20 week scan - Placental Dysfunction and Suspected IUGR

[Hoping4amiracle]

This is a cry for help more than anything else.

We knew we were likely to hit growth restrictions as our papp-a result was very low (0.12 MoM) however at the 20 week scan a couple of the bones (femur and humorous) measured on the 3rd and 1st percentile. The other measurements (tummy, skull, cerebellum, etc etc) all ranged between 10-30 percentile. It was a full skeletal scan so I can't name all unfortunately. The baby's weight was a tiny 285 grams which I think puts it in the 5th percentile. There was significant notching on the doppler check (both arteries) although the blood flow to the baby was good.

Beyond that the baby was active, all it's vital organs are functioning well and there's no sign of any distress.

I guess I'm just looking for hope and to hear positive stories from other women - how much weight did you gain between fortnightly scans? I've been told 500grams is the first milestone we need to hit but no idea how long that would take if baby is 285g just now. Did anything help - rest, lying on your left hand side, beetroot juice, increased calories and protein, iron, acupuncture ... anything?

There's a link to pre-eclampsia, any tips on how to stave this off as long as possible?

If you were diagnosed with IUGR this early when did you give birth and how much did baby weigh?

If you got to the end of this post - thanks and I'm grateful for any insight.

I don’t have any experience of this but wanted to bump this for you.

I don't have direct experience of this but wanted to offer support, I've got low papp a albeit a slightly higher value and have been taking aspirin to help prevent pe- did they advise you to do that? Also been drinking beetroot juice daily as there's some promising studies about it. 38 weeks now and all is well. I can't say it's the same situation, or for certain if what I have been doing has impacted anything but it certainly made me feel like I was being proactive. Hopefully others can offer more relevant experiences, maybe try the antenatal tests thread too?

Hello,

yes on asprin, been on asprin since conception due to recurrent miscarriage. I read about beetroot juice and ordered today - how many glasses do you take a day?

I also have some progesterone left over and I read it can be good at preventing pre-eclampsia.

Have you had any growth issues at all with low Papp-a?

At first 1 glass but upped it to 2 the last few weeks. Vile but better with a dash of orange juice....baby has been on the smaller side, certainly compared with my son but she's tracking her line OK. I had high cord pressure for one of the scans but it settled by 34 weeks. Interesting about the progesterone, not heard that before but I know how it feels, you want to try anything especially after recurrant miscarriages. I had several too before this one. It's obviously impossible to relax and it's so annoying when people say that but anything you can do to escape for a while is bound to help with blood pressure. I've done acupuncture and reflexology regularly both are lovely, interestingly at acupuncture they always have a focus on your pulse so maybe there is something in that.

Hi, I had an IUGR baby, placental insufficiency was our cause, didn’t want to read and run. I suspect Covid followed by a bad untreated yeast infection caused it. We found out about the IUGR at 32 weeks, but I think it started at 25 weeks. My little one is still a short guy, but he is healthy and great. I had a c section at 36+6. The specialist said there was no way they would let me go past 37 weeks, but they would do everything to keep him in as long as possible to that point. The specialist said IUGR babies can get very stressed by natural births which can put them in the NICU. They would have let it go either way if I pushed for a natural birth, but I trusted that advice (my older one is a NICU baby, and I didn't want another if I could do anything to avoid it). The hardest thing for me was the feeling like I was doing nothing and then the multiple times a week monitoring followed by the measurements weekly. I felt useless. The fact the measurements are so all over the place is the hardest part. They’re 20-30% inaccurate. I’d be told one week he had grown to the 8% then the next we were back at 1%. 3 days before the section I was told he was 4lbs 5oz, and he was definitely nicu bound, mine had a 5lbs cut off. He was 5lbs 1oz but I didn’t pack a single onesie as I wasn’t expecting to get to keep him with me. Things I did: ate so much protein. I think I lived on eggs, sweet potato and steak. Rested, lightly exercised, drank all the water. Lord knows if any of it helped, but it made me feel I was in control of it somehow. Sending huge hugs your way. I’ve been there and it’s scary. Listen to the doctors and go to all the appointments. That’s what they told me was the best thing I could do. I hope you get positive growth news x

I had a low papp-a (0.2) and IUGR baby girl. She always measured behind to what she should have been. She dropped to 5th centile at 20 weeks and stayed on the same centile until I was induced at 38 weeks and 3 days at the advice of our consultant. I gave birth naturally and she was born on the 13th centile (2.6kg). She put on weight very quickly and she is now on the 50th centile for both weight and height. So some IUGR babies do catch up once they are born. I remember being in your position and googling frantically about low papp-a and IUGR. There is a low papp-a support group on Facebook that you might want to join. https://www.facebook.com/groups/129843767631323
Wishing you all the best and keeping my fingers crossed for you that everything turns out ok.

@Chasingbaby2 - I know I really don’t like beetroot but will try anything if it might help. I did acupuncture for fertility and it was all about increasing the flow of blood to the uterus which is kind of what I need right now so might ping the practitioner for advice.

@costahotchocolatesaremyweakness - congratulations on your healthy baby boy. I think I’d be coping better if I’d found out about IUGR later in pregnancy, atleast there would be a chance if baby came early. Right now it just feels like a long wait - the consultant said I need to be atleast 24 weeks and 500 grams but even then the outlook is poor. I just feel so far away from that milestone. But yes, I’ve upped the calorie and protein intake, read yoga is good so starting that and lots of rest and water. Also added high dose vitamin E and beetroot juice. Just need to feel like I’m helping the baby x

Thanks @luckyfaith and this sounds very similar to me with the low Papp-a and growth issues identified at 20 weeks. It’s so encouraging to hear you had a beautiful and healthy baby!

From what I’ve read baby’s growth is asymmetrical as head, tummy, brain are all in the 20-30th percentile and it says online that the prognosis is slightly more positive if that’s the case as it means baby is prioritising nutrients and oxygen to its vital organs. I’m trying to hold on to that x

I had the same with my first daughter, she was on the 0.4th centile when born. Perfectly happy and healthy :)

Sorry should say I also had a c section at 37 weeks. (C section due to unrelated condition)

My daughter was diagnosed with IUGF at around 12 weeks she was told all kinds of things as the pregnancy progressed we were all worried sick my daughter was in bits she lives in Australia and I’m here in the uk it was an awful time she also got diagnosed with melanoma skin cancer and had that cut out while pregnant it’s was heartbreaking baby was born at 38 weeks a little premature but that’s all she is nearly 3 and perfect in every way and my daughter is melanoma free ….she is pregnant again so anxious until 12 week scan good luck I’m sure all will be fine x

Hi @Nicetobenice67 , oh my goodness what a terribly worrying time you guys must have had and I lean so much on my mum that distance must have made it all the more difficult. I am so glad to hear baby is doing well now, it does give me some hope.

Thanks @Thefaceofboe - how far along where you when diagnosed with placental dysfunction/IUGR?

How did everyone prepare for baby’s arrival, I don’t think I can buy anything and I don’t even know what to say when asked how I’m keeping x

Thank you so much …my daughter was 12 weeks when she found out and every time she was scanned they said worrying things …I googled so much and it’s quite common and most babies will be ok so that was very reassuring…my daughter resigned to something being horribly wrong but they were going to carry on with the pregnancy no matter what we got some very small sizes to start but tbh baby wasn’t in them for long she soon started gaining weight she did get jaundice in first few days and was in ICU but that’s common in premature babies we prepared for the worst but like I say we worried needlessly for the who pregnancy they even said baby looks like she has big lips 🤣🤣 I said well that’s great for this day and age but jokes aside everything turned out wonderful she is perfect and your baby will be too ….I cannot say don’t worry as it human nature but try to enjoy your pregnancy and read up as much as you can about PLACENTA DISFUNCTION / IUGR …with the right care scans ect you will be fine I know my daughter had scans more often and they kept a close eye on the pregnancy good luck xx

It was at my 20 week scan! Honestly I just bought tiny baby clothes and that was that. I was told to prepare for a NICU stay but thank god she was fine. I’m 17 weeks now with my second so a bit anxious to see how this baby is getting on

Exactly that my daughter is pregnant again and will be anxious until 12 week scan

When you are in that situation it's so hard not to worry and think of the worse case scenarios. I worried myself sick every time I went for a scan and I found the whole pregnancy so stressful. The regular scans really helped and the consultants were amazing at always explaining clearly what was happening and what the next steps would be. It was literally living from one week to another but we managed to get to 38 weeks and I'm keeping my fingers crossed that everything goes well for you and your little one. Just to add, we also opted for an amnio after our 20 weeks scan just to rule out any issues so that also gave us a bit of a hope that the baby was just small.

In terms of clothes, we bought 'tiny baby' size which were still a bit big to begin with but she filled them up pretty quickly.

If you can be open about how you are feeling that will help so you are not internalising all of your feelings and feel isolated. Sending you lots of strength 🤗

Hi OP. Honestly, all things considered, it sounds like you are doing great. I remember posting here about my IUGR diagnosis and asking for guidance back when I found out, and tbh all the responses, much like this, were that the babies were ok. They caught, and generally ended up very healthy. In a way that made me feel more nervous, as I thought maybe I would be the odd one out. But it was much ultimately better than expected, though I agree that time drags like no other when pregnant, and dealing with complications. Similar to you, my baby was asymmetrical and the doctor made the same statement that the vital organs were being protected, and they were right. Ironically my 18 month old is about 15% height, 20% weight, and 98% on the head circumference rankings now 😂. Crossing everything for a healthy, happy outcome for you all x