Success after IF

Experience with IUGR - small at 32 week scan

I have been measuring small the last few appts and had a 32 week growth scan today to check on the baby.  The baby's head circumference and femur length were in the 50% range, but the circumference of the abdomen was in the 5th percentile range.  I was told that the baby is getting the nutrients to the most important area (head/brain), but is not gaining weight in other areas which is causing the very small abdomen. I have been put on modified bedrest and have an appt with a neonatal specialist on Monday.  The Dr. thinks it might be due to poor cord blood flow or that the placenta is not functioning properly. 

 Anyone else have experience with this?  I couldn't get a feel for how concerned I should be.  I have gained 20lbs so far, so she doesn't think it is a problem with not eating enough and I don't feel like I could eat much more anyway.  TIA!

Re: Experience with IUGR - small at 32 week scan

  • Dylan's was discovered at 33 weeks.  I'd been measuring small and when I dropped 2 weeks below in belly measurements they sent me to the peri.

    Dylan's head was in the 98th %ile, abdomen in the 4th %ile, and femur in the 50th %ile.

    They told me the same thing... when the abdomen is small they worry that the nutrients are being channeled to the brain.

    I had a placental study done and it all came back fine.

    Here's the kicker for us.  DH has a 14 yr old from a previous marriage (at that point in time he was 10).  He has a HUGE head.  DH has a HUGE head.  I'm skinny as a rail and so is DH.  Wicked fast metabolism.

    I went on bed rest, ate like a demon trying to fatten up the baby and just held on tight for the ride.

    I was told he had to come out by 38 weeks because with IUGR that's the standard of care.

    They did an amnio at 37.5 weeks and took him section at 38 weeks.  I was prepared for NICU and breathing issues (even though his amnio showed 98% chance that his lungs were fully developed).

    He was born and....

     

    He was totally fine.

     

    He's just skinny.

    Still is to this day.

    And he's got a big noggin.

    Still does to this day.

     

    I know it's impossible not to worry but I wanted you to know that sometimes some babies are just skinny by nature.

    There was no nutrient robbing going on.  No placental malfunction.

    But.... I'm 100% grateful that I had a wonderful team of professionals who were totally on top of his care.

    Sounds like you do to!

    So my word of wisdom is to mentally prepare because if you get a true IUGR diagnosis chances are they're going to recommend delivery by 38 weeks at the latest.

    GL to you and keep us updated!!!

    Shell 

    Our IF journey: 1 m/c, 1 IVF with only 3 eggs retrieved yielding Dylan and a lost twin, 1 shocker unmedicated BFP resulting in Jace, 3 more unmedicated pregnancies ending in more losses.
    Total score: 6 pregnancies, 5 losses, 2 amazing blessings that I'm thankful for every single day.
  • me, baby B (cali) was in the 10th percentile and she had issues with her cord, Are they going to do a doppler flow on you?

    I would be more than happy to talk about my pg with you, but I have a fussy baby right now. You can email me at mrs.babbsy@yahoo.com

    I would be more than happy to answer questions. She had absent blood flow at times too. Let me know if I can help you. Cali was born into the 10th percentile at 34 weeks and is doing great at 2 months old. We were just released from the NICU follow up for her weight:)

    GL and I am here. Sorry I can't go into more detail, but Savannah won't let me put her down.

    I talk about it all on my blog too.

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    "Someday we will look at our babies and know it will be worth it. If it was easy, we would not have had our babies, the babies we were meant to have." From Amy052006
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  • Thank you for both responding.  Babbs - I followed your story with Cali (itty) and I didn't realize it was IUGR.  It makes me feel better than everything turned out great for both of you girls and your babies. 

    I believe they are going to do the doppler flow test on Monday and hopefully the specialist will have more answers and I may follow up with more questions on Monday.  My regular OB was out today, so I saw another Dr. in the practice that isn't familiar with my history and she seemed very concerned.  She also mentioned that with IVF pregnancies, it is more common to have problems with the placenta and cord flow than a normal pregnancy.  I had never heard that before.

  • Me- my DD measured very small at the 32 week growth scan.  She was 30% for head circ, 7% for femur length, 3% for weight.  Estimated at that time to be around 3 lbs 10 oz.  I had one or two more doppler ultrasounds after that, I think.  And NST's two to three times a week. Modified bed rest.  My Dr wasn't strict on this she just wanted me to stop working and to take it easy.

    She was born the day before 37 weeks, I was supposed to be induced that day, but went into labor on my own.  She was 4 lbs 1.9 oz 17 inches long.  Not on the growth scale at all.  She spent a short time of observation in the NICU for having difficulty keeping her temp up, but was in our room a few hours later.  She had to pass the carseat test before I could take her home with me.

    The day I brought her home she was 3 lbs 12 oz, one day later 3 lbs 12.7 oz, next day 3lbs 14 oz.  A week later 4 lbs 5 oz.  At eight weeks she was 7lbs 

    She has never been on the growth scan since then,  She has been consistently in the 10-15% for height, 30-50% for head circ, and < 1% for weight.  She is a week away from two now and hovering around 21-22 lbs.

     But she has been completely healthy.  I kept her inside most of that first winter, due to her small size.  She has only had one ear infection, a couple of stomach viruses, and a few colds.  She has met all of her milestones on target.  One thing I will say is she ate all the time for the first year.  Every 40 minutes to two hours for the first four months.  Every three hours until she was a year.  So that was a challenge being EBF.  But it all worked out well. 

     It is a hard dx to get and I am so sorry,  I would be willing to answer any questions you may have.  Just page me and I will send you my e-mail.  Thinking of you. 

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  • If you have the doppler flow test, ask what your ratio is and ask them what it should be.

    There isn't a lot of info out there about flow studies, so I drilled the u/s techs with questions so I learned a lot. feel free to ask questions. I had a heard time with it because I didn't have a lot of info. This was the reason I was put on hospital bedrest and I had 2 NST's a day and at least 2 doppler flow studies a week, but of the time I had them everyday.

    GL and I am here for you.

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    "Someday we will look at our babies and know it will be worth it. If it was easy, we would not have had our babies, the babies we were meant to have." From Amy052006
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  • Yep, I've had tons of experience with IUGR.  J was born at 36w 1d @ 3lb 7oz - I was induced due to IUGR.   I measured small the entire pregnancy and then at 28 weeks, it was "discovered".  I got steroid shots and since then, had weekly ultrasounds for growth and multiple non-stress tests per week.  I was on modified bed rest, too.  The IUGR was a result of a poor placenta with poor blood flow.  Upon delivery, we saw that the cord was attached on the side of the placenta instead of the middle, like normal.

    I've seen IUGR babies born a little small who have done just fine and functioned as normal children with minimal or no NICU time.  In my case, J was in the NICU for 10 days for hypoglycemia, learning to regulate body temp, feeding & growing, and he was treated for jaundice there.

    Since then, he's had a whole host of issues - many that earlier preemies have.  The most profound is low muscle tone which has impacted gross and fine motor skills as well as some sensory issues.  He also has reflux, rather bad. 

    The good news was that he has never had breathing issues - probably thanks to the steroid shots and the fact he stayed in until 36 weeks.

    So, I guess my take home message is that to be prepared for the worst but hope for the best.  You may have a baby with no problems or issue whatsoever or you may have a baby with more preemie-like issues. 

    Btw - don't google - there is alot of scary info out there!

    Good luck and feel free to page me with questions.

     

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