Fetal Growth/Small Gestational Age

Sweet_D · January 2016

Hopefully no one else has to deal with this but I figured it would help to start a thread for those who may be. A lot I've read says that u/s growth can be off by as much as 2 lbs and most of the time moms end up worrying over nothing.

Went in for my 30-5 appointment last week. U/S showed that the baby was weighting less than she should be. 2 lbs 15 oz. Not sure what she should be at that point. OB thought it was more a placenta issue or maybe I just make small babies. Told me to back off work a little more and to lay on my left side twice a day for 2 hrs each time for blood flow if it is a placenta issue.

Had a scheduled appointment with high risk yesterday (31-4). They also did an u/s Baby is up compared to last week's u/s - 3 lbs 3 oz but her stomach is measuring small. They had me do a non stress test while I was there also. Everything looked good with that. High risk wants me to go to my OB once a week and also his office once a week for non stress tests and bi-weekly ultrasounds. High risk thinks it's more because of the lack of weight I've gained vs placenta.

Trying not to worry, rest up a little more, and up my protein consumption to fatten up this girl over the next few weeks!

cmerribury · January 2016

I don't have this issue, in fact I make giant babies (which is a concern, too) but I wanted to send over my support for you. You may also want to add some high fat foods to your diet (healthy, of course) to help out. Avocado, grass fed butter, nuts like cashews and walnuts...all of those would really help with you (and presumably baby) putting on weight.

Sweet_D · January 2016

Thanks @cmerribury for the tips!

alligreer88 · January 2016

I'm 30w also and from what I've read, typical size is just under or at 3lbs for this week. Am I totally confused? Sounds like that's where you are and your doctors are concerned?

Sweet_D · January 2016

@alligreer88 OB says baby is measuring small. High Risk says baby's belly and baby are measuring small. I'm going to ask for more specifics next week when I see both now that I've been researching. Both u/s techs commented about possibly being below average when doing the ultrasounds before talking to either dr.

cupcakeclare · January 2016

I'm going through a similar thing. At my 30 week appointment a week ago they did a growth scan that shows his abdomen was measuring in the 10th percentile. They are sending me to a high risk Doctor for a second opinion. That's not until the 19th though, so I'll come back and update how that goes.
I'm also trying not to worry, and I'm very hopeful that our babies are perfectly healthy.
I was actually monitored a little extra throughout my last pregnancy because my DD and I continually measured behind. Turns out she was just small and perfectly healthy at 6 lbs at full term.
Sorry for the novel! All that to say, a small baby doesn't neccasrily mean anything is wrong and that I'd rather our doctors be overly cautious.

jstanton0822 · January 2016

I had the same problem.
My belly measured 2 weeks too small a few weeks ago. Doc ordered an ultrasound.
I'm 5'7" and 138 lbs. I've literally gained 5 pounds this entire pregnancy.
I've been worried for weeks that baby isn't getting enough nutrients.

Yesterday was 30-6. U/S showed that baby measured 3+ pounds (18th percentile). So perfectly normal.

Drink all the whole milk you can tolerate, follow doctor's instructions, but PLEASE try not to worry.
Baby is going to be fine!

jenniferamcooper · January 2016

My first was born at the SGA threshold he was 12th percentile. I also gained very little weight (lost 15, gained 10) due to MS. This time around baby is measuring in the 18th percentile, they're not following me for this because they're certain I don't gain a lot of weight in pregnancy and just make small babies. It's hard but try not to panic, Google and research. I spent so much time on this non-issue.
I'm so happy that they're following you closely, it's nice to know you have a concerned medical team that is following up. You're really in the best hands.

red3ye · January 2016

Ds always has measured tall but thin. These babies... well just to say that during last ultrasound, tech goes, "wow she has a chubby belly" in reference to the little girl.

oceanchild · January 2016

We were just talking about this at babycafe yesterday! One of our mamas has a first baby (now 3y) that is a little peanut – has always been super petite, but very healthy and very developmentally advanced. When she was pregnant with her second (now 7m old), they diagnosed the baby with IUGR. Like not just under 10%, but under 4%! They were pretty dismal about it, and she was terrified. Baby was born at 39w and was 7lbs. (First baby was 8lbs at 42w, but is only 24lb now at 3y). Well her chunky 7m old weighed in at 20lb yesterday and is roly-poly as ever!
I know it's all anecdotal, but sometimes the positive stories can help ease one's mind.

jenniferamcooper · January 2016

@oceanchild roly-poly is right! My beanpole almost 2-year old is 24lbs soaking wet. Good for your friend. It gives me hope that March baby might have a roll or two at some point : )

FutureMrsCaesar · January 2016

I'm in a somewhat similar situation execpt my u/s Dr and OB don't seem concerned at all, I'm the one who is concerned. I had an u/s monday at 30w3d and baby was just over 3 lbs measuring at the 19%. I'll have another ultrasound in 4 weeks so I guess as long as she stays at that percentile then everything is fine and she's predicted to be ~7lbs at birth. My first 2 babies were 8 lbs so to me anything less than 7 (DS3 was 6.13 despite me gaining almost 30lbs) seems really small. I developed an autoimmune disease after DS2 which can cause poor growth in the 3rd trimester so I'm definitely a little concerned. However I will say that 1. this baby is super low already which makes getting good measurements difficult and 2. with DS2 I had an ultrasound a few days before he was born and it said he was only measuring 37 weeks, and he was born at 8 lbs...sooo they are definitely not entirely accurate. Also my belly is huge, but my weight gain hasn't been that crazy so she can't possibly be that small, otherwise wtf is making my belly so huge???

Parker16772 · January 2016

I haven't had an issue this pregnancy but with DS1 I was told he was measuring small (right under 4 lbs) at 36 weeks (I had a growth ultrasound then because my BP was super high and they thought they were going to have to deliver him). He ended up being 6lbs 8oz at 38 weeks and was in the 10th percentile for head, height and weight. He is 31lbs at four and has moved up to the 25th percentile for height and weight. Me and DH were both around 6lbs so I wasn't surprised that we had a smaller baby.

CecilB93 · January 2016

I've been told this baby is measuring right on schedule based on the fundal height measurements. I've only had the one anatomy scan where I think he may have been a few days ahead, nothing concerning at all. But, I was born at 6 pounds and half an ounce, only one day before my due date. So I never really thought 6# babies were considered small, my mom did used to say I was a small baby, but she never said it in a way that seemed like an issue, just that I wasn't huge.

mwashington88 · January 2016

I'm currently in the same situation as you. Today makes 31 weeks. At 30w3d I went for an ultrasound and was told she had dropped from the 20th percentile to the 9th percentile. Her abdomen was measuring small although she was 3lbs. This meant I would have to come in for ultrasounds weekly for monitoring. "OK", I thought. The next morning my midwife calls me freaking out saying I am considered high risk. Then, I was told I needed to stop working immediately. To say this news smacked me off my feet, is a complete understatement. I went to get a biophysical profile (have this done, it will give you a little peace of mind) completed yesterday, which tests breathing, body movement, muscle tone, and fluid. The results came back 8/8.

So on Monday I'm scheduled for doppler ultrasound to test blood flow. I have been doing a lot of research in these past 3 days so my plan of action is to eat a lot more smaller meals throughout the day and keep a food journal to take to my next ultrasound. Hopefully this will beef her up. My pre-pregnancy weight was 122 and I'm currently at 134.

Anyone else experiencing a similar situation, please share your thought!

Please keep us posted!

KBENADUM · January 2016

I had the same thing happen this past pregnancy. MFM determined that I was having a blood flow issue and she was starting to measure a week behind at 20 weeks and had me follow up at 24 weeks with them (I had a previous growth restricted baby with my first who was 3 weeks behind in size.) At my 24 week apt they noticed bloodflow from baby to placenta was decreased even more and I was put on bedrest for the weekend, get a couple steroid rounds, monitor my BP and for any signs of Pre-E and Helps. I was discharged a week later and had to go to MFM office twice a week for NST and ultrasound for BPP. I made it to 26 weeks before they found the blood flow was starting ro reverse, and her growth was more behind (Aprox 5th percentile). She was starting to have leas growth in her belly and she'd only put on 2oz since the first hospitalization. I was readmitted for a Mag Sulfate dose and reevaluate after a day or so. The next morning they said they needed to go ahead and take the baby. She was born 4 weeks ago at 1lb 4oz, deffinatly smaller for her est gestational age, but it was almost spot on from what the ultrasound measurements were saying. Bedrest helped slow down any issuea I had and drinking lota of water helped ensure I was hydrated and baby was getting best bloodflow I could give her. At the time (course we were all in our second trimester still) I was also on a low dose aspirin once a day to increase any blood flow issues cause of my previous growth restriction baby.

rosieschmozie · January 2016

My babes is small as well (3.3 lbs for 32 weeks) and like others have mentioned, I too have auto-imune diseases that can cause placenta insufficiency and therefore effect babies growth. I've been having growth scans since week 28 every other two weeks and I may be induced at 37 weeks just to minimise any serious risks. I'm also on a low dose of asperine and try to sleep on my left side as much as possible. The only thing I wonder about is if I should rest more during the day. My doctor didn't say anything about that, but I hear some women are ordered to bed rest. Weight wise I've gained a healthy 13 lbs for 32 weeks (or at least, I think that's a healthy amount). Are any of you ordered to bed rest or to take more rest? I am still active, I walk and bike daily. No exercise, but just you know, do stuff around the house, go for a walk, grocery shopping etc. I don't have a car so I bike anywhere further then 15 min walking distance. Do you girls here have an opinion or advice about that?

As for you @Sweet_D you're not alone! I have the same problem as well. I do too worry, but as long as baby is active and moving like usual, she's probably fine! That's the main thing my doctor told to watch: babies movements, so I'm on them like a hawk

Good luck to you!

jenniferamcooper · January 2016

@mwashington88 not to bash your midwife or your relationship with her but in no way should she be calling you "freaking out", it's entirely unprofessional. I know it's late in the game but I'd seriously consider blending your care (if you haven't already) to include an OB. I'm all for using midwives but when I hear of midwives and GPs calling patients and freaking out or talking about worse case scenarios then it concerns me.
I had a high maternal serum screen for Down syndrome and when my GP called to refer me to the high risk ultrasound centre instead of the regular one for my 20-week anatomy scan. She was calm, methodical and gave me the next steps we'll be taking and a follow-up appointment for immediately after the u/s so that we can discuss the results I got from the radiologist. Everything was fine with my screen but I I felt confident in my care knowing how my GP handles high risk situations.

amafor · January 2016

I had a similar situation with my last pregnancy. Low papp-a diagnose came first which can cause iugr. Mfm had me on a low dose of aspirin to assist. Ptl put me on hospital bed rest at 24 weeks. They did bbps every 2 weeks and each week his percentile went down. At 36 weeks he was 14th percentile. He put on a TONS in the last month, coming into the world at 6 lb 14oz. The smaller meals and laying on the left side were encouraged as was protien.....lots and lots of protien. Protien powder in my milk, beans with everything, protien shakes.

The only thing I can say from a btdt perspective is that it can change in a heartbeat. Your little one may just be growing at his own rate.

Sending positve thoughts your way that you see some reassuring progress.

Sweet_D · January 2016

I don't enjoy that so many others are running into this too!

Went for my 2 week follow up with OB. She's gained a pound in two weeks. Stomach still not on track with the rest of her growth, it's 1-2 weeks behind. She's also only at 12%, better than where she was before which I believe he said was 7%. NST was perfect. I go see high risk on Thursday. OB wants me back next week too. looks like for sure I'll be doing weekly or bi-weekly NST from here on out. So things are slowly looking better, but OB wants to see her get to at least 25% before he feels everything is safe with her size.

Sweet_D · February 2016

Looking like they'll induce at 38 weeks at the latest. She's growing but her stomach is still behind. She's being diagnosed as IUGR.

Anyone else with updates? Hopefully some good growth for everyone!

FutureMrsCaesar · February 2016

Awesome you have a plan in place, 38 weeks isn't hardly early at all, she'll be just fine and thrive I'm sure! My little girl jumped up in percentiles, from 30-34 weeks and is up to 5 lbs-yay! I continue to measure small but whatever.

Sweet_D · February 2016

@FutureMrsCaesar over 5 lbs is great!! My friend used to be a nicu nurse and she said the goal is always 5 lbs and up

Sweet_D · February 2016

Minimal growth between this week and last week. Basically enough that dr wouldn't induce yet. We'll be picking a date next Monday which puts me at 37w 4d. I was told more rest this week and if anything decreases with kick counts to call the dr immediately. High risk again on Thursday to get their two cents as well. She hit 5 lbs 1 oz at yesterday's appointment. Hoping to get as much packed on her this next week to get over 5.5. Stomach still not growing well though.

hows everyone else's weights?

mshukh · February 2016

@Sweet_D 5lbs 1 oz is great! Here's some perspective. My husband was born barely clearing 5lbs 2oz and is perfectly healthy as far as I can tell. He was also born when they didn't do any scans and was full term. His mom and dad are just not big people. His mom's whole side of the family are rather small people. So chances are your child is going to be just fine, but it is good to know to prepare for when she is here.

I was measuring small as well from 32 weeks on. They did a growth scan and it was confirmed kiddo was measuring behind at 33rd percentile and was actually diagnosed IUGR due to abdominal circumpherence below 10th percentile. They just repeated the growth scan at 35 weeks and took me off monitoring and IUGR as baby was in the 46th percentile and AC measurement increased. He's just a skinny kid I'm sure. But I did stop running and started eating a lot more protein and fat starting at 32 weeks just to make certain. We have another scan scheduled for 38 weeks just to confirm everything is going smoothly. Crossing fingers.

Sweet_D · February 2016

High risk measured her in at 4 lbs 12 oz on the 11th so they decided to induce. That didn't pan out so I had an emergency c-section after 30 hrs of labor. She ended up measuring 4 lbs 8 oz so not horribly off from u/s measurements. She's currently in the NICU trying to stabilize her blood sugar and get her to eat a little more on her own. Hoping we can take her home sometime this week.

Doxies4life · February 2016

At my last appointment baby is measurung at 35 weeks 5.3 oz, I am almost 38 weeks. Doc has me going twice a week now with a stress test and ultrasound as well as a vaginal exam every appointment . I was told to bring my hospital bag to each appointment and that I needed to preregister with the hospital as he expects that I will be sent for an emergency c section in the next few appointments. Everything else looks great with baby girl. All of her organs are functioning properly, her movement is good and there is a sufficient amount of amneotic fluid. My gestational diabetes numbers are good with an occasional spike here and there ( mardi gras, super bowl etc). So yeah, try to keep the stress level down didn't really apply here.

Positive thoughts your way

Sweet_D · February 2016

Good luck @Doxies4life at least you've made it past to almost 38 weeks. All the testing every week can be so scary!

mshukh · February 2016

Good luck @Doxies4life. I hate the weekly tests and scans. They do absolutely nothing to bring stress levels down. But you're almost at 38 weeks! that's great!

ecswim2fast · February 2016

I'm confused about the percentiles. My baby was 2lbs 15oz at 29.6 weeks and they told me he was 56%. Do different Dr. have different standards?

Doxies4life · February 2016

Sorry it's been a bit since i checked in. Still going strong. Baby girl played a bit of catch up and is now measuring at 37 weeks I make 39 on Thursday. Still doing 2 appt a week, still stressing with that. They did set an induction date that is a few days past my due date. It was the next available date. So I'll be in the 41 week range unless little miss thang decides on her own appearance

as a side note I've consistently had contractions s for about 4 days now but nothing close enough to get excited.

Just breathing over here and waiting impatiently

mshukh · February 2016

@doxies4life that sounds awesome! Hope things keep looking up for you. You're almost there.

LadyWest31 · February 2016

I am having same issue here. Though I am very small in size and suffered from severe hyperemisis in the first 6months I lost about 10kg of my weight. My midwife is so concerned about the weight of my baby and placed me on weekly scan, blood test.

There is an increase in growth si far but they say the baby is still small. But my baby is mega active kicks very often and this gives me hope that he is doing well.

I am very positive that everything will çome out fine with all of us mothers and babies.

2goofykids · February 2016

I'm in the same boat as you! I'm 37 weeks tomorrow and this last Monday they did an US and diagnosed the baby with a growth restriction. It sounds like yours is asymmetrical, same as mine. At this point, there's not a whole lot to be done aside from monitoring - your weight gain will not impact the baby, placenta issue or otherwise. While it's likely that I do make small babies, the placenta is definitely on the small side, and the specialist seems to think it'll wear out before I hit 40 weeks. Don't worry though! It sounds like you are in good hands and being watched closely.

cmerribury · February 2016

ecswim2fast said:

I'm confused about the percentiles. My baby was 2lbs 15oz at 29.6 weeks and they told me he was 56%. Do different Dr. have different standards?

No. That percentile is based on babies born at 29 weeks, not full term. Does that make more sense?

Doxies4life · March 2016

Well y'all baby girl has caught up and is estimated to weigh 7 lbs 10 oz! Doc told me to get off the diabetic diet as my last round of blood work didn't even have me in pre diabetes range. Scheduled for induction on the 7th due date is this Thursday. Almost there!

mshukh · March 2016

@doxies4lifeThat's awesome! Just curious, is the induction something you guys want to do or their recommendation? Did you do anything different to get her weight up?

We also caught up estimated weight at 38 weeks was 6lb 9 oz and at 44% overall with good amniotic fluid and all other readings. So they let us go back to our original plan of spontaneous labor with possibility of water birth.

Doxies4life · March 2016

mshukh said:

@doxies4lifeThat's awesome! Just curious, is the induction something you guys want to do or their recommendation? Did you do anything different to get her weight up?

We also caught up estimated weight at 38 weeks was 6lb 9 oz and at 44% overall with good amniotic fluid and all other readings. So they let us go back to our original plan of spontaneous labor with possibility of water birth.

Hey there! It was suggested by the doctor, but it is welcomed. My first was scheduled for induction and I went into labor the day before. Once I got the epidural my labor stopped cold for about 6 hours. No contractions no more dilation so I ended up on progesterone or however you spell it and my daughter showed up about 2 hours later. That was of course 17 years ago... this pregnancy has been very difficult as of the 2nd trimester. So having a definitive end in sight is very welcomed.

Only thing I did that piled on weight for baby girl this time was get off of the diabetic diet. I have only gained 28 lbs this go round ( for my first I gained around 60 lbs and left the hospital weighing 4 lbs more than when I got there. I actually asked if they forgot something inside of me).

With that being said I am 40 weeks as of today and have had contractions every 40 to 45 mins for the last week. I'm way done. I really should have ordered this baby on amazon prime. They have 2 day guaranteed delivery

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