IUGR

AnonnAni

I posted this in high risk but someone PM'd me and told me to come over here for some insight.

A little bit of background would be that I had cervical issues which I had with my prior pregnancy and I am being followed by a high risk specialist this time pregnancy. 

This time around I have managed thus far to stay ahead of the curve and stay at a cervical length of 3.2 (thank you P17 shots).

HOWEVER; at 23 weeks they noted that I had "low normal" fluid levels. They checks again 4 days later and said it looked fine. Then on Monday they noted again that I had "low normal" fluid and that my DD is measuring small (3rd percentile!!!!!) so now it seems I have IUGR to contend *smh*  this just couldn't be a breezy pregnancy.  And to at this point (25 weeks) it seems like a damning diagnosis. I just cant wrap my head around how worried I should be so I have shot immediately to "scared sh!tless". 

With my son it was like ok you have an incompetent cervix, so do this this this and that. With this pregnancy, its totally different from what I have read there seems to be nothing you can do  but wait and it seems like in most cases it means a crazy early delivery. Is there anything other then steroid shots I should be looking into?

AnonnAni

It seems crazy early for me to be diagnosed with IUGR which I guess is part of the reason this seems so "damning" to me.  It was the very first time she was measured so for her to be so small on the very first measure was like WOW, what chance does she have to catch up now if she is already behind!

I hope and pray it means just more monitoring *deep sigh*

jennbent

Our IUGR was first noted at 19 weeks...DS was already 2 weeks behind by then.  We were heavily monitored until being admitted to the hospital at 25 weeks due to backwards cord flow.  Spent 3 weeks in the hospital.  During that time of bedrest, DS basically stopped growing, and doctors decided he would do much better on the outside than in (he did!)  He was born at 28 weeks weighing 1 pound 3 oz - the size of a 23 weeker.  Very small, yes, but he's done so well!  We had enough time to do 2 rounds of steroids so his lungs are performing better than babies 3 times his size.  We're on day 63 in the NICU and they may let us go home next week! 

You're right - unfortunately there isn't a whole lot you can do usually for IUGR.  We tried the high-protein diet and bed rest in the hospital, but neither one of them did diddly squat to help my son grow.  The "good" thing about your situation is that you'll get lots of extra monitoring now so the doctors and you can be prepared for this. 

Your situation doesn't have to be as extreme as mine.  Every baby is different and like previous posters have said, you might make it much further in your pregnancy than you think!  Good luck and think positive!

Mrs. Alice

AnonnAni:

It seems crazy early for me to be diagnosed with IUGR which I guess is part of the reason this seems so "damning" to me.  It was the very first time she was measured so for her to be so small on the very first measure was like WOW, what chance does she have to catch up now if she is already behind!

I hope and pray it means just more monitoring *deep sigh*

It sounds like you need to have a good talk with your Doctor.  Are you seeing a perinatologist?  Have they checked umbilical cord dopplers?  If not, you need to.  They specialize in high risk pregnancies and complications. 

My twins had issues resulting in IUGR in baby A.  He started measuring behind at 22 weeks and then at 24 weeks the blood in his umbilical cord was in reverse and absent end diastolic flow.  They admitted me for the rest of my pregnancy and gave me steriod shots in prepartion.  It was the scariest thing I've ever been through and like you it was frustrating because there really was not much I could do. 

My Dr.'s plan was expectant management which just means, get as far along as we could to deliver them safely.  I had growth scans every 2 weeks, BPPs and fluid checks 3x a week, and fetal monitoring 3x day in the hospital.  I was on modified bed rest, increased my protein, and drank 2 boost shakes a day.  My peri said he would deliver if the following happened: growth measurement below 5th percentile (associated with higher fetal demise rates), reverse end diastolic flow (very dangerous also causes fetal demise), and/or fetal distress.  Lots of luck and prayer to you.

AnonnAni

I am seeing a high risk specialist. But my seeking hims was totally unrelated to this current issue, but b/c I was being so closely monitored to make sure I had no cervical changes I was getting bi-weekly ultrasounds either way. 

They measured her last Monday which is when they noted she was 600 grams and should have been close to 675-700 grams but it was the 1st weight so they have no bases for her other then this initial one. They check placental function via doppler and found that to be fine, and checked fluid level and at the moment its "low normal" so I have another fluid level check and doppler tomorrow (thursday) and then they will do those two as well as measure her again this coming Monday.

 

ashk7

Like pp said and my dr said to me " a small baby doesn't mean a sick baby" Every baby has its own journey. We noticed dd was measuring small at our 20 week anatomy scan also found out I had a 2 vessel umbilical cord. At this point she was only 4 days small, nothing to worry about but because of my cord I needed extra monitoring. At growth scan 3 weeks later she was 2 weeks behind, still not horrible. Then at 30 weeks I noticed decreased movement one day called dr went in to l&d and she was having heart rate drops, showing signs of distress, we were admitted and heavily monitored I received both rounds of steroids and had a growth ultrasound where she was measuring 6 weeks behind. We delivered c sectionthat next morning. All this happened over a 5 day hospital stay, she was delivered at 31w4d weighing 2 pounds 6 ounces.  With iugr babies there comes a time they are better out then in and once they get out tend to thrive. DD never needed breathing support was in special care nursery until I was discharged then they moved her across the street to children's NICU. She did have a long but uneventful NICU stay, it took her a while to build up her endurance to eat all feedings orally. She is now almost 5 months 3 adjusted and is a happy healthy baby!! Like I said every story s different but that's ours! Good luck keeping that baby baking! This board is great for support snd questions!!!!

CTbride79

ashk7:

" a small baby doesn't mean a sick baby"

This!  We did not find out about my IUGR with DS until 31 weeks, when my belly measured small for the first time.  It was caused by placental insufficiency (what caused that, we don't know) and then we were forced to deliver him just a week later due to severe pre-e, and because the placenta was basically showing signs of failure. 

A friend had IUGR with her DD, who is now 3 1/2 and perfectly normal.  She did not have any of the other complications I had and she was born around 36 weeks, weighed 4-11 and spent NO time in the NICU.  They knew a couple of months in advance and had a scheduled c-section, but her DD had no issues whatsoever. 

My DS is still little (at almost 6 months he's the size of an average 2 month old) but he is perfectly healthy, breathed room air from the beginning, and is meeting developmental milestones :-) 

I hope you can make it as close to term as possible!  It sounds like you are planning on getting the steroid shots, which is great...I got my first one the day we found out DS was small, so he had a few days to allow them to take effect which I think really helped him a great deal! 

Mrs. Alice

runningmommy519:

I'd also like to point out that my doctor told me that a lot of times when the baby has IUGR the babies develop other things faster. Eg lung development etc because their bodies know something is wrong so things develop quicker. 

This is true and what they told me.  However since my small twin had reverse flow, he was under a lot of stress in utero and needed the ventilator for about 3 weeks, a week on cpap and oxygen for another month.  Gestational age is usually much more important than birth weight.  So the longer baby can stay safely inside, the better.  My docs said we would celebrate if we got to 32 weeks and by some miracle if we made it to 34 weeks, the risks were too great and they would deliver by then.

appylovee

They caught my sons iugr at around 21 weeks. We had really low fluid also. got steroid shots at5 26 weeks. We made it to 34 weeks, but he only weighed 3lbs. he was off the chart for some time. i went for bi weekly bpps & nsts. & alternating weekly level 2 & dopplers. I also saw my ob every week.

snoangel79

Both my kids started measuring small at 25w. My daughter was 4th percentile when born at 34, son was 13th. She was actually measuring 0% that day on U/S. They will watch you like a hawk from now on with biophysicals and NST's. As long as baby is still growing at a rate they are ok with they will keep LO in. My daughter continued to grow the minimum every week. Also, my emergency c-section wasn't because of that and my daughter came out doing better than my son. I think she's smarter than him also at this point! She rolls both ways and babbles up a storm so right on developmentally. She also weighs just over 10lbs now, so she's not even on the charts for her age or adjusted age, but doctor says she's doing well! Just a super peanut!!

Divashrink1982

My son was diagnosed with IUGR after he was born at 36w 0d at 5 lbs 2.2 oz. We knew that he was small before that because of growth scans, but he really stopped growing in the last 2 weeks or so of my pregnancy. I was induced with him at 35+5, but it wasn't because of the IUGR - it was due to pre-e. He spent less than a day in the NICU and was able to come home with me when I was discharged. He is still a tiny peanut - 16 weeks tomorrow and right around 11 lbs - but he is definitely growing! GL!

AnonnAni

So far I have had 2 scan since both saying doppler wave for placenta function is normal and both saying that fluid level is normal. But they haven't measured her since the Monday they noted her small size so I guess for that measurement I need to wait another week (as if this week hasn't been long enough of a wait).