Severe SGA at 20 week scan?

[georgarina]

Hi, just had my 20 week scan and baby has been diagnosed as severely small for gestational age with measurements all coming up between 3rd-7th percentile. Placental blood flow looks good but the placenta is situated very low which they said could be a problem.

They don't know now if baby has always been small, is naturally small, or if growth has slowed/is due to a placental malfunction.

Basically just freaking out. I'm waiting for another scan date but haven't had this with my other babies so not sure about baby being naturally small (others were 25/50/60th percentile).

Anyone who has dealt with this I would love to hear any stories because this is all new to me.

Ask for an amniocentesis to rule out some genetic issues with the baby. But try not to freak out. The centiles are all within normal and someone has to be the smallest. Plus ultrasounds are notorious unreliable for weight and size.

Thank you. I already had the NIPT which came back low risk so I don't know what other tests they're planning to do. They said anything below 10th percentile counts as growth restriction and 3rd is severe. All I can do is wait to find out more.

I had NIPT too, which came back low risk. An anomaly was picked up at my 20 week and they referred me to feral medicine and I was offered, and had, an amnio. It looks for lots (but not all) chromosomal issues. That came back fine. Beyond that there isn’t much available.

Ask about an amnio (very low risk, miscarriage stats don’t allow for MC that would have happened anyway and are based on 1970s data) if you want as much info as you can have.

Thanks. I'll definitely go for the amnio if they offer it next week.

I've been looking up symmetric IUGR and it's so worrying. I keep reading phrases like 'poor prognosis' and 'negative outcomes.'

It's not long now until the appointment but obviously I can't stop thinking about it.

@georgarina have you had any updates? My 20 week scan showed the HC on the 3rd and FL on the 7th. I’m due a re scan on Thursday but loosing my mind with worry

hope you and baby are doing well

Hi, I'm 35 weeks tomorrow and baby has HC and FL on the <3rd and AC is now normal. This is apparently considered consistent growth. Due to AC and fetal weight she's now on the 6th percentile overall which means if all continues on this track I will be able to go into labour naturally and use the birth centre rather than the labour ward.

In terms of what it means for baby, I'm still completely in the dark. Will have to wait and see.

Good luck, try not to worry too much, write down all the questions you have. The IUGR support group on FB is also helpful.

@georgarina oh that’s good to hear, have you had extra scans / monitoring throughout?
mine dont refer to fetal medicine unless it goes under the 3rd so not sure if I’ll have extra scans or not… I’m booked in at 32 and 36 weeks but for a different reason.

Its so hard not knowing if the baby is okay in there 😩

hope all goes well x

@Sprinklerainbows Yes I know, it's so hard not knowing. Have they offered you an amnio? The consultant told me I was high risk for premature labour with the amnio (due to other complicating factors as well - uterine prolapse) so I didn't do it, but it could give you some more information. Have they done a TORCH screening to check for infection? And checked the umbilical cord?

I have had scans every 3 weeks with FMU and now bumped up to every 2 weeks because she was <3rd percentile overall up until last month. They also referred me from FMU to the small baby clinic at my hospital (literally only difference as far as I can tell is a different sonographer and scanning room!)

I really hope all goes well for you. They did tell me in the vast majority of cases babies are just naturally small with no particular reason. Still it's really hard to have something like this hanging over you when you just want to be excited for baby to come :( but will update with any news/how everything turns out x

Hi @georgarina at my scan i was told my bubba looked on the small side around her tummy.
I straight away started to eat nuts (almonds, cashew and walnuts), like a handful if not more everyday and i ate half an Avacado regularly, by the time my next scan came round my bubba had got bigger 🙏
Hope the above helps xx

@georgarina wow sounds like you’ve really been looked after.
if I’m honestly it’s completely up in the air atm. Said she it’s technically normal because it’s not below the 3rd centile it’s ON it. So basically I’ll have to see what they say tomorrow at the rescan.

she literally said well she might be small or it might be something genetic, just wait and see what happens. And then basically pushed me out the door 😐

I also have a low lying placenta too!
but no time for questions 🤦🏼‍♀️ so equally as in the blue about that too

@georgarina it’s measuring around the 2.5 percentile now so we have been referred to fetal medicine. They are going to call in the morning apparently.
mixed feelings but she didn’t seem concerned which is good x

@Sprinklerainbows oh I'm really glad you have been referred and are getting a phone call. Just write down all your questions so you don't forget anything, and write down their answers. I was <3rd percentile all the way through this pregnancy until last month. I would just ask everything you want to know...potential causes, testing options, what it means for your birth plan, chance of longer hospital stay, projected size if baby stays on this line, etc. Good luck x

Thank you! I feel a lot more comfortable now that we’ll be under their care, I know they’ll look after us.
another thing noted on the scan was an echogenic bowel… apparently can be associated with a small baby. But again they didn’t seem concerned really
Thank you, those questions are really helpful! Such a lot to think about 😅 x

@Sprinklerainbows keeping everything crossed for you...it's such a stressful time but just keep in mind they are relaxed because it's much more likely to be fine than be a problem. Hope the call went well and they offered some more information!

@georgarina hello thank you! The call was SCARY I felt so much worse afterwards. She mentioned the testing and what they could mean in terms of termination! I was in so much shock I couldn’t believe it as that just hadn’t entered my head. so she called us in to have a face to face chat which I did feel much better about afterwards.
due to the echogenic bowel plus the head we’ve been referred to a hospital in London and will be seen and scanned early next week by them.
today I had the TORCH test. And both me and my husband had bloods to see if we are carriers of cystic fibrosis (due to the bowel). She said they’ll want to do an amnio at the scan next week but I’ve decided I don’t want it and I’m going to have the NIPT instead privately.
She said based on the scan in London, they’ll make a decision if we’ll have scans every 2 weeks or every 4. My hope is that she’ll have had a lovely growth spurt and this all goes away 😅
It’s such a lot of information to take in!

Hi girls,

I'm sorry to hear you're going through this, do you have any updates? I'm currently going through the same at 20 weeks - waiting for the FMU referral, but basically baby is in the 3rd centile. I'm sick with worry and cant sleep at all, glad i found this relatively recent thread. Hope you're all well now

Hi all hope you're well and everything worked out with the further scans and tests? Also in the same position now and have a further scan with fetal medicine this week, I'm worried sick. Baby measuring very small on all fronts (HC, AC and FL)

Sending lots of love x

Hi all, just wanted to update, baby girl is now a month old and was born at 6lb 15oz, on the 35th percentile for all measurements. No idea what happened there...was induced after being told her growth had slowed further and the placenta was likely failing.

If anyone is in my position, I would book a private scan if possible.

Sending love and good luck

Congratulations 🥳

Thank you 😊💕
Was a shock when they told me her weight and I realised none of the premie outfits I'd bought would fit!
But yes an amazing result x

Just to reiterate though, even when they thought she would be SGA they assumed everything would be fine x

@georgarina aw that’s great news congratulations!
what gestation were you induced? I’m 30 weeks now and her growth has started to tail

such nice news to hear she wasn’t small after all, I’m hoping for the same outcome 🤞🏼 xx