Thanks NHS…

[Tryingandhoping2020]

Can anyone tell me if this is usual process or if I should be expecting more?

2nd pregnancy. 1st pregnancy with my daughter was straightforward and birth was textbook, midwife led unit, water birth, went into labour naturally at 39 weeks and she was 8lb 3.

Had a growth scan at 31 weeks because I was consistently measuring 3cm over on fundal height (I had to request this rather than midwife picking up on it). The results of the growth scan were pretty worrying to me as baby is on 97th percentile with abdominal measurement off the chart. I asked my midwife for a GTT which I had and it was thankfully normal.

Skip forward to my 34 week appointment last week, midwife said she’d be referring me to a consultant because of the results of the growth scan, so she wouldn’t be doing any fundal height measurements. (I asked her to measure anyway, still 3cm over). She said I’d likely have to be on labour ward with possibility of an early induction but details would have to be discussed with the consultant. I asked her if I should be having more growth scans, she said this was up to the consultant.

Went away from the appointment feeling slightly gutted that this is looking to be a more medicalised birth but accepting whatever’s safest for baby and reassured that I’d be speaking to the consultant so I could properly weigh up risks and get a birth plan in place.

I've just had the appointment through today, and it’s not until I’m 38 weeks? So would be too late for a growth scan I’m assuming (what if she’s accelerated growth and needs to be induced earlier??) and seems so late to get my head around a birth plan and make any decisions. Just feeling totally unsupported, anxious and unsure on what to expect now 😢

Has anyone had a similar situation? Should I push for an earlier appointment/another growth scan?

I have also been encouraged to have an induction because of IVF, although baby is measuring on at the 90th percentile, so I’m not mad about him coming early. Like you I’ve got a growth scan booked in at 38 weeks and an appointment with the consultant after to book in the induction for some point in week 39. At my 34 week consultant appointment she said they like to induce before 40 weeks. I’m guessing if you go into spontaneous labour before then, that’s great but the important thing is to get the baby out before 40 weeks+.

My midwife has only measured my bump once because of the growth scans at 34 and 38 weeks.

Might be worth giving the midwife another call before if you are anxious? You can still think about your birth preferences?

I hope your second birth goes as smoothly as your first!

I don't think your midwife has done anything wrong here. The sonographer should have referred you for a medical review after your scan. The midwife has now referred you and you've likely been given the next available appointment. Phone and ask to be put on the waiting list or contact Triage and see if you can wait for a medical review there. Midwife is right that they'll likely recommend induction, so you might want to have a read around suspected LGA babies and induction.

You can have a growth scan at term (40 weeks) and occasionally past that, but has to be consultant request. At my Trust you aren't put on an automatic rescanning pathway if baby is above 90th %ile on scan- the consultant has to request another scan at or around term to inform management

NHS recommends that fundal height is only taken from 28 weeks for subsequent pregnancies so how ‘consistently’ were you measuring over your line at only 31 weeks?

You don’t need repeated scans but an up to date one before your consultant appointment would be useful. It may be coming through as a separate letter or just phone the consultant or scan clinic and mention that you have a consultant appointment and clarify whether you need a scan before this.

Thank you all, 38 weeks just seems so late to have the first (and I assume only) appointment with the consultant. I thought it would be more like 36 weeks so I had some time to get my head around whatever is discussed. It’s a good idea to contact and see if I should be getting another scan beforehand so I at least have that info at the appointment.

@pixiedust79maybe consistent was the wrong word to use, I meant 28 and 31 week measurements were both over by 3cm. I asked for the 31 week appt as I was concerned about measuring 3 weeks ahead (which turns out I was right to be as scan revealed giant baby!)

Hey, just wanted to say fellow ivf mama here. They pushed me to be induced, I looked into it all and felt I was low risk. The ivf policy is quite outdated I found. DD was born at 41+4 no complications. Obviously your circumstances may be different but just wanted to mention incase you were keen for a spontaneous labour/minimal intervention xx

Op. Easier said than done but try not to stress, the scans and fundal heights can be completely off. Someone said to me once that bigger babies don’t get bigger heads, she was very petite and had delivered big babies. You may still get the birth you want 🤞🤞

Agree an earlier appointment would help you get your head around the birth plan. You should try to request this if it would make you feel more supported. But 38 weeks would give the consultant a more recent weight and would likely impact decision making. 38 weeks not too late for a growth scan.
Agree wiith PP who said that sonograoher should've gotten the ball rolling with a obs review. In my unit this would happen there and then in fetal assessment with the doctor covering the scanning unit that day.
If not in the context of diabetes then a big baby doesn't generally need earlier birth unless estimated to be 5kg or more. Do you know the estimated weight and did they tell you what the growth trajectory is looking like for term? Hope you get some clarity and feel better supported in the coming weeks.

Just to say, the scan saying you're having a big baby doesn't mean you actually are. I had a 34 week growth scan and was told the exact same thing as you - baby in the 90+ centile, massive abdomen. Had to go in for GTT (normal) but told I was having a 90th centile baby for the rest of my pregnancy. Consultant and midwife both said there was no need for an early induction, but I agreed with the midwife I would have a sweep at my 40 week appointment. Baby arrived at 39+5 before I made it to that appointment...and she was bang on the 50th centile, weighed 7lb 11oz. 🙄The fundal height measurements and the scan measurements were miles away from the reality - so your baby might not be as big as you're expecting!