Small baby, daily CTG monitoring, early delivery??

[earlybaby]

This is my third baby but I've not been through this sort of thing before. I'm 27 weeks.

I went in to the hospital for reduced movements on Wednesday, had a CTG trace done which they weren't entirely happy with (heart rate dropped quite low at one stage). Dr referred me for an emergency scan to check fluid levels, blood flow, etc and it was all good, apart from she's measuring small on the tenth centile.

I've been referred to fetal medicine and I have an appt next Thurs for a scan and to see the consultant. Until then I have to have daily monitoring. It always takes nearly an hour to get the right reading from the machine that means we can stop.

Does it seem likely that they might deliver early?? I suspect her growth must have tailed off for them to be this concerned? I'm really in the dark here, I haven't been told an awful lot!

NC for this btw, I am a regular.

Anyone?

Bumping for you.
Yes, I’d say to expect an early prem delivery.

Thank you!

Really?? I'm also wondering about the daily monitoring, even the midwives who do it were surprised it was every day.

It's good they're being a little more cautious, the extra monitoring will hopefully be giving you reassurance until you can be seen for scan/consultant and then hopefully a plan will be put in place.
If it's any reassurance my 2nd was born on the 8th centile, she had an undiagnosed cord/placenta issue but was absolutely perfect, just a smaller package x

That is reassuring, thank you.

Not an expert but I’ve had a complicated pregnancy with additional scans etc. I would ‘prepare’ for early delivery (ie make sure bag is packed, make sure childcare is ready to go, invest in a couple of prem babygrows if you can) and play it by ear. It’s quite difficult to have an exact course of action at this point. Make sure you raise all questions with your consultant. Good luck!

Instinct is telling me to do exactly that wouldlove. I suppose I won't really know more until my appt on Thursday.

I don’t have any experience but it’s good they’re being cautious and monitoring daily, it could possibly mean an early delivery but I’d imagine they’d want to keep baby in as long as possible till they are “better out than in”….just for reassurance tho my brother in laws wife had twins at 28weeks and they’re perfectly healthy now with no additional needs after a fairly long stay in nicu x

I'd say prepare for early delivery. I got kept in for 3 hourly CTG's after growth tailed off and fluid seemed reduced then was delivered early. They very much took the stance that the longer inside the better, and the closer they can safely take you to 36 weeks the better. They decided to deliver me as the combination of low weight and low fluid was a high infection risk. If it had been one or the other they'd have maybe been happy to wait longer (albeit with monitoring)

Hi hope you’re ok. Try not to worry to much they are always over cautious.
I’m also having growth scans. I had one at 28 weeks and baby was doing fine on the 50th percentile.
Had another at 32 weeks and she had drop to the 7th percentile. They told me they would be delivering baby early but would try and get her to 36 weeks. I had a scan the week after to measure the fluid and blood supply and it was all fine.
After another growth scan this week at 34 weeks she it staying on track on the 7th percentile which they are happy with and have now told me they will leave me until 39th weeks. Although it was a different doctor this time.
I am 35 weeks tomorrow and have to have a scan every week until she arrives.
I think they just have to take it week by week and see what happens.
My midwife told me that they will not get baby out before 37 weeks unless it’s absolutely necessary.
I hope this helps.

Hi Vi, thank you for that. It's good to know the extra details. I'm imagining ongoing scans rather than very early delivery 🤞🤞

How many weeks are you now?

Oh, just seen 35 weeks! Not long to go for you then.

My little one was fine at weeks 12/20, 25-35%, then at week 32 we had a routine scan and I got sent for admission with a 1-2.5% IUGR baby. Somehow we got through 2x weekly heartbeat checks, monitoring and weekly growth scans and made it the whole way to week 36+6. The little one had a c section as IUGR babies can get easily stressed with a normal delivery. And somehow just made 5lbs 1oz. We’re almost 4 weeks in, he’s gaining nicely and thriving (touchwood). If I could give any advice I’d say when we found out about the placental insufficiency I did anything I could, I slept as much as possible and ate a high protein diet. Between week 32-37 he went from 3lbs 5 to 5lbs 1, so despite averaging 1% for stomach size, he grew. Wishing you all the best and hoping for growth for your baby x

This is known as early onset fetal growth restriction. Early onset (before 32 weeks) is more concerning than late onset as the baby has longer to go until an ideal delivery time.

We try to get baby to at least 36 weeks with very close monitoring but if they have to (abnormal heart rate, liquor reducing, blood flow through the cord reducing etc.) we can deliver at this gestation. This would be an absolute last resort however.

I would say prepare for early delivery and hope you don’t need it. A lot comes down to how baby gets on with the following growth scans. If baby stays on the 10th centile that’s fine as they are small but growing. If they start dropping centiles that is more concerning.

It’s clear you are being closely monitored so that’s good. Remember movements are really important so any doubt go and get checked over, even if you’ve had a CTG that day and later feel the movements aren’t right go back. A CTG is only valid for the time you are connected to it so it isn’t a reason to ignore concerns.

Hope your little one hangs on a fair few weeks longer.

Thank you madwife, that's really, really helpful. I'm feeling guilty and awful that I'm letting her down somehow 😞 I don't drink, have never smoked in my life, eat a balanced diet, take pregnancy vitamins, so I'm not too sure what's gone wrong 😞

Her movements have been fine so far (apart from a blip last Weds which was what prompted me to go in and be seen). I wouldn't hesitate to call if I felt something was off though.

I'm booked for a biophysical scan on Thurs and to see the consultant. I'm beyond grateful that I'm being kept a close eye on - NHS at its best.

Please don't feel that way. You are this baby's mum - you will be her world and you are absolutely not letting her down.

I had a small baby (suspected IUGR). We made it to 38w and she was born a better size than they expected at 5lbs 12oz. The day my water broke, my BP suddenly shot up to 155/110 and DD was born less than 24hrs later. I had been taking asprin as due to age / fertility treatment and a poor doppler on the cord flow at the 12w scan, but all subsequent scans had been fine. I felt absolutely fine - no symptoms whatsoever. The doctors told me afterwards that they thought maybe there had been some underlying BP issues all along, but clearly all the monitoring, BP checks etc hadn't picked it up. Sometimes these things happen.

Fingers crossed she can stay put for as long as possible. After birth, my DD had a two week NICU stay (unrelated to her size - she had sepsis), but if your baby does come early, there are lots of great threads on MN about NICU stays with tips for getting through it. But hopefully you won't need them!