maybe a bump in the road?

[leeann34]

Well I went for my check up today and Emma weighed 2 lb 3 oz. The doctor said that was a little small for 27 weeks 5 days. Also that her long bones was measuring short. He said they were not to worried about it yet because her brain and stomach were measuring okay and that basically I shouldn't worry about it ....but because of my prior history of severe preeclampsia he wants me to come in once a week now for a biophysical profile to make sure everything is okay. She is measuring in the 15th percentile and the doctor said they don't become to concerned unless its in the 5th percentile. Everything else measured good. Blood pressure and amniotic fluid good. Blood flow through the placenta was good. I am trying not to worry but honestly I am. Anyone else been given this type of information?

[caryn]

This is quite common in these pregnancies. IUGR is associated with preeclampsia (probably because the placentas tend to be shallowly implanted) and with pregnancies subsequent to preeclampsia. There are usually several posters at any time who've run into this - sometimes it will mean preterm delivery because placental perfusion will begin to fail and there won't be enough blood flowing through to keep the fetus supplied with oxygen and nutrients.

Do you go back next Monday? IIRC you're also almost at the gestational age where they'd have you start kickcounts a few times a day, which is another good way to make sure the kiddo is getting what she needs...

[leeann34]

Hi Caryn. Yes I go back Monday for a biophysical profile and I am doing kick counts. Emma seems to be doing okay with her movements on the kick count. I am just worried now and anxious for my next ultrasound. They will measure her in two weeks because a week is not enough time to see if she starts falling behind. Things were going so well too....and the doctor said not to worry. Yeah right!

[lemons]

Yes, I understand the worry when told that your baby isn't growing as hoped. My daughter consistently measured small, but with the opposite measures- her long bones were measuring ok but her head and abdomen were measuring small. Of course, my husband and I thought "oh, no. She is going to have a small head. What will that mean for her?" When I talked to my physician about it, he also said not to worry about it, since maybe she was going to have long legs. And to be honest, she was quite leggy when she was born. And her arms were really long. She looked like a monkey I think that it is natural to focus on what we consider to be the negatives, but there is often another way to look at these situations.

On a more serious note, ultrasound measures are not as accurate as we are led to believe. And my physician felt the same way about serial ultrasounds. We were having one every two weeks to watch her growth because any sooner than that would not have been informative. While she measured small, she was growing until 30 weeks. And then at 30 weeks, she hadn't shown any growth via ultrasound and the umbilical flow was decreased and the amniotic fluid was slightly low. It was at this point that she was delivered. She was 8 ounces bigger than the ultrasound (five hours before she was born) had predicted.

While we often talk of IUGR here on the forum, I don't know that I have come across any posts dealing with the fact that there are two different classes of IUGR. And I don't remember where I read this but I will look to find a good review for you: The first, Symmetrical IUGR, is characterized by a baby that is small but proportional, long bones and head are all considered to be the same "amount" small. This type of IUGR is thought to arise because the placenta has been severely effected for the entire pregnancy, basically limping along. The second class of IUGR is called "Asymmetrical IUGR" and is characterized by an overall small baby but where the head is proportionately bigger than the body. The idea is that the placenta was working well enough in the beginning to support growth but at some point started to fail. At that point, the baby's brain hijacked more blood flow and was able to continue developing as needed. And here is why I am telling you this- if I recall correctly, baby's born with Asymmetrical (or head-sparing) IUGR do better than baby's born with Symmetrical IUGR.

I'm sorry that you are having to worry about Baby Emma's growth but I am happy to hear that your physician is being very careful and attentive. And I will keep you and Emma in my thoughts.

[ellemoon]

Remember, those ultrasounds aren't 100% accurate with measurements. Unless you get more than one ultrasound that shows growth restriction, don't get too worried yet. Not to mention, that doesn't sound like too bad of a weight for a 27 weeker. My DD was 2lbs 11oz at 29w and they didn't say anything about IUGR. I have a friend who had her baby at 26 weeks due to a diagnosis of terminal Leukemia (tragic) and the baby was 1lb 13oz. Remember those ultrasounds can be off by even a lb sometimes. I hope everything turns out to be just fine!

[leeann34]

Thank you ladies for the information and some encouragement. I have been down in the dumps today by thinking the worse is going to happen. It sure does help to read your posts and get some feedback. Thank you bunches!

[caryn]

The thing is: if you do see some growth restriction, it's so very common in these pregnancies that they are watching for it already, and will monitor closely - which means you'll get the care you need. For most of us, our first pregnancy isn't high risk and we slip through the diagnostic cracks. But now that you've got a reason to watch for complications, the monitoring should catch any problems.

I'm glad you're feeling better!

[mychaelelaine]

I hope things work out perfectly Leann! I'm just now seeing your update.