Slightly worried - IUGR vs SGA vs Everything-is-Fine-PLEASE-stop-worrying

HeyStVincent · December 2014

....Or a lot worried.

I had my first 2-week appt yesterday (at 31 weeks) and my fundal height was measuring small. It sounds like I was on the "very-low-end-of-normal", which I would normally be OK with (it's still normal), but the doctor I saw said there was NO growth since my appt two weeks prior. He was also concerned about my weight gain, which I was feeling pretty good about. I've gained 26 lbs this pregnancy (as of yesterday), but I was small when I started, so he said wants me to gain more than 35 lbs (but didn't give me an exact number). I'm fine with trying to do that, I'm just worried that there could be something else going on with the baby or my placenta which would be causing this problem. He told me to take this new development seriously, but to try and not worry too much about it and we'll see where I am measuring at my next appointment before we start worrying. I've been told my fundal height has been measuring perfectly up until now, so I'm kinda surprised.

The doctor I saw on Weds was not my usual doctor, and of course after I left the office I had all kinds of questions going through my head about "what if" and so on and so forth. I emailed my doctor tonight those specific questions, and I'm sure he now thinks I'm in an insane person. Anyway, I'm wondering if anyone here has had a similar experience (you were fine until third trimester and then started measuring small)? How did it turn out? If you had intrauterine growth restriction (IUGR) or your baby was small for gestational age (SGA) what was the course of care after they were born? Did they need a lot of special attention?

I know I just posed a lot questions...but I'm just looking for someone who has been through this. Thanks!

usmcwife89 · December 2014

I don't have any experience but I'm going to keep you in my thoughts. I really hope everything turns out for the best! *hugs*

Edit: hit post too soon

Dani_Love · December 2014

I was never directly told I had iugr but was monitored twice a week for it. They seemed to think my daughter would be 4 pounds and she came out 6 pounds 12 ounces. She has always been in the 4th percentile for weight but has never needed any special attention and didn't have to go to nicu like the doctors warned me about. She's two now and only 23 pounds but a happy, healthy, developmentally on track toddler.

T and P's for you!

HeyStVincent · December 2014

Thanks, ladies!

@Dani_Love It's great to hear that all was well with your daughter and continues to be will with her!

Dani_Love · December 2014

It was scary when I read my chart and realized that's what they were monitoring but it all ended up well :-) hopefully it's the same for you! I had twice weekly ultrasound and nst so they may recommend that but I had fun listening to her heartbeat and seeing her all the time

lizzybean · December 2014

My daughter was 6 lbs even at birth. They anticipated her to be 8+ lbs because of how huge my belly was. Fundal height can be extremely inaccurate. Just think of how your belly shape changes every time LO moves or shifts! If they are not asking for follow up ultrasounds, I doubt they are really worried about it, so try not to be also!

CogDis · December 2014

Sorry you're worried. I know it is difficult, but I wouldn't worry until your doctors suggest there is reason for concern. These definitions of "normal" are all set based on population level data and applied to individuals. Therefore there are always going to be people who fall outside of the normal ranges while being perfectly healthy. With something as inexact as fundal height, I would be even less concerned. The way 2 different practitioners measure can vary tremendously as well. It might turn out that if you were to have been measured by your regular doc that there actually was an increase in size based on how they measure it. It is an incredibly inaccurate measurement in comparison with other measures of health factors taken, so really try my to worry!

Good luck being sent your way!

mommadozer · December 2014

Two of my friends babies had IUGR and they turned out fine. I think before you hit the panic button, they would of scheduled you for an ultrasound to do a more thorough check on the baby's size and to check to make sure the baby has enough fluid if they thought it was a serious issue. I could be wrong though since it has not happened to me personally. My friend just delivered her baby at 34 weeks due to IUGR. Baby was perfectly fine and didn't require NICU because she was 5 pounds.

HailsMom · December 2014

I wouldn't worry about fundal height at all. As PP has said, if they were truly concerned, they would have done a growth scan. It could also just be that baby is hanging out lower or was folded up nicely. Fwiw: my DD was 7lbs when she was born and has ended up being in about the 10th % since. Not all the kids can be average, some of them have to make up the lower end of the scale.

mamabisme · December 2014

My weight gain and fundal height are always on the low end (this is my third pregnancy). I think I'm a pretty regular sized person pre-pregnancy (5'7", size 6) but for whatever reason I don't gain much or get very big. It has earned me an extra (third tri) ultrasound with both previous pregnancies but no talk of that yet. Both babies were in the 7-8 lb range at birth and healthy. If you continue to measure small they may just do a growth scan which will hopefully put everyone's mind at ease. Good luck. Try not to worry. We all carry differently.

Maple403 · December 2014

I'm sure they will be doing some follow up and as you learn more it will hopefully be less stressful. My friend just had her baby and was monitored from weeks 36-40 because her baby was small. They first caught it by a lack of growth in fundal height, then confirmed by ultrasound the baby was in the 6th percentile. However, she had no problems with the placenta or anything else that indicated the baby was at risk. She was induced on her edd and has a very healthy tiny baby (5 lbs 6oz) at birth. Baby is packing on weight like a champ and is 2 wks old today!

MissEm15 · December 2014

They are doing extra NSTs & u/s for me bc they think baby b is growth restricted. I've been on bed rest the last two weeks (bc of this issue but 6 weeks total) & after my f/u u/s today I could be going back in the hospital on bed rest. That's all they can do besides extra monitoring for now. If your doc hasn't said anything like that to you... I wouldn't worry until you had to.

Oh and as far as fundal height mine didn't change in the last week & doc wasn't worried bc of positioning.

mishka29 · December 2014

With DD I was measuring 3 weeks behind at one point. I did go for growth ultrasounds and she was just fine. People would comment all the time about how small I was, etc, etc. She was 7lbs at birth.

Like PPs have said fundal height isn't the best indicator, and everyone carries different. Try not too worry to much!

Sahara6971 · December 2014

I don't have experience with this, but I am thinking of you and sending good thoughts your way!

elephantsonpatrol · December 2014

Fundal height is a poor measure of growth - all it does is look at where the top of your uterus is. It doesn't tell you how big LO has grown inside. No doctor would diagnose IUGR or SGA without an ultrasound, and it takes more than one for IUGR.

Since it doesn't sound like they scheduled even one U/S, I wouldn't worry.

ColleenS629 · December 2014

One of my twins was IUGR and SGA but we knew that from growth u/s not from measuring fundal height. When the MFM noticed that his growth was slowing, I had NSTs twice a week and BPPs and growth ultrasounds every other week. When his growth slowed too much, they had to be born early. He actually did fine once he was born. He had a little trouble breastfeeding but we were able to work it out. He packed on the pounds like crazy after he was born. My other, non-IUGR/ SGA twin, actually did worse because he was not stressed in utero and therefore, his lungs were not ready for him to be born early. He had to go to the NICU while my IUGR/ SGA baby was able to go to the regular nursery.

aggiebug · December 2014

I can imagine how scary it is as a possibility.

IUGR and SGA are big issues that are closely monitored. So take heart knowing that the Dr wasn't worried enough to get you in to do an u/s asap.

bes12 · December 2014

My IUGR was discovered at 36 weeks, I had an ultrasound which put DS in the 9th percentile and it led to me being induced. Ultrasound was only a few ounces off, he was born at 5 lbs 14 ounces at right over 37 weeks. Other than our ear infection issues (which I'm sure are unrelated), he's a happy healthy toddler! He's actually in the 90th percentile for weight and height!

jennjilljo · December 2014

It sounds like the Dr made it seem scary. I agree with PPs that if they aren't scheduling an u/s then is more of "huh, that seems odd" than a "hmm, somethings wrong". Best wishes for you and baby.

HeyStVincent · December 2014

Thanks everyone for your support and well wishes! To those of you who have been through this before or are currently going through it - thanks so much for sharing your story. It really does make me feel a lot better. You have no idea how much better you've made my evening...maybe I'll actually sleep tonight!

My doctor hasn't gotten back with me yet, but that's not unusual. He only checks his non-urgent messages every few days. I'm pretty sure he thinks I'm insane after the email I sent him last night with 8 million questions about monitoring, timing of monitoring, IUGR/SGA outcomes, etc. I feel like I'm THAT patient right now - the one I'm usually trying to talk down off of a ledge at work!

Dani_Love · December 2014

It's a scary thing to hear and I wish I had been more proactive and gotten better information out of my doctor. There's nothing wrong with asking questions :-)

thegoodpotato · December 2014

I don't know that I'm measuring small, but my fundal height measured at 31 weeks and I'm almost 33. My midwife just said that we have a "nice, little baby" who will just fly out when she comes.

I love my midwife.

nauticalmama · December 2014

@holachicaaa‌ Don't freak out! My fundal height was measuring small too and everything turned out fine. I was told fundal height is just not that good of a size indicator, so many factors that can effect it. Fingers crossed that everything is okay:)

mamabisme · December 2014

@holachicaaa‌, I've measured small for fundal height in both previous pregnancies. I got an extra ultrasound to check fluid and growth both times and all was well. Both babies were totally normal size (7-8lb range) at birth. I guess it's just how I carry. So far, no one has said anything about my fundal height with this pregnancy. I look small compared to others that are due around the same time. I wouldn't be surprised if I am measuring small again this time. I haven't asked and so far no one has mentioned it.

SaraL1175 · December 2014

I'm sorry to share a bad outcome, but my 3rd baby was IUGR and unfortunately did not make it. She was stillborn at 39.5 weeks. Stillbirth is rare but there are increased occurrences of it with IUGR. When we were expecting her, many people blew off my worries by sharing their scary circumstances that all turned out ok. Therefore, I'm not going to say "don't worry." If your baby is small, then your baby has an elevated risk for a poor outcome. Have due concern.

I'm sharing this information just so you understand to take this all seriously, advocate for yourself and your baby, etc.

elephantsonpatrol · December 2014

holachicaaa said:

bumping the thread, as I just left my doctor's appointment and they're sending me for a growth scan ultrasound due to fundal height being on the low side. I'm trying not to be too concerned, as the anatomy scan was good at 20 weeks and I had an elective ultrasound a few weeks ago. The tech took measurements and said I was measuring right on target (I know it wasn't a doctor's office, but still). So, we will find out Saturday how he is measuring and I will be trying not to worry until then.

Anyone else currently measuring small for third trimester?

Try not to worry. You have not been diagnosed with IUGR. No one has measured your baby small yet. Fundal Height is a poor predictor of fetal size

HeyStVincent · December 2014

@SaraL1175 - I'm sorry to hear your experience. How awful for you and your family. I hope you've been able to heal some from that experience. I appreciate your honesty as well.

@holachicaaa - I'm sorry to hear about your situation - sounds a lot like mine, so I know how hard it is to try to not freak out about it. As a sort of update: I go back tomorrow morning for my regular two-week checkup and will also find out where I'm measuring. If I've gotten anymore behind (size-wise) I'll have to have an NST or BPP (ultrasound). My husband is going to this appt as well which makes me feel better.

If worst case happens and your baby is measuring small, you will both be monitored really closely by your doctor (or a specialist) - possibly 2x/week, depending on the baby's need. If there is a problem anywhere along the way you would be induced. I'm not trying to tell you this because I think you're going to get bad news (I don't, I bet everything will be fine!). I just want you to know that if it is worst case scenario, there are ways of managing it and monitoring your LO's progress.

Fingers crossed and positive thoughts for good news on Saturday, and keep us updated!!

HeyStVincent · December 2014

@holachicaaa - My doctor called me back last Monday night while my husband and I were driving home for the holiday. He said I was measuring 1cm behind and that 1cm isn't a big deal. He said if I'm still 1cm behind at my next appt (tmrw) then everything is fine because that means I've grown appropriately since my last appt. However, if I'm measuring more than 1cm behind, then we'll need to do an US to look at growth and the health of the baby.

I do feel like I've had growth since my appt two weeks ago. My shirts feel smaller (I had to retire a pair of scrubs this week) and I'm more uncomfortable. I also feel that her movements are stronger and I can easily find where she is in my uterus now (which I used to not be able to do quite so easily).

I'm really hoping this was just a fluke measurement for us both!

HeyStVincent · December 2014

Update: had my appointment today. Everything is measuring back on track - 33cm at 33 weeks and 28 lbs of weight gain so far! We are making progress - woohoo!!

@holachicaaa‌ and everyone else going through this - I hope you get similar good news at your next appointments and ultrasounds. Will be send lots of positive thoughts and wishes your way!

Dani_Love · January 2015

Awesome update!! So happy to hear this!

HeyStVincent · January 2015

@holachicaaa‌ - YAY I am so happy to hear that your ultrasound went well!! I agree 100% with comments about being small - especially from people who aren't doctors! Last weekend I was in a baby clothes boutique at home and the salesperson (or owner?) tried to tell me that I could buy a preemie outfit for my LO because "You are so small, there is a good chance that your baby will be really small too." I wanted to tell her to BACK OFF and that my baby would be a normal weight and size and would not be preemie size if she's not actually a preemie! Not to mention all the comments I've gotten since people first found out I was pregnant about how someone my size will never be able to have a vaginal birth. I've also been told, "you'll probably go early" because my small frame couldn't possibly accommodate a full term infant. My doctor laughed then apologized for people's behavior when I mentioned it to him. Ugh. People.

Slightly worried - IUGR vs SGA vs Everything-is-Fine-PLEASE-stop-worrying

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