Nervous after MFM consult (long, probably pointless post)

xladybassx

Hi ladies. I had my first MFM consult this morning. I was there for three and a half hours! They were able to confirm that both babies are girls. Unfortunately, both of them are measuring small. Baby A is in the 16th percentile which is still within normal, but at the very low end of normal. Baby B is only measuring in the 5th percentile, and a full week behind baby A. Baby B is small enough to be classified as IUGR (intrauterine growth retardation). Baby B also has a smaller than normal head and stomach. Both babies have shorter than normal femurs. Apparently the short femur is considered a soft marker for chromosomal issues like trisomy 13, trisomy 18, and Down Syndrome. We opted not to get the quad screen done when it was offered because of the risk of false positive (and I am a worrier). Now I really wish I had, because if I had normal quad screen results my mind would be at so much ease. The doctor recommended the materniT21 test, and I decided to let them do it. The doctor said that in all likelihood the small size is due to the multiple gestation and the fact that I am really small myself...and the short femurs may not be an issue because the babies are so little that they might still be proportionate. She said she had to work out a few formulas with all of the data still to get more information. Still, there is a chance something could be wrong. Even if its just that the babies are little and there is no chromosomal abnormality, it still has me very worried.

Today is a hard day. I was at this appointment alone because my husband is training out in the field this whole week. He will not be home until Friday so until then I have to just deal with this worry on my own. Every other woman in the waiting room had someone with them, either a partner or a friend. I know I can handle it, but it really sucks. I don't want to talk to any family or friends until I've talked to him. I am going back to my OB next week, and then the MFM again October 9. They are also referring me to a perinatal cardiologist because of the potential for chromosomal issues. They also want to start seeing me weekly after 23 weeks to keep a closer eye on growth. Hopefully my next visit will show increased growth and really long femurs! Anyway, that's it. If you made it this far through all my rambling you deserve a cupcake!

luvboston

Hugs my daughter had a short femur and its because we are short she was always in the low percentiles and the mat 21 test came out inconclusive. Also the mat 21 test is not good in twins because it only tells you if one is ok or not so you end up having to do an amnio. She also measured 1-2 weeks behind the entire pregnancy. We did the amnio and it gave us peace of mind because they thought she had downs but she also had an EIf and echogenic bowel. Good luck

Start packing on the protien that helps iugr

hootie123

I just want to give you a huge hug - especially since you were there alone.  I'm glad you did the mat21 so you have more info.  Your twins are di/di correct?    I didn't get a percentile - just an approx weight - did you get that info? 
GL - thinking of you!

PurpleIris30

I'm so sorry - this all sounds very stressful, especially when you were there without your husband. If you are small, then I'm hoping that the babies have just inherited your small stature -- remind yourself that the percentages are compared to averages for all babies' size, so some babies are just going to be smaller than average and that doesn't mean that something is necessarily wrong.  

I am glad they will be monitoring you closely though.  

Oh, and as for the MaterniT21 test, it's still a "good" test for twins.  The issue with di-di twins that are likely fraternal is that if the test comes back positive for a chromosomal abnormality, you just wouldn't know which twin was affected without further testing (however, your doctors would likely want to confirm with an amnio at that point anyway).  However, if it comes back negative, then both twins should be fine.  If they can't get enough of a sample for both, it would be inconclusive.  So it's a good, non-invasive way to start testing, and you can do an amnio later if it's indicated.  We did the test with our twins (mo-di identicals, so slightly different scenario), and it came back negative for both.

jezebel57

wow, i'm sorry you are going through this and have to do so alone for now.  did they say how many weeks they were measuring or what their weights were?  i know our boys' femurs were measuring small as well and i was told they can catch up within a few weeks?  eat tons of protein and try to plump those gals up!!!!!  i'll be thinking of you and sending positive thoughts your way that you get through this and get the information you need to be a wonderful mommy to these girls.    

BeeBee08

I'm sorry that you have this worry.  I just wanted to send you some ((hugs)).  I don't know any advice or have anything to add, but I am keeping all three of you in my T&P! 

xladybassx

Sorry, I should have mentioned weight. Baby A was 301 grams, which is at the very low end of normal. She is at 16% right now but if she were to fall below 10 she would be in that IUGR category with her sister. I don't remember them saying a weight for Baby B, but she is measuring a week behind her sister. I guess since A is still within normal she must be measuring ok for 20 weeks which would put B at 19 weeks. Oh, and yes the babies are di/di.

With the small stature thing, I am not short but I have always been very thin. I am 5'6" and weighed 116 pounds before pregnancy. 116 was the most I had ever weighed, with the exception of IVF bloat. I've never dieted or exercised (regularly), its just the way my body is. I was 6.5 pounds at birth, which is normal but on the small side. By contrast, my husband is 6'6" tall and right around 200. He is thin for as tall as he is, but he has a solid build, not stick thin. He was over 9 pounds at birth.

I know the materniT21 test is controversial for twins because if something comes back wrong it won't tell us which baby (or both) is affected. My hope is that it will come back negative so we know that we are only dealing with IUGR and no other complications. I figured if this non-invasive test had a chance of pointing us in a direction, it was worth trying.

Gr8te

((Hugs)) T&Ps that everything is ok.

melkel559

Huge hugs to you and lots of thoughts and prayers coming your way for your baby girls.

monimu13

Lots of hugs to you today.  Sorry you had to be alone while hearing all that news.  FX that they both pack on some weight!

golfrgal

Fx that everything turns out fine!

rrdiva1

Sending hugs! 

rox825

I'm sorry about the stressful appointment, I hope that you get some good news back from the test.

Keephope2012

Wow that sounds like a tough appointment. So sorry you had to be there alone. Sending positive and growing vibes to your girls!

jezebel57

xladybassx said:

Sorry, I should have mentioned weight. Baby A was 301 grams, which is at the very low end of normal. She is at 16% right now but if she were to fall below 10 she would be in that IUGR category with her sister. I don't remember them saying a weight for Baby B, but she is measuring a week behind her sister. I guess since A is still within normal she must be measuring ok for 20 weeks which would put B at 19 weeks. Oh, and yes the babies are di/di.

With the small stature thing, I am not short but I have always been very thin. I am 5'6" and weighed 116 pounds before pregnancy. 116 was the most I had ever weighed, with the exception of IVF bloat. I've never dieted or exercised (regularly), its just the way my body is. I was 6.5 pounds at birth, which is normal but on the small side. By contrast, my husband is 6'6" tall and right around 200. He is thin for as tall as he is, but he has a solid build, not stick thin. He was over 9 pounds at birth.

I know the materniT21 test is controversial for twins because if something comes back wrong it won't tell us which baby (or both) is affected. My hope is that it will come back negative so we know that we are only dealing with IUGR and no other complications. I figured if this non-invasive test had a chance of pointing us in a direction, it was worth trying.

I have to say that I am wondering what they are comparing to? Both my babes were 300 grams at 20 weeks and they said were totally normal? I looked up average fetal weight for 20 weeks and several sources say 300 is average. Wondering if you may not have anything to worry about after all hopefully?!

ForevAAROSE

Aw hun, what a day. I had a sucky mfm appt too. I truly think that your baby girls will be okay. Also the cardiologist report is so much more accurate than a scan. I know how tough it is to be at the appt alone because hubby wasn't with me at the mfm appt . Hang in there! Prayers and hugs

imoverit

Hugs. Sorry you are dealing with this. Hope you get some clear answers soon.

xladybassx

jezebel57 said:

I have to say that I am wondering what they are comparing to? Both my babes were 300 grams at 20 weeks and they said were totally normal? I looked up average fetal weight for 20 weeks and several sources say 300 is average. Wondering if you may not have anything to worry about after all hopefully?!
Wow, that is encouraging to hear. Maybe my MFM is just overly cautious for some reason. That's strange that multiple sources are saying 300g is normal at 20 weeks when my MFM made it sound like a big problem, but definitely encouraging. I really hope I really have nothing to worry about...hopefully the results of the materniT and cardiologist scan will put my mind at ease as well!

DahliaFlower

I'm sorry you had to be there alone.  Those MFM visits can be really stressful, even when things are going reasonably well, and they gave you several things to worry about.  My best suggestion would be to try to put it out of your mind, think positive healthy thoughts until you know something more definitive.  Getting stressed won't help you or your babies.  I know it's hard, but I really think it's best to focus on the positive for now.  

jezebel57

xladybassx said:

jezebel57 said:

I have to say that I am wondering what they are comparing to? Both my babes were 300 grams at 20 weeks and they said were totally normal? I looked up average fetal weight for 20 weeks and several sources say 300 is average. Wondering if you may not have anything to worry about after all hopefully?!

Wow, that is encouraging to hear. Maybe my MFM is just overly cautious for some reason. That's strange that multiple sources are saying 300g is normal at 20 weeks when my MFM made it sound like a big problem, but definitely encouraging. I really hope I really have nothing to worry about...hopefully the results of the materniT and cardiologist scan will put my mind at ease as well!


I am a huge fan of more testing! Glad you have other things set up to put your mind at ease and hope its just an overly cautious MFM. They can tend to be very disheartening and aren't very positive at times lol. Sorry you are struggling right now.

htn1763

I am so sorry you have to worry. Hopefully the MaternT21 results can allow you to relax. 

RoseHQ12

Hugs to you, so much to process & deal with alone. I am sorry your DH can't be here right now. I had some similar issues along the way but it all worked out in the end & I hope for the same outcome for you. Huge hugs going your way.

IBackBevo

Can't see how far along you are, but my LO had iugr. I had pree. I think iugr is a lot more CCommon in multiple pregnancies. I am on an iugr board and I can tell you the vast majority are not due to chromosomal issues. ..so that should be some relief. The vast majority are due to some sort of placental issues. Again, I think this is not uncommon with twins. They had me on a high protein diet. There is some mixed info about whether this helps, but I think most iugr mamas have been told that. Also, I have found research suggesting that vitamin d supplementation helps and baby aspirin helps. You might ask ypur MFM about thesethings. SSorry for typos

xladybassx

IBackBevo said:

Can't see how far along you are, but my LO had iugr. I had pree. I think iugr is a lot more CCommon in multiple pregnancies. I am on an iugr board and I can tell you the vast majority are not due to chromosomal issues. ..so that should be some relief. The vast majority are due to some sort of placental issues. Again, I think this is not uncommon with twins. They had me on a high protein diet. There is some mixed info about whether this helps, but I think most iugr mamas have been told that. Also, I have found research suggesting that vitamin d supplementation helps and baby aspirin helps. You might ask ypur MFM about thesethings. SSorry for typos

I had my scan at 20 weeks, 3 days ago. Where is this IUGR board? I would be interested in lurking/joining and learning as much as I can. Thank you for the suggestions! I read about high protein diets (a few sources say specifically lots of eggs could be helpful) and a few other ladies on here suggested that as well. I will ask my doc about vitamin D and baby aspirin. Also, I'm not sure if it makes a difference but my twins are di/di so they each have their own placenta.