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What problems can IUGR babies encounter?

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What problems can IUGR babies encounter?

Postby expert on call » Sun Feb 16, 2003 05:47 pm

Hi there!!

The saga continues. On Thursday my doctor ordered an ultrasound to check growth, and the baby was smaller than they thought she should be (32w1d at the ultrasound). She measured 3lbs 8oz, give or take 6oz. There is apparently some indication of IUGR. Is this common with preeclamsia?? SHe is also concerned because the blood flow from the baby to the placenta is low, indicating that Molly is working harder to get blood and nutrients or something. Now my doctor has me going in for twice weekly non stress tests and weekly biophysical profiles, and has instructed me to "pack my bags, because it could be any time now." My BP had been down (now it's creeping back up) and my protein has been +1 all week. Yesterday I took my BP at home with the help of my home health monitoring system, and my BP was 150/100 for 20 minutes, and my pulse was "tachy" at 142bpm. By the time I got to the hospital and they left me in bed for 30 minutes on my left side, my BP went down. I'm doing another 24 hour urine collection, but I'm frustrated because they sent me home, and within 4 hours of getting home, my BP went sky high again!! I'm almost afraid to go to the doctor anymore!! Thank goodness I"m at 33 weeks tomorrow!!!! What are some of the problems babies can encounter from IUGR? This is a new one for me, but my doc says it's part and parcel of pre-e. Thanks in advance!!!

Megan
DH Jason
DD Bridget 4/5/2000 (39 weeks, no preeclampsia)
Molly due 4/3/2003
on bedrest for preeclampsia since 28 weeks.
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Re : What problems can IUGR babies encounter?

Postby expert on call » Sun Feb 16, 2003 05:49 pm

Hello Megan,

Sorry to get back with you sooner. Your email arrived the day I left for a snowshoe trip. Please forgive the delay. Actually several days have gone by, I do hope all is well. You asked several important questions. First IUGR (Interuterine growth retardation) is an expected outcome of preeclampsia. The placentas tend to be small and the maternal arteries are not as large as a normotensive pregnancy. However, I would also like to give you great encouragement as even 3 pounds 2 oz is a nice size at 32 weeks with the complication of preeclamsia. It is wise and important to have frequent US and biophysicial profiles. As for being uncertain whether or not to call your doctor... CALL! Day or night. The reason why your pressure readings vary is because preeclampsia is a vasospasic disease which means the vessels spasm, therefore the B/P will vary. Call your doctor frequently and do not give into pressure or feelings that you are imposing. You can even ask for rationales for sending you home and for reassurance through lab testing (uric acid, blood counts, fibrinogen levels).

As for the nursery course of IUGR is also based on gestational age. At 33 weeks please expect that Molly will need oxygen support (usually by a special hood, but may require intubation (a breathing machine) for a few days. Intravenous access lines are usually placed through her umbilical cord for fluid and antibiotics to protect her from infections. Small babies tend to have some problems with blood sugars (corrected by the IV fluids) and have difficulty keeping warm (therefore placed in a warmed isolette).
After the initial shock and recovery from delivery IUGR babies do as well as others.

I hope that your last few days have not been too stressful. Please forgive my delay in writing. If we can be of any other assistance or answer ANY questions, please ask.

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Re : What problems can IUGR babies encounter?

Postby megan9499 » Sun Feb 16, 2003 06:51 pm

Thank you SO much!! I was beginning to think I had a rare complication from preeclampsia!! We're hanging in there here in Minnesota!! My doc is doing twice weekly non stress tests and once a week biophysical and growth assessments. This week I needed 3 NSTs because my BP has been climbing up and up (although after a few hours in the hospital my BP will slowly go down). There is some concern because the rate of blood flow from the placenta to the baby (fetal doppler study?) has been over a 4 (which is apparently the threshhold for concern) after 2 separate occasions. My doctor is watching me like a hawk with frequent doctor visits, home health nursing taking BP 3x a day and doing twice daily fetal kick counts, checking weight, protein, ketones, etc. I'm just praying to make it to 36 weeks. I'm 33w4d today (Sunday) and had set my 1st goal at 32 weeks, now my next goal is 34 weeks. My doctor has said that once I get to 35 weeks, she "begins to lose motivation to keep me pregnant when these symptoms arise" and will consider inducing. We haven't had steroid shots yet, and she says after 34 weeks the steroids are useless. I know I"m in good hands, but with this being a 2nd pregnancy after going 39 weeks with my 1st daughter, having problems crop up like this are really shocking! Thanks for writing back!!

[:)]

Megan
DH Jason
DD Bridget 4/5/2000 (39 weeks, no preeclampsia)
Molly due 4/3/2003
on bedrest for preeclampsia since 28 weeks.
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