Does anyone know anything about IUGR - shared experiences much appreciated

[EmLouT]

I am 24.4 weeks pregnant and at my 20 week scan I was told that the blood flow to the placenta is restricted and that the baby is very small and may have IUGR. Does anyone have any experience of this - where might it lead?

Thanks

Hi
Are you under consultant-led care and what have they advised?

The impact of IUGR depends on gestational age. My baby's growth slowed in the last 2 weeks and so I so I was induced as the docs thought my placenta had stopped functioning efficiently. They thought it was better for my baby to be out so that I could feed her.

It is vitally important that you have as mucg advise as possible aboit how to support your placenta. What have you been told?

Yes, I am under consultant led care and they have advised me to take low dose asprin and to have growth scans every four weeks. I am also having blood pressure and urine checks with my GP every two weeks. Next scan is at 28 weeks. Is there anything else I can do?

Thanks for the input.

I am quite surprised your growth scans will be every 4 weeks given they suspect IUGR. Maybe they intend to scan you more frequently towards the end of pregnancy.

I would suggest you read as much as possible about IUGR - bluntly speaking, some of it is scary but I think the more info you have, the more questions you can ask your doctors.

My daugher sadly passed away shorlty after her birth but it was nothing to do with her growth slowing. She developed a very rapid infection. During that pregnancy, I never visited a single forum, didn't read up on possible complications and so pretty much ignorant as I never expected something so devastating could happen. In this pregnancy (ended due to missed miscarriage) I read up on so much stuff so every time I had an appointment, I could quiz my doctors about anything that was worrying me. My consultant even said that if I came across anytihng I thought he should consider, to let him know. Of course the knowledge I have gained isn't even a drop in the ocean compared to their training but I feel that they know they can't fob me off. Also, I have asked for extra tests and they have given them to me.

Actually, have you been tested for clotting disorders? That may explain reduced blood to placenta. The apirin is supposed to thin the blood and improve supply to placenta. I had a niggling feeling after my daughter's death that clotting could have caused placental insufficiency. I requested clotting tests and they came back abnormal. I am having them repeated to make sure it is a consistent result. It may well explain this miscarriage. I would say call your consultant and ask him about clotting. If you can rule out clotting then that is one less thing to wory about. If you do have a clotting problem them maybe they will give you additional thinners.

Anyway I hope you find the answers you need. Please let me know you get on.

Hi
My dd had Iugr which was picked up at 36 weeks, they decided to induce me at 38 weeks and she spent 24 hours in scbu but is now a lively 2 year old although she is small.
I've had 3 m/c also and was tested for the blood clotting disorder which I have (anti-cardilipin antibodies). My last pregnancy I was put on clexane and asprin, given scans every 4 weeks untill I was 28 weeks then every 2 weeks. At 35 weeks he stopped growing so I had dailt ctg's and was induced at 36 weeks. He didn't need special care but it did take him a long time to feed.
Sounds like the hospital are keeping a close eye on you. Best of luck

Hiya

I just wanted to add - keep an eye on your baby's movements. My midwife gave me a kick chart and although they are not used anymore it really helped me monitor the baby's movements as I lost my first baby due to a cord/growth problem and the first I knew was when I noticed the baby had gone a bit quiet

Don't stress to much though (easier said than done).

agree with chumpalina about monitoring movements. My dd had iugr and is now a healthy 11 yr old.
I was induced at 36 weeks and she weighed 4lbs 11oz . good luck
with ds I had loads of scans and no problems

Thanks all for your ressurance - it's good to have someone to talk to!

Hi EmLouT

I have just read your message and I had exactly the same problem with my pregnancy.

I attended my 20 week scan and was told that my baby was weeks behind in growth especially his long bones and they didn't even measure on the centile charts. To cut a long story short I was later admitted to the Silver Star Unit at the JR at Oxford who were out of this world. I had restricted flow through the cord to the point where it was non existant. I was given daily asprin and weekly dopplers to check the flow. Owen held on in there until he was delivered by c-section at 36 weeks weighing in at 4lbs 3oz. Owen is now 12 months old and although still smaller than his peers is perfect in every way, he took his first steps last week.

The first hospital I was under were not very familar with IUGR and diagnosed other things that could be wrong with Owen. I would encourage you to make sure your consultant/hospital are fully up to speed on IUGR and know how to manage it properly. As I say, the Silver Star ward at the JR were brilliant and I cannot praise them enough.

I hope this helps.

Sam

Hi EmLouT

When I was pregnant with DS, his growth started to tail off at 32 weeks. And there were concerns that there may was IUGR. It is great that you are under consultant lead care. The things I would share from my experience are the following:

• I would push for more frequent scans (especially after 28 weeks), I was being scanned at least fortnightly

- I assume that in addition to the normal growth scans, they are also doing doppler scans?

• You are slightly too early in your pregnancy to be told to monitor your bubs daily movements, but from around the 28 week mark, you do need to start keeping an eye on frequency of movements
• Your consultant will most likely tell you to call in any episodes of reduced movements and you will be asked to go in for CTG traces to monitor movement. Without scaring you too much, if there is suspected IUGR, the earliest symptom that things are not all well with the baby is if the baby starts to move less. And reduced movement needs to be checked out straightaway. Pack a good book, because I was sometimes hooked up to the monitor for well over an hour.
• Have a hospital bag packed early and kept ready in the car. If one of the traces/ scans concern your consultant, they could admit you there and then, so be prepared.
• Be open to different birth methods. I was totally geared for a natural birth but combo of suspected IUGR with resolute breach baby meant I was advised to go for a csection. And I listened to them.

My consultant said that they were going to try to get me to 37 weeks so long as scans / movements did not cause alarm. I did get to 37 weeks (waters broke night before planned csection) and DS was born via csection weighing 5lb 1oz.

DS actually didnt have IUGR, came out kicking and screaming, very healthy and strong. Think DH and I just grow em small.

The only other part I would prepare you for(if you are keen to breastfeed) is if your LO comes out a little on the smaller side, you may be advised to start feeding formula immediately as opposed to waiting for your milk to come in.
DS was always put to my breast and managed to feed a little, but tired easily. I then expressed colustrum which was given to him, and he was then topped up with formula. I spent the first few days in floods of tears convinced that this would mean DS wouldnt be able to breastfeed.
I was wrong. My milk came in on day 3, and because DS had been feeding well- he had enough energy to latch on a start feeding for longer periods (topping up with bmilk). By the time I left the hospital on day 5, he was breastfeeding wonderfully with no top ups via bottle required. He didnt go into SCBU, or get Jaundice and lost none of his birth weight by discharge.

Sorry for the humongous post. I just know how scary this whole experience can be, and wanted to share all the stuff I had learnt when I went through it.

HTH and keep us updated as to how you get on.

mistletoekisses - thank you for the kind and informative post. Have been keeping an eye on bubs and went to DAU yesterday because of reduced movement but they were very funny with me as they say they don't monitor babies under 26 weeks (I am 25+ 5). I finally convinced them to hook me up and the baby is fine - it's just all so stressful!

Re breast feeding. I am very keen to breast feed this baby but I know from experience with my son (who was tongue tied until surgery at two weeks) that it is not always possible to do so exclusively - he was combination fed and is a strapping, smart little man so I will do whatever is necessary.

Will keep you posted.

I'm really glad to have found this thread, I went for my 28 week scan yesterday and the baby's abdomen and femur length growth have dropped off. At 24 weeks all the measurements were at the top end of the normal range but yesterday the tummy and leg bone were near the bottom of normal.

I had 2 markers earlier for possible problems of this nature - low PAPP-A and high uterine artery PI.

My BP is up a bit so they took bloods to check for pre eclampsia (I'm ringing for the results today) and I'm being seen in the consultant's clinic next week and having another scan the week after that.

I am pretty nervous but trying to put a brave face on it. I think the hospital (King's) is really on the ball. I feel loads of movement too, and I'd know to contact them if this changes.

Bear - it sounds as though you are in very good hands. I know that saying not to worry doesnt really help. My last 5 weeks of pregnancy with DS was pretty stressful. But dont hesitate to get to the hospital if you have any concerns and dont be scared to ask as many questions as you need to when you see the consultant. Per my previous post, DS was absolutely fine.

Emlou - how are you getting on?

Thanks Misteltoekisses, your long post was really helpful and informative.

I got the blood test results a couple of hours ago and they were all normal thank goodness.

Bear - try not to worry too much. Small abdomen is a sign that your baby is being very clever and using all its resources to strengthen vital organs rather than to put on fat.

I too had high uterine PI at 20 weeks. This seems to be getting better with every scan (fortnightly at the moment) My little man has a normal head and femur size but a very small tummy - he has howevever, remained on the 3rd centile for the past six weeks and that is a good sign. At 28 / 29 weeks you have made it over the biggest hurdle. I am now 32 weeks and have been told that although baby now only weighs about 3lb - if he were to be born tomorrow he would be fine.

IUGR sounds terrifying when you first hear your baby may be suffering from it but I feel in a much better place now - if I go to term the baby will be about 6lb which is a respectable weight. So long as the blood flow through the umbelical cord is good and there are no signs of calcification on the placenta, the best thing for your baby to do is sit tight even if not growing much. IUGR babies tend to be very hardy and catch up well after birth. Just keep doing what you are doing and make sure that you are being kept a good eye on. It's better that you know their might be a problem so docs can monitor you more closely. My DS' growth dropped off in the last 6 weeks and nobody knew it was happening - he was just over 6lb when born and had been on 75th percentile at 34 weeks - he is happy and healthy and suffered no ill effects.