QuestionI am currently 21 weeks pregnant, with my second child. My first pregnancy was free of complications, my son measured either spot on, or ahead the whole time, and weighed 8lbs1oz at birth at 41weeks. I am tall, 5'10", as is my husband, 6'1", neither of us were small babies, both weighing in around 8lbs.
In this pregnancy, at 5, 6, and 13 weeks, I experienced substantial bleeds. At 5 weeks, a subchorionic hematoma was discovered by ultrasound, which grew at 7 weeks and they believe it bled out at 13 weeks. I had ultrasounds to check on the baby at 5, 7 and 13 weeks. I'm positive on my dates, was charting my bbt, and used ovulation predictor tests. At 13 weeks, the baby was measuring approximately 5 days ahead.
At my routine ultrasound at 19 weeks, the SCH was gone, but the baby was catagorized as "small", between the 10th and 11th percentiles (I don't have the data available to me, I'm going based on what my midwife told me). My fundal height at my 20 week appointment was 16cm.
My midwife has ordered a Doppler (?) scan, as well as a growth scan, because she's concerned the baby isn't growing properly. At this point, I've put on 7-8lbs, I eat very nutritional foods (absolutely no junk, mostly lean means, whole grains and vegetables), and eat a lot. My blood pressure is low, and although I had PIH with my son, that appears not to be a problem this time around. I do not smoke, or do drugs.
I have no experience with complicated pregnancies, and this pregnancy has been a rollercoaster ride, emotionally. I'm trying to avoid researching online, because the material out there is scary. At this point, should I be worried about IUGR, or is it too early to tell if that's a factor? Do you know what a Doppler study is? Could the baby not be growing because of the the SCH earlier in my pregnancy?
I'm trying to do everything I can to make sure my little girl is okay, but I have a gut feeling that something is wrong. I don't have the next ultrasound until after 24 weeks. I'd appreciate any insight you could provide, regarding measuring small for dates both on the ultrasound and by fundal height.
Thanks :)
AnswerHi,
I can offer you my insight, but I need to do it with the disclaimer that I am a childbirth educator and not a medical professional.
What I CAN tell you is this:
At this point all you can do is wait, which is SO hard because you want to do something! There could be a problem...or not. They want to see how quickly your baby continues to grow. It could be IUGR, which is why they are keeping an eye on it, but it might not be that at all. She could just be small, and even though you and your husband are tall, she might have gotten genes from a branch of your family that has her being smaller than average but at the same time, completely healthy. They can't determine for sure whether it's a small baby or a baby who isn't growing at the rate they would like to see; they will need to continue to monitor her growth.
The Doppler scan is done just like an ultrasound using ultrasound equipment, except they are specifically checking blood flow in different parts of your baby's body. They generally do the Doppler scan a few different times because they are looking to see how certain measurements change, and that helps them determine more accurately if there is a problem.
You will have a much better picture of what is going on after the 24 week u/s and when you get the results of the Doppler scan and growth scan. .
Avoiding internet research is a very smart thing. Dr. Google is not always your friend. :)
I don't think the SCH is a factor, but check with your midwife on that. With fundal height, they would expect your fundal height to be closer to 20 cm at 20 weeks.
IUGR is much more of a problem if it is undiagnosed. If after all of the testing they suspect IUGR they will continue to monitor your baby. If they feel that she is not growing in utero, they will deliver her early. The good news is that IUGR babies, although very tiny, tend to do very well after birth and tend to grow just fine after they are born. Their lungs tend to be ok but they need NICU time to grow.
You are doing everything right for your baby. Take it a day at a time. I know it's very scary not knowing and just waiting.
I wish you the best with your pregnancy. You should have some answers in a few weeks, and I hope that all your worrying was for nothing. Hang in there.
Sincerely,
