Fundal height measuring small & midwife unsure of next steps

[CharlieAndMoose]

I had my 28 week appointment with my midwife today, though I'm actually 29+2. It was the first time I've had my fundal height measurement taken. The midwife struggled to find the baby from an external exam, then after taking the measurement, advised that it placed the baby in the 10th percentile, so quite significantly below average. My pregnancy is IVF so I've been told from the beginning it's classed as high risk and consultant led.

Anyway, the midwife said she wasn't sure if this would require a follow-up growth scan, so she sent the notes to the consultant and said that she'd be in touch via text this evening to share their feedback. She also said that if I need a scan, it'll take place within 2 days, but couldn't tell me when or how this would be communicated to me. Anyway, it's been 5 hours now and I've not heard from her. I don't have a contact number for her as I've seen a different midwife the past 3 appointments, so I'm not sure where to take it from here - do I assume no news is good news, or somehow try to chase it up?

I'm not feeling too concerned as baby is currently very wriggly and I personally have noticed a significant growth in my bump in the past week or so. But I do feel like I've been left hanging a little and with no direction as to who to contact for further information! Has anyone else been in a similar position with a small measurement at this stage? What happened next, did you have a scan (and if so, how was this organised) or did you wait for the next measurement appointment?

Do you have a copy of your growth chart? On and below 10th centile are managed differently.

The midwife's responsibility is to refer to the consultant obstetrician
Beyond that she cannot make any decisions regarding action to be taken.
IME it will take a lot longer than a few hours for the consultant to read your notes and make a plan, arrange an appointment to see you, examine you, make a decision and communicate it to the midwife.
I am sure she will contact you when the consultant communicates with her.
You have said baby is active amd growing.
I am sure the midwife has told you to contact her if baby is not active, so I think just sit tight unless you are worried about fetal movements.

No, she showed me the chart on screen but I don't have a copy of it.

That's fair enough, but she shouldn't have suggested that it would be confirmed today if that wasn't going to be the case. I did explicitly ask how and when I'd be informed of the next steps, and she said "I'll text you tonight". If she'd been more open ended, such as "someone will call or text within a few days", I'd have no expectations! I'll sit tight for now if I don't hear anything in the next day or so, hopefully Google can throw up some answers as to which department to contact in my local health authority.

You should have a number to contact whether midwives or the antenatal/maternity unit for when you go into labour - usually both! - on your maternity notes cover/back. If they aren’t there, Google maternity unit for the hospital you plan to give birth in.

I’d personally chase up tomorrow via phone call but that’s just me. It would usually result in a growth scan, especially if around/under 10th centile - but try not to worry as they are notoriously way off usually.

It’s worth noting that fundal height is a really crude measurement and really only offers any information if the same midwife does the measurement each time via the same technique, feeling the same landmark points as a guide. The first one is a tricky one to judge because there is no historical measurement to plot growth against, though if you are measuring small the midwife will have protocols to follow hence referral. As PP have said, I would probably call tomorrow to chase just in case it’s got lost in the system. Do you have paper notes or are you on badger?

Mine always measured smaller and was born on 9 percentile. Has been on 9th percentile ever since. He’s the smallest in his class. Normal pregnancy. Normal birth unassisted. I’m very fat. But my baby is small and lean.

I had almost exactly this. Midwife took just one bump measurement around 28wks very quickly which put me at 6th percentile. Had a growth scan a few days later and baby was bang on average. Have had another scan since at 32 wks and baby was in 70th percentile.

I wouldn’t trust those bump measurements! I am tall and the percentiles are based off a population average. Also depends on the baby’s position too. So I’d try not to worry but worth following up on getting a growth scan for reassurance

Sorry just reread your post and saw you asked about how the follow up scan was arranged. Because I was below 10th percentile and my next scan wasn’t for 3+ weeks, they booked me in for the follow up scan. They called me directly to arrange.

That's useful to know, thanks!

Our area uses a system called mypregnancynotes which I think is the same idea as badger. Though it doesn't get updated often. Would the growth chart likely be recorded there?

Also an IVF pregnancy and measuring small consistently on fundal height measurements. I'm tall and not sure if this is why. Had 3 growth scans now and all place baby over 50th centile. Try not to worry too much (I did at first) as like pp say, fundal height is such a crude measurement!

My fundal height measured small once, around 32 weeks, and I was sent for a growth scan … which showed a huge baby, so huge in fact he was over 11lbs at birth.

I remember my midwife telling me my baby girl was on the very small side according to my fundal height at 30 weeks. She was 9lb 6oz when she was born at 40 weeks.

Crossed my legs reading this 😂

It should be as they log them on the computer so it should automatically update! If any help, on badger it’s under ‘maternity record’ then ‘intergrowth fundal height chart’.

As a side note, I also gave birth to our IVF baby in Nov and very late (like 38 weeks) the consultant called to book me in for induction at 40 weeks due to IVF. It completely side lined me as no one had mentioned it prior, and they were fairly pushy. I looked into it and the extra risk factor didn’t apply to me under the circumstances of my IVF so opted to wait for spontaneous labour. It’s completely individual how you would like to approach labour so am not trying to push any opinions on you. I just would have appreciated knowing! So good luck with it all and congrats on your pregnancy!

Thank you for sharing. I'm also really not keen on the idea of induction, I haven't heard any positive labour stories from women who've done it, so it's definitely something I'll be querying should it come up.

No problem! And same same, even the ‘positive induction’ stories on YouTube take days & days! I’ve seen some women on here say they had positive inductions though but I wanted to avoid it if possible. And it just felt wild no one had mentioned it to me before 38 weeks, felt pressured then to make a quick decision! So glad I went with my gut/own research though.

My hospital also uses My pregnancy notes and you can see your fundal height chart. I think it is on one of the first pages, something like Summary or Care Summary and then you need to scroll down quite a way.

My first measurement was tiny (5th percentile or something) but since then my fundal height has consistently measured at 95th percentile! So it might not mean much at this stage

My bump with my daughter was always on the 10th percentile so I didn't qualify for growth scans. If it had dipped below the 10th percentile I would have done.
She was born at 38+6 at 6lb13 so a pretty good weight, I'm only 5ft2 and slim build I believe this was 60th percentile based on my chart. She's 4 now and 25th percentile for weight and 2nd percentile for height so short but a good weight which might have explained the difference in utero