear the dopplers are getting worse, but very glad you are almost at 36 weeks so at a really good delivery point and that your little one is being so thoroughly monitored. let us know how this week goes please!

My update is 34+3 specialist checkup, looks to be around 3lbs 14oz, still 2nd percentile for growth, which is apparently the same as last week. Heartbeat and blood flow is still good, so they want to keep him in for the time being, and the olihydraminos (low amniotic fluid) is the biggest concern right now, being low 5cm mark. Both the specialist and sonographer think given the low fluid he won't be able to flip, so will stay breech, and a c section will be 99% likely. I'd honestly rather have a C section at this point, just to not stress him out, so it feels better knowing that. Next week is my mark where my DD arrived, and she was 4lbs 14 oz, so it is a bit strange knowing this little one is a full lb behind and my DD was small and struggled, but different children and births, so just hoping for a shorter NICU stay if he can go longer. Just have to keep him cooking till 36.5-37 to get some weight on him. That is my goal! Cue a weekend of eating all the foods :). If nothing else, I feel rounder lol.

Morning ladies,

@Moancup sorry your dopplers have got worse! Hope the CTG today is okay! The fact you're nearly 36 weeks will be greatly in your favour!

@madeleine85 hopefully all being well you'll make that 36 weeks too! And in meantime little guy will put on at least another pound! 🤞 have you got another scan next Friday?

Supposed to be having a lay in this morning yet babys movements are bugging me, normally when I go bed in evening and when I wake, baby is moving like mad! Get my best videos at these times haha
However last night and this morning she's been very quiet....had slight movements but nothing like normal, so laying here hoping she will pick up otherwise will have to ring my maternity triage

Hi Ellie - if the movements have been reduced since last night I would call them now. I did exactly that after a very similar pattern with my son (had never called about reduced movements before), went in and they delivered him! Doubt very much the same will happen for you but no need to wait.

@EllieJai44 yeah I have a doctors belly Doppler, 2 nst/fluid checks and a specialist visit next week. I think the security guards know me now at the hospital 😂. Did you end up getting checked for movement? 2 days ago I barely felt this guy until night time, yesterday he didn’t stop moving! Today is an inbetween. They like to keep us guessing! The specialist was definitely asking about movement yesterday, so the little one kicked him hard enough he noticed! Hope you’re checked out and reassured x

@madeleine85 yes I did go get checked! Little monkey had a party on e on the machine! Made me feel silly! But main thing was all was okay, think the anxiety just gets to me sometimes and I hate not knowing what's going on either!

@EllieJai44 glad youre all ok and got some peace of mind! They like to keep us guessing (and looking paranoid) 😂

Please do not feel silly for going in @EllieJai44. They’ll see parties from previously shy babies all the time and they will not remotely judge you for wanting to be checked. It’s rammed into us to be extra vigilant! Although I’m not feeling very good at it - yesterday the consultant said the baby wasn’t moving as much as normal under her probe and I hadn’t really noticed.

CTG all good today, so unless I notice a decline in movements and have to go in I’ll definitely make it until Wednesday. Which is good because I’m waiting on more tiny baby clothes to arrive!

@Moancup that's good you'll be lasting slightly longer! How are you feeling about it all?

I love buying baby clothes and I have too many now haha because my previous 2 have been smaller babies, I guessed it may happen again and have tiny baby size covered! Haha