Reduced fetal growth

[G14633]

just curious to hear from others who have been in a similar situation

I had a scan at 32 weeks. Baby estimated weight was 4.13 Ib. (91st centile) I had another scan at 34 (11 days later) baby hadn’t gained weighted. (50th centile now)

I’ve had reduced movements and went to pregnancy assessment on Saturday. monitor showed baby was ok.

i have another scan at 36 weeks (this Friday).

just wondered what options will be explored if baby still isn’t gaining weight as hoped?

@G14633 I was induced with my LO who stopped growing. It was identified initially at week 36/37 following reduced movement. Went back a week later and only small weight gain but placenta flow ok. Went back week later again at was even less weight gain so was offered to be induced or daily monitoring for a week and then another scan. I opted for induction and it happened at week 39. They originally measured at 20 weeks / bump measurements as 50th centile, first scan dropped to 30th ish and then estimated at 20th. Born under 10th centile so classed as SGA. Induction was fine (minus the midwife not believing I was labouring until I begged to be checked and was 30mins away from the birth so it was a quick birth and contractions started almost immediately and needed an episiotomy, all done with paracetamol and gas and air. I didn’t feel the for a c section it felt 39 weeks was a good time to try, however if I was any less than that I would have opted for a c section.

I experienced this with my first pregnancy, and had dopplers (twice a week) to check blood flow to baby to make sure that there wasn't an issue with the placenta which was reducing growth. One of the dopplers came back showing some restricted blood flow, so they decided to deliver my baby at 36 weeks by c-section. It all happened quite quickly! Baby was perfect with no issues (but small), but they delivered early as there is a risk of stillbirth in those circumstances.

I would push for regular monitoring (I think they can only do growth scans every two weeks but you can get dopplers done more regularly - I had them twice weekly and they were happy to do this). The dopplers are just a simple non-invasive scan, and I found I had to push to get them more frequently (although they agreed pretty easily).

I would just be prepared for potentially having your baby delivered a little earlier than you might be expecting if Friday's scan shows that growth isn't increasing. My baby was absolutely fine so please don't worry too much, but it is something they need to keep a close eye on.

I was referred to fetal medicine and scanned every 2 weeks. My situation was a little different though as my baby was always under the 10th centile and I was eventually induced when we got to the 1st centile.

I was scanned every 2 weeks and the blood flow to the placenta was checked every time. The flow was ok.

I was induced at 40 weeks due to static growth for the previous 4 weeks. The 38 week scan showed growth but was wrong, the 40 week scan showed same growth as the 36th one. I was induced at 40+1 and ended up with a forceps delivery.

Baby was fine, but 2nd percentile.

Keep an eye on the baby movements, you can also use a baby kicks counting app to see if there is a drop in their pattern.

But don’t worry otherwise, they’re keeping an eye on you and the baby.

Just a curiosity, but I wonder if all of you with IUGR (intra uterine growth restriction) also had low Papp-A at the combined scan at 12 weeks? (Under 0.5 mmol)

that was my case and they told me this was a risk, but not many women seemed to be aware of this?

I was told to take aspiring 75mg from week 16.

4 years later, second pregnancy, low Papp-A but writing limits (0.67) they told me the protocol has been updated and to take 150mg daily, with my evening mean, from week 12.

when they told me that, I’ve looked it up myself too and indeed it says you need to take 150mg, staring sometime between weeks 12-16 (12 best) and that is useless to start from 16 onwards. So it might not have made any difference to my first baby. Hope it does now.

are any of you following this protocol too?

That's not reduced growth, that's static growth. I'd be mentally preparing yourself for early delivery as if growth is still static after the next scan they may want to book you in for a section.

Induction of labour may be a consideration too so look into the risks and benefits of both IOL and ELCS.

Also be very nice foul of baby's movements and have a low threshold for going in for monitoring if you notice any change in the baby's normal pattern.

One thing that worries me is my placenta is at the front. I feel very little movement often nothing all day and only once or twice when I sit down at night. So I spend all day worrying something is wrong

this is my second baby. I felt my daughter lots throughout the day and night

*mindful

@nannync yes, started with reduced growth from week 28, ended up with no growth from week 36.

@G14633 you can go to the clinic weekly or more often if you feel you need to, to check the baby. They’ll be fine with that, as you can’t feel movements very well.

@nannync i see now you’re referring to @G14633 .

@G14633 if the next scan shows the same, you’ll probably be offered an induction.

if it shows growth, can you ask them what’s the chances of the scan being wrong? Like it was for me at 38 weeks.

I was scanned every 2 weeks, and as a pp said my baby’s predicted birth weight was actually wrong. They did however conclude baby had stopped growing. I was given steroid injections to bring on the baby’s lungs and then my baby was born slightly early.