3rd centile at 28 weeke and IBD

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I've just had a growth scan and baby is only on 3rd centile. Been referred to fetal medicine who have said they'll measure again in 2 weeks. I asked if my Crohn's could be the cause and she said she wasn't an expert in Crohn's and didn't know, but that the other consultant I'm seeing would know more, and that was it. My next appointment with my consultant isn't for another two weeks, I've only seen him once so far, and trying to get through to him is impossible.

Does anyone have any experience with IUGR and IBD? What should I be asking for if anything at all?.

I'm so worried, any experiences would be helpful.

My daughter almost 3 was diagnosed with IUGR at 30 weeks and was born on the 0.4th centile! She was 4lb at 37+3 but perfectly healthy :)

They never found a cause for her growth restriction. The growth scans with fetal medicine were very accurate for us and they will just scan you every 2 weeks.

I was really scared but I’m pregnant again now with another small baby and trying to be a bit more positive.

Hi OP, I've been in your shoes (though hoping for you it is just an error of a reading). My second was IUGR. FIrst thing I will say is that the scans can be quite inaccurate, I think 20-30% either direction, so i'll hope that this is the case for you and the next scan brings good news and less worry. My specialist wouldn't really give us a solid growth percentage until they had 3 done for an average. I am a small person at 5'1 and we were measuring between 25-35% on the scale on my first bunch of scans which sounded about right. I got covid at c.24 weeks, then thrush, which I stupidly let linger for a week or so, and then placental failure where it was basically functioning for the basics to allow survival, but not passing much for nutrients. Our son is now almost 2, and perfectly healthy, but still little, except for his giant head. The doctors basically sent us for a lot of monitoring, scans, fetal heartbeat checks etc. As long as he consistently grew at 1-5% on the growth scale he got to stay in until 37 weeks, if he fell off they would get him out sooner. We made it to that point and he didn't need the NICU or anything which was not what was expected, I didnt bring any onesies to hospital thinking he wasn't coming home. For the 2 months left of pregnancy I went for monitoring 3 times a week (growth scans and heartbeat monitoring), ate all the protein I could take, rested and did very light exercise. I gained a lot of weight, and the baby gained some. He was 5lbs 1oz and birth at 37 weeks. It is a really worrying, frustrating time when you are waiting for answers, and I generally felt pretty useless, and the fact that the scans were not accurate meant that one week we would see higher growth, and the next we would be back down to what the two weeks before was at, and it was really disheartening. I would ask what the doctor's plan is re. measurements, and where the small size is showing. Usually the body prioritises essential organs when the baby is IUGR, so the head % might be a lot larger than the femur length %, which is odd to hear at first, but is reassuring to know that the organ development is doing what it should. Also ask what the maximum term of the pregnancy would be, and consider discussing if you want a natural birth or C section with your doctor. The specialist told me that IUGR babies can really struggle with the stress of natural birth which can cause post birth complications, and based on that we did a C section, but I've heard IUGR mums doing natural births and all was ok. Hoping that you get some positive news at your next scan x

@Thefaceofboe @costahotchocolatesaremyweakness Thank you both so much for your comments. So happy to hear your little ones are okay 💛

Other than the serial growth scans, did they do any investigations into why your babies were small? This is what's getting me down the most. I thought they'd want to check what's causing the slow growth. My first baby was born at 7lbs so I was not expecting this.

Other than asking if I was a drug user/heavy drinker (I’m not), they did a very detailed blood flow scan of the placenta I think to make sure that there was no issue there. They deemed it “placental insufficiency” and said that there was nothing at that point that could be done except monitoring/growth scans. I lost my plug the week of my c section and it was a nasty grey/beige colour and at that point my suspicions about it being caused by an infection were confirmed. When I had the baby the doctor asked that they took the placenta for testing. I’m in a different country so I’m not sure what they were checking for, but I never heard back. I think unfortunately when there is slow growth and they’re still inside, there is frustratingly little that can be done. Though I’m sorry as I know that’s not what you want to hear right now. Hoping for positive growth for you at your next scan x

Hi OP, I have Crohns disease and my second baby was IUGR from 24 weeks (first was absolutely fine!). My Crohns was really well managed at the time and my gastro consultant was involved with my care before, during and after my pregnancy in tandem with the OB consultant/fetal medicine consultant. The time between the scans was unbearable at the time, the measurements they were most concerned about for my daughter were the femur length scores and head size. It really helped to remember that there's only mm in the difference in centiles and it really does make a difference who is scanning you. The fetal medicine team were great, so much more detailed than the standard scans and they spend all day with mothers in the same situation so I found them really compassionate and explained everything. I was surprised that they were not overly concerned whether you actually raise centiles it's more that the growth continues in line with the centiles.

For my daughter, she was on the 2nd centile throughout my last trimester and then delivered at 37 weeks. Born at just over 4.5lb. tiny but perfectly formed, no health issues whatsoever! She's now 3 and you wouldn't know it!!

I found that most crohns meds are still able to be taken during pregnancy and in the event of any flare up you may be able to be prescribed steriods as well but this may be something you want to query yourself. Once you're in the fetal medicine pathway, I think you might remain on it for the rest of your pregnancy, but that might be trust specific, but that's just extra scans! (although the anxiety will remain regardless!). So you may have questions around delivery, and if being under a consultant might change your plans. I had to deliver my daughter early, due to suspected growth tailing off. At that point, it was agreed that a c-section was the safer option for her as inducing a smaller baby (especially after a full term previous baby) has it's owns challenges.