Growth Question

BP607 · June 2014

I posted a question a few weeks ago about growth, but I have some new concerns. At my last appt, baby was actually measuring ahead 1 week. I was 31 weeks, he measured 32, now at 33 weeks, he still measures 32. Dr. wants to do growth ultrasound next vs at 36 weeks because he has only grown really 3cm in about 5 weeks. I feel bigger and definitely feel baby moving in there a lot. Anyone else have any measurement issues or good thoughts? I've been super worried since I left my appt and it's going to be a long week waiting for this US.

cookieinva · June 2014

My ob doesn't even do growth ultrasounds since they aren't really accurate enough to give detailed info. I am not sure they are really accurate enough to definitively say your LO has grown 3 cm in 5 weeks. I was under the impression that so long as baby is measuring roughly within say plus or minus two weeks, with no other issues and all other things being healthy, that baby should be fine since they do come in a rnge of sizes. What exactly is your dr worried about? What does your dr plan to do pending results of the US?

LenaLove · June 2014

I'm going for growth ultrasounds every 2 weeks because my first baby was small. So far so good, baby boy is measuring in the 20th percentile. I have my follow-up on Friday, as long as he is getting bigger we are okay.

With my first I measured small, and she was small. No health problems whatsoever, and is a normal healthy almost 4 year old.

I think fundal measurements can change depending on baby's position. I know I actually got smaller when my daughter dropped. They were going to send me for another ultrasound, but I went into labor 2 days later.

Fingers crossed that all is well for you!

BP607 · June 2014

cookieinva said:

My ob doesn't even do growth ultrasounds since they aren't really accurate enough to give detailed info. I am not sure they are really accurate enough to definitively say your LO has grown 3 cm in 5 weeks. I was under the impression that so long as baby is measuring roughly within say plus or minus two weeks, with no other issues and all other things being healthy, that baby should be fine since they do come in a rnge of sizes. What exactly is your dr worried about? What does your dr plan to do pending results of the US?

I'm guessing that he is not growing at a proper weight. She did tell me about the plus or minus two weeks when she first started doing them, but the concern is it doesn't seem like he is growing much based on her measurements. Pending the results of the US, I think she will make a decision if he is actually growing on track or if there is something going on.

EllaSmella · June 2014

I am in sort of the same boat, and was with my first pregnancy as well. With my son, I always measured about 2 weeks behind, but then towards the end of pregnancy (like after 35 weeks) started falling further behind. They sent me for a growth ultrasound at 37 weeks to check his size. He was in the 50th percentile and was born at 7lbs 4 oz.

This time, I've been measuring behind by about 3 weeks since about 28 weeks, but because LO measured in the 87th percentile at my 20 week ultrasound, they have held off doing anything about it. At my 32 week appointment, they told me if she didn't catch up to +/- 2 weeks by 34 weeks, they would send me for an ultrasound. At 34 weeks, I was 2 weeks behind, which meant I didn't need the ultrasound.

It's stressful to have something hanging over your head week to week that you can't really control (my babies just like to cuddle up to my spine, I think!) and it's hard when it's such an arbitrary measurement sometimes (baby's position really affects it). Sending you good thoughts for a chubby baby in there.

BP607 · June 2014

EllaSmella said:

I am in sort of the same boat, and was with my first pregnancy as well. With my son, I always measured about 2 weeks behind, but then towards the end of pregnancy (like after 35 weeks) started falling further behind. They sent me for a growth ultrasound at 37 weeks to check his size. He was in the 50th percentile and was born at 7lbs 4 oz.

This time, I've been measuring behind by about 3 weeks since about 28 weeks, but because LO measured in the 87th percentile at my 20 week ultrasound, they have held off doing anything about it. At my 32 week appointment, they told me if she didn't catch up to +/- 2 weeks by 34 weeks, they would send me for an ultrasound. At 34 weeks, I was 2 weeks behind, which meant I didn't need the ultrasound.

It's stressful to have something hanging over your head week to week that you can't really control (my babies just like to cuddle up to my spine, I think!) and it's hard when it's such an arbitrary measurement sometimes (baby's position really affects it). Sending you good thoughts for a chubby baby in there.

Thanks so much! I'm just surprised by all of this considering DS was 9 lbs 11 oz and I didn't have GD. I was huge the whole time. This time I do feel smaller, but I also started out 20 pounds lighter and have not gained near the weight I did last time. I know this DS could be 2 pounds smaller and still be a normal weight baby, I just felt anxious after leaving my appt today not really knowing what to expect.

EllaSmella · June 2014

@bp607 - They do make it all seem rather ominous, don't they? I know they are just trying to cover their bases and make sure they account for anything that departs from the norm, and of course I want to do what's best for my baby's health.

It was especially frustrating for me this time because at my 32 week appointment, I had gained 7 lbs in 4 weeks and they asked me "what's going on with your weight gain?" but then proceeded to tell me that I was measuring too far behind and would probably need an ultrasound. I felt like I just couldn't win.

I'm wondering what they'll tell me at my 36 week appointment, which is next week...

BP607 · June 2014

@ellasmella - Yes same here, I got scolded for my weight gain a few weeks ago and have been doing better since, gaining around what I am supposed to but yet not measuring where I'm supposed to. It's upsetting and frustrating.

reils500 · June 2014

I had to go in for an ultrasound last week to check baby's growth because my belly hasn't grown. At my 35 wk appointment fundal measurement was 33 & had only grown 1cm in the past month. My OB said it wasn't the number but the rate of growth which concerned her. The ultrasound showed LO is healthy & placenta & cord look good.
Good luck!

TurtleMonsters · June 2014

I've tapered off gaining, they said it was normal in the last few weeks. I also have diet changes as a cause for not gaining weight. I wouldn't worry:)

Ecomom17 · June 2014

I have similar things going on and was diagnosed with IUGR at 31 weeks, so I've been going in for NSTs twice a week and had a follow-up US to check baby's growth and will have another one next week. His growth had increased a little bit, so things are heading in the right direction. Also DS was small, so I'd be surprised if this one turned out to be a porker anyway.

For those of you saying u/s measurements aren't accurate, that's not really true. What they're measuring to check baby's growth is head circumference, femur length, and stomach circumference. They get growth percentages from those and estimate baby's weight. So the weight itself might not be super accurate, but the measurements certainly are. Baby's actual weight doesn't really matter as much as growth rate. So if your baby's growth rate is in the low percentiles (mine was around 4th %ile at one point), then there should be some concern. The big concern is whether baby is getting enough oxygen/blood flow from the placenta and whether the fluid is low, so your u/s will show that. For me, all that has been good and my fluid level even went up. They also haven't said boo about my weight gain, which to me seems like a lot but I guess they figure anything extra will help baby, too?

Anyway, I wouldn't worry too much since they're keeping an eye on things and will have directives for you to follow once they know better what's going on. Better that they err on the side of caution than ignore potential problems, right?

MrsGeekyPants · June 2014

@Ecomom17‌ would they do weekly nst for large babies as well?

Ecomom17 · June 2014

I wouldn't think so, since a large baby is certainly getting enough fluids/nutrients/etc. As I understand it, the main purpose of an NST is to see whether baby is getting enough oxygen/blood flow from the placenta. They need to see baby's heart rate increase by 15 bmp several times over 20 min. and also see if heart rate drops when baby moves, which tells them if he's getting enough oxygen. I wouldn't think a large baby would bring up the same concerns, but I'm not a doctor! I would ask your OB if that's something they might do.

MrsGeekyPants · June 2014

I ask bc today at my apt 36w they did a growth scan and he is 6lb 13oz already and the OB said next week they were doing a nst didn't say why then when I was checking out the reception said that the OB wants to do weekly ultrasounds till he comes. She didn't seem concerned at all ? I don't have gd but maybe just so it's not a surprise if he needs to be cut out ?

BP607 · June 2014

Thanks, ladies, yes, better to err on the side of caution. Thanks for sharing your experiences!

purplekuda · June 2014

I'm sorry your going through this! I'm going through something similar. At my first third trimester ultrasound last week they were worried about my blood pressure so sent me for ultrasound and found amniotic fluid level was low along with decreased abdominal circumference relative to height and think there is growth restriction which is odd as I have gained a little more than recommended.

Have to get weekly u/s and nst but want to deliver me by 36 weeks!

EllaSmella · June 2014

Ecomom17 said:

For those of you saying u/s measurements aren't accurate, that's not really true. What they're measuring to check baby's growth is head circumference, femur length, and stomach circumference. They get growth percentages from those and estimate baby's weight. So the weight itself might not be super accurate, but the measurements certainly are.

Nope, I respectfully disagree. With my first son, I had a growth ultrasound at the OB office at 37 weeks. They measured his tummy in the 5th precentile and estimated weight at 4lbs and change. They were alarmed and sent me to MFM the next day for a more detailed scan. That scan showed baby's abdomen in the 40th percentile and just under 6lbs. MFM said that the baby's position the day prior had made the abdomen measurements inaccurate. Especially at the end of pregnancy when babies start to drop, it can be very difficult to accurately estimate both size and/or weight. Measurements are not always correct and what's more, the weight estimate not a true weight - it is based off the compilation of the length/circumference measurements.

ajhamb · June 2014

I just went in for another growth scan yesterday, as baby measured small (6th percentile) in the 30 wk growth scan. The Dr we met with yesterday actually told us that because the baby is in breech position, the accuracy can be way off. Apparently the measurements' accuracy have a great deal to do with the baby's positioning.

Even though he is still measuring in the 6th percentile, we were told that because all the signs on the BPP were good.

LenaLove · June 2014

When they said they wanted me to go in for growth ultrasounds I asked what they would do if the baby was small and they said they would monitor for growth, and if growth was restricted they would induce/perform a c-section. I will push back a bit on that to make sure it is completely necessary, but of course I just want baby to be okay. DD was 5lbs 11oz at 38 weeks 3 days but healthy, so I'm not super worried. Fingers crossed that at tomorrow's ultrasound baby has gotten bigger! DD was rubbing my belly and telling me it looked bigger so Eddie must be growing! Hope she is right

dawnxlennae · June 2014

I am going for a growth ultrasound tomorrow because I am measuring 33 at 37 weeks... my doc said she just wants it done to just make sure everything is okay. She says that some people just are good baby carriers and carry small but still deliver 8lb babies!

We will see. Stay postive!

Ecomom17 · June 2014

EllaSmella said:

Ecomom17 said:

For those of you saying u/s measurements aren't accurate, that's not really true. What they're measuring to check baby's growth is head circumference, femur length, and stomach circumference. They get growth percentages from those and estimate baby's weight. So the weight itself might not be super accurate, but the measurements certainly are.
Nope, I respectfully disagree. With my first son, I had a growth ultrasound at the OB office at 37 weeks. They measured his tummy in the 5th precentile and estimated weight at 4lbs and change. They were alarmed and sent me to MFM the next day for a more detailed scan. That scan showed baby's abdomen in the 40th percentile and just under 6lbs. MFM said that the baby's position the day prior had made the abdomen measurements inaccurate. Especially at the end of pregnancy when babies start to drop, it can be very difficult to accurately estimate both size and/or weight. Measurements are not always correct and what's more, the weight estimate not a true weight - it is based off the compilation of the length/circumference measurements.

That's what I said, that the weight is not exact. And of course, you're right that baby's position might affect how well the person reading the u/s can measure. It also depends on the person reading it. In my case, I've had a doctor who specializes in reading scans reading my u/s so perhaps her experience factors in, plus baby has been cooperative as far as position goes. However, baby's growth rate can be very accurately assessed assuming those factors are in place.

Ecomom17 · June 2014

MrsGeekyPants said:

I ask bc today at my apt 36w they did a growth scan and he is 6lb 13oz already and the OB said next week they were doing a nst didn't say why then when I was checking out the reception said that the OB wants to do weekly ultrasounds till he comes. She didn't seem concerned at all ? I don't have gd but maybe just so it's not a surprise if he needs to be cut out ?

I'm super interested to know the answer, now, so if you ask your OB to specify why the NST is necessary I'd love to hear what she says! Kind of surprising they want to do weekly u/s but I guess with "bigger" babies it's not all that uncommon? Don't let them scare you into a c-section just b/c he's bigger. Lots of women deliver larger babies vaginally perfectly safely. My aunt's smallest baby was over 9 lbs and she delivered all 3 vaginally and med-free. Anyway, let me know if you find out specifically what they're looking for with the NSTs!

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