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Conference moira::parenting_v3

Title:Parenting
Notice:READ 1.27 BEFORE WRITING
Moderator:CSC32::DUBOIS
Created:Wed May 30 1990
Last Modified:Tue May 27 1997
Last Successful Update:Fri Jun 06 1997
Number of topics:1364
Total number of notes:23848

725.0. "Pregnancy/growth retardation" by DNEAST::CARMICHAEL_S () Mon Feb 25 1991 17:56

    I scanned thru the dirctory and didn't see anything on this but then
    again, the way things have been going today, I could've missed it.
    
         I am about 31 weeks pregnant and had an ultrasound late last week.
    They found that the baby waas about 4 weeks behind in growth than what
    they thought he should be.  In other words, their dating showed that,
    for his size, he should be at around 27 weeks.  I have had 2 other
    ultrasounds and they were about a week behind.  They were done at 13
    and 17 weeks.  The week behind I can understand as I KNOW when I
    ovulate and it isn't at 14 days, it's 18-21.  But the rest of this
    scares me a bit.  THis is my first one so I worry about everything. 
    They are going to keep a close watch on it and they can't give me any
    real good reasons or explanations at this point about what may be wrong
    and that bothers me even more.  They just say don't worry for now.  Yeah
    right.  Easy for them to say.  What I was wondering is if this has
    happened to anyone else before and how the outcome was.  The doctor
    referred to this as growth retardation.  Not to be confused with mental
    retardation she said.  Any other similar experiences that you'd like to
    share would be GREATLY appreciated.
    
    
                    -First time mom and VERY worried.
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725.1KAOFS::S_BROOKAsk Not for whom the bell tolls, it tolls for ME!Mon Feb 25 1991 18:1223
    One thing that must be said, is that like the post-partum "growth
    charts" and percentiles etc ... if some kids weren't bigger than
    average and some kids weren't smaller than average, then we wouldn't
    have the charts -  and we wouldn't have a lot of worried parents!
    
    Still, the most important thing to really be concerned about is that
    you still are feeling movement and so on, indicating that the baby
    is otherwise ok.
    
    Were there ever small people in your families ?  Such traits can
    be a throw back from many generations ... they say as many as six
    for colour traits for example.  My wife and her mother are both
    very small, and I am thin, so it is not at all surprising to find
    our children are smaller than average.  Even if you are of normal size
    now, what were you like as a baby ?   There are a million and one
    variables ... that's why, apart from checking the obvious ones ..
    like your own diet, there's not a lot the Dr will or can do at this
    stage.
    
    So, just make sure that you have a good diet ... and not just a big
    diet, and I'm sure all will work out ok.
    
    Stuart
725.2Relative growth importantNOVA::WASSERMANDeb Wasserman, DTN 264-1863Mon Feb 25 1991 18:334
    I think the important thing is not the absolute size of the baby, but
    the fact that it is growing at a steady pace, and that you are gaining
    weight at an acceptable rate.  If the baby stops growing, that's a
    problem.  
725.3SWSCIM::DIAZMon Feb 25 1991 19:0813
    For my second ultrasound (I've forgotten how many weeks, sorry), the
    doctor discovered something similar, in my case they said the head was
    smaller than it should have been. I was scheduled for another
    ultrasound a couple weeks later to check it out. It could have been an
    indication that the placenta was malfunctioning because the growth was
    out of proportion. After all the worry it turned out to be bad
    measurements in the ultrasound.
    
    So what I would concentrate on if I were you is that, the baby is in
    proportion, the doctor is not talking about taking the baby early so
    he is not worried about its growth currently just monitoring it. If the
    doctor was worried, he have you in for frequent tests, etc. If he's not
    worried, you shouldn't worry.
725.4PIPLIN::CHANGMon Feb 25 1991 19:2218
    I know how you feel now.  I had a similar problem with my second.
    Throughout the preganacy, my OB thought she was about 4 weeks behind
    in size.  However, my period is very regular.  It is impossible to 
    mess up the due date.  I also had two ultrasounds, one at 22 week
    and one at 30 week, both showed she was about 2 weeks behind.  Since
    both me and my husband are tall (I am 5'7", my husband is 6'1") and
    our first is big too (he was 9lbs at birth), it is unlikely that I
    will have a small baby.  I was worried throught my preganacy.
    Monica was only 3 days early and she was 7 lbs at birth.  Later, my OB
    told me that because I was carrying very low, and baby's position, 
    it was difficult for him and ultrasound to measure baby's size.
    
    So, what I am trying to say is ... relax! Ultrasound isn't always 
    accurate.  As long as baby is moving and growing, it will be fine.
    Try to enjoy your final weeks of preganacy.
    
    Wendy   
    
725.5Tests are EASY to mess up!BCSE::WEIERPatty, DTN 381-0877Mon Feb 25 1991 19:3714
    I'll reiterate the possibility that the TEST is at fault here!!!  When
    we had amnios done for my first to determine how developed his lungs
    were, the first amnio came back that he was ALMOST ok to deliver
    (another couple days, he should've been fine).  A week later, the amnio
    was repeated, and the 2nd one came back that his lungs were severely
    UNDERdeveloped (yes, worse than the first test!).  Three days later he
    was born, with VERY healthy, fully developed lungs.  
    
    Remember the technicians (and Drs) are just people too, and NO test is
    foolproof!  I wouldn't worry until you have a series of tests that
    indicate the same condition .... and you do have a series of tests that
    indicate the baby is ok!
    
    
725.6Don't Worry!!!NEWPRT::WAGNER_BAMon Feb 25 1991 20:5014
    All of these replys are very good advice!  
    
    But just remember even if there were a growth problem,  they are VERY
    treatable!  Our neighbor girl across the street was diagnosed with a
    growth deficiency.  She ran the gammit of tests, and found out she
    didn't have a growth hormone deficiency (in which she would have to
    take a shot in the arm for everyday until she was 14), but she has a
    kidney problem, and the treatment is a little baking soda type drink 4
    times a day.  She is almost 2 years old by the way, and has the body of
    a one year old.  Both her parents are very short so they didn't suspect
    anything for a while, until the doctor noticed she stopped gaining
    weight.
    
    We are so lucky these days to have the technology that we do!
725.7feeling a bit better!DNEAST::CARMICHAEL_STue Feb 26 1991 10:4330
         Wow!  Thanks all of you for your replies.  I feel a lot better
    just getting ANY information that I can.
    
         I am scheduled for another ultrasound this coming Monday in a
    larger city with more sophisticated equipemnt just so my doctor can see
    if there is something she didn't see.  I'm hoping that the
    measurements this time will be a little closer.  After this it will be
    ultrasounds every 2 weeks and, if the baby gets too far behind, I will
    have to deliver early.  Not looking forward to getting induced but all
    I care about now is the baby.
    
         The baby IS very low.  His head is right down by my pelvic bone.
    
         I am tall(5'10") but was thin (132lbs) when I started.  I was
    only 6lbs 1/2 oz when I was born and my mother had 2 preemies.  The
    biggest of the 5 of us didn't even hit 7lbs. My husband told me that he
    was only a little over 6lbs himself at birth.  I do eat right and I do
    eat whenever I am hungry (and sometimes when I'm not!).  I just don't
    eat alot compared to many other people's standards.  I have gained
    around 20 pounds so far.  I'm told there isn't anything wrong with
    that.  So, I've just been sort of leaning towards a small baby
    especially where everything with the baby and I has been perfectily
    fine up until now.  Of course, I still worry!
    
         Keep the replies coming.  I really do appreciate them and I will
    keep you posted.
    
                -Sue
    
         
725.8UTLRASOUNDS CAN BE WRONG!DEMON::MARRAMATue Feb 26 1991 12:4518
    
    I am 35 weeks pregnant and I had my first ultrasound when I was 17
    weeks.  The technician told me that I was 16 weeks, now I know when
    I had my last period and when I ovulated so I just went by 17 weeks.
    About 3 weeks ago I was put in the hospital for several abdominal pain,
    they had me have another ultrasound.  My doctor told me that it showed
    the baby as being older that what I was.  So you see, your baby can
    grow tremendously in one month.  Also, the last month it grows alot.
    I have gained 18lbs this whole pregnancy and I think I am going to have
    a 7lb or 8lb baby.  Just as long as you are eating right and putting on
    weight try not to worry!!!
    
    Good luck and enjoy!!!
    
    Kim
    
    
    
725.9Our storyAPACHE::APACHE::FRIEDRICHSTake the money and run!Tue Feb 26 1991 13:5038
    Our son was diagnosed with severe Intrauterine Growth Retardation
    (IUGR) at 30 weeks gestation.  Basically the placenta was not supporting
    life appropriately.  He was delivered early, at 30 weeks, and spent a 
    long time in the hospital.  He was delivered by c-section, 75% of IUGR
    are delivered by c-section.  He is still no where near a growth chart,
    but is developmentally normal.  He has some typical "Preemie" problems
    but is basically normal health wise.  Problems are high risk for
    respiratory disease. 
    
    Go for all the tests possible.  They did ultrasounds twice a week, and
    an amniocentisis to check for lung development.  Most IUGR have good
    lungs, because the baby is under stress in utero.  Don't rush into
    anything, get all the info possible, and ask every question you can
    think of concerning anything.  Most of all, get to the best hospital
    possible for obstetrics and Neonatal care.  Also speak to a
    neonatologist if they discuss delivering the child early to prepare
    yourself for possible problems.
    
    Basically, everything turned out fine for us, but it is a long road. 
    I know I have inflicted alot of fear into your life, but these problems
    do occur.  After all this I will say try not to worry, there is
    absolutely nothing you can do to stop it, nor did you do anything to
    cause it.  After 21 months, we still have no reason why it happened, it
    just happens.  
    
    Remember, don't rush into anything, get all the information possible,
    and if you want, take a day to make the decision.  Also, pay attention
    to the ultrasound, I went to an Ultrasound Specialist, and the
    technician did a first ultrasound and then the doctor came in and did
    another.  Make them explain everything, that is what they are there
    for.  The course of my pregnancy was based on the ultrasound.
    
    Feel free to send me mail.  ALso my wife is at home and will be willing
    to talk to you. Support is very important.
    
    I pray nothing is wrong.  Good luck.  Let us know what happens, when
    you feel like it.  
    
725.10RTL::ROLLMANTue Feb 26 1991 15:3322

I think the "carrying low" is a big factor in an accurate measurement.  I also
carried low and had weekly ultrasounds.  They had trouble getting accurate 
measurements every week because they couldn't get a clear picture of her head.
However, she continued to gain every week, even though I didn't.

Also she weighed 6lbs, 4ozs at birth (one week early), even though I'm 5'7" 
and my husband is 6'2".  I think I read somewhere that baby weight at birth is 
related to the mother's birth size, given an adequate diet.

In addition, I had an ultrasound at Brigham and Women's in Boston and
they were wrong on their estimate of gestation.  Even the most respected
make mistakes.

So, hang in there and don't worry.  (yea, yea, do as I say, not as I did).

BTW, if you're going to have a series of ultrasounds, don't hesitate to ask 
the technician for ultrasound pictures.  We have a really weird picture of our 
daughter's face when she was a 35 week fetus.  She is looking straight at the 
camera with her eyes open.  When she was born we were amazed, she looked just 
like her picture.
725.11My ExperienceAPACHE::MAZZUCOTELLITue Feb 26 1991 16:0339
    My doctor told me the same thing when I was about 35 weeks and that's
    when my doctor ordered my first ultrasound.  I too was positive of when I
    conceived so I knew the due date was accurate.  
    
    What causes them to
    suspect that there is IUGR is the percentage of growth from an early
    ultrasound (done around 12 weeks).  But, like many people have stated
    before, due to many variables (machine, technician, etc) the ultrasound
    may not be the most accurate.  Later ultrasounds done by themselves, as
    in my case, do not give an accurate rendering of possible IUGR because
    early fetal growth is about the same, but later growth is probably more
    hereditary -- that's how you get a 18 incher or a 20+ incher.
    
    If the baby does have IUGR and goes full term, the baby's head will
    look even more out of proportion to its body than "normal" babies. 
    There may be other affects but I'm not an expert.
    
    What my doctor did was order the ultrasounds and non-stress tests to
    see if the fetus was under any stress and to see if the placenta was
    functioning properly (right amount of fluid).  If the womb looks like
    it is not supporting the baby properly, then they would get the baby
    out early.
    
    All my tests came back fine (no distress, plenty of fluid) but my
    doctor decided to induce one week early.  I was disappointed when he
    told me that but at that same office visit he stretched my cervix
    (OUCH!).  In some women this sends them into labor right away, with me
    it took a couple days (even though the labor pains started the next
    day).  I ended up delivering the day before I was scheduled to be
    induced!  The result, a healthy, perfectly proportioned, little girl!
    She was 5 lb 7oz and 18 inches.  On the small size but perfectly
    healthy.  I look back at pictures and can't believe that she was that
    small, but she's now 7 months old and in the 50th percentile for weight
    and about the 25th percentile for height.
    
    Bottom line, there is some reason to be concerned, but follow your
    doctor's advice and enjoy your last few weeks!
    
    Jane
725.12small uterus ?POWDML::LALIBERTETue Feb 26 1991 16:0617
    We had the same IUGR diagnosis with my son (he's now 3)...i was
    having weekly ultrasounds towards the end and they found he was
    not gaining any weight over the last 3 weeks before delivery.
    During these tests I also had a test where they check the placenta
    and since that placenta was a-ok, they did not consider the growth
    issue to be a real problem....even to the point that "I" was the
    one who noticed the numbers and had to mention it to the doctor !
    
    I had gained about 52 pounds and thought i was having a big baby
    but he was only 5 1/2 pounds. he was very skinny when he was born
    and still to this day he is small but my father-in-law is small
    so it could all be genetics.
    
    However, I do have an extra small uterus because of DES complications
    so this is what the doctors said may have caused the IUGR. But I
    could tell they were not really sure. 
    
725.13Accuracy (?) of ultrasounds...CRONIC::ORTHTue Feb 26 1991 16:2816
    With our last child, my wife became gestationally diabetic near the
    end, and they did wekkly ultrasounds, as there is a greater possibility
    of a large baby. At 38 weeks, she was measuring 43 weeks, and they were
    convincd that the baby was *at least* 10-11 lbs. They induced a week
    early, and he weighed in at 8 lbs. 15 oz.! So much for accuracy!
    
    With this pregnancy, she has only had two ultrsounds so far. One showed
    right on target, and the other they wouldn't even measure the
    baby....the baby was breech (head up), and they said that measurements
    then are very inaccurate, either too high or too low. They also said
    very low babies (those that are head down, at least), make accurate
    measurements nearly impossible. If either of these was the case with
    you, then take the measurements with a grain of salt. Ask your doctor
    if this could have been the case for you.
    
    --dave--
725.14Small doesn't always mean bad newsELMAGO::PHUNTLEYTue Feb 26 1991 17:2123
    I had a similar experience.  However, my doctor's biggest concern
    was my lack of weight gain.  I only gained 13 pounds my entire
    pregnancy and ended up weighing less after the delivery than I did
    before pregnancy.  My original due date was the beginning of May
    and this changed continually throughout my pregnancy.  Joshua was
    finally born June 19th, 1989.  I had thought my menstrual cycle
    was very regular but I guess it wasn't--the dating was way off in
    regards to my actual delivery date.  I had numerous ultrasounds,
    bloodtests, GTTs, etc. and all determined that the baby was small
    for gestational age, etc.  However, Joshua was a average 6 lbs.
    15ozs. at birth and extremely healthy (APGARS of 7 and 9) at birth.
    He is now very large for his age--wears size 3 toddler at 20 months.
    He still is slim (25lbs) but quite tall.  My doctor did put me on
    leave early from work--went on leave in March since I had only gained
    4 pounds at 6 months of pregnancy and she considered me to be "high"
    risk.  FWIW, all was well despite all my worrying and fear of the
    worst.
    
    Feel free to send me mail @ ELMAGO::Phuntley.
    
    Regards,
    Pam
    
725.15My storyIOSG::RUMBELOWJWed Feb 27 1991 06:3953
I was diagnosed as having Inter-Uterine Growth Retardation when I was 
34 weeks pregnant.  I can really sympathise with what you're going 
through, I know what it's like and how worrying it is.

In my case, my doctor thought that the baby felt small at a routine 
34 week check and sent me to the hospital to have a scan.  The doctor 
at the hospital though that the baby was about four weeks behind and 
immediately attmitted me into hospital.  They did stress tests which 
showed that the baby was fine, so they decided to keep me in bed (in 
hospital) for two weeks to see if that helped the growth rate.  I 
felt perfectly well and healthy but had to stay in hospital for two 
weeks - it felt very strange!  After two weeks I had another scan 
which showed that the growth rate had picked up a bit, but the baby 
was still small. So I was sent home with strict instructions not to 
do ANYTHING.  It was very frustrating - I didn't have anything ready 
for the baby and had planned on doing all my shopping, sorting out 
the nursery, cooking meals for the freezer etc etc in the last six 
weeks.  But, really what's most important is to do what's best for 
the baby.

I had weekly check-ups at the hospital and another scan at 38 weeks.  
This scan showed that the growth rate was slowing down again and they 
estimated the baby's weight at 4.5lb.  So they decided to induce me.  
My doctor doesn't like doing c-sections unless absolutely necessaary, 
and I wanted to avoid a c-section, so he went for induction.  He 
wasn't sure if it would work because I wasn't ready to give birth, 
but in fact it did work.  Alison was born 9.5 hours after the start 
of the induction, and I was only in serious pain for about half a 
dozen contractions.  Alison weighed 5lb and was very healthy, but 
very skinny.  The midwife said that my placenta was unhealthy and had 
probably to fail, but foolishly I didn't think to ask for any more 
details at the time.

My daughter spent the first month of her life just sleeping and 
eating, and I felt for a long time that she was about a month behind 
developmentally (although my doctor didn't agree - she thought she 
was fine!).  Alison is now 21 months old and I don't think she's 
behind any more.  She's still small, but not abnormally so (I'm
5'1" and my husband is 5'7" so I don't expect her to be very big).

When I asked "Why is this happening to me?"  the doctors didn't know 
for sure, but they said that smoking, maternal age and stress can 
have an effect (I don't smoke, I'm in my early thirties - not sure if 
that's old!, but I was quite stressed at work).  The only thing they 
could suggest to help was to get as much rest as possible.  

Do try not to worry, try to rest as much as you can, and remind 
yourself that most small for dates babies are just that - small for 
dates, and there is nothing else wrong with them.  

Good luck

- Janet
725.16Everything turned out fineDNEAST::CARMICHAEL_SFri May 24 1991 15:5839
    Well, just thought I would update you all on what finally happened with
    all of this.  I ended up having stress test on a weekly basis and ultra
    sounds every two weeks.  On the second ultrasound at 34 1/2 weeks the
    doctor confirmed that my baby was indeed falling further behind.  At
    this point the lower torso was about 6 weeks behind.  That's scary. 
    So, they ordered amniocentesis to check lung maturity.  I was petrified
    cause I hate needles but it really wasn't that bad.  The test that they
    do usually only takes a day and they were supposed to call me that
    evening.  Well, someone in the lab screwed up and didn't get the test
    going until late that afternoon.  The next day I got a call saying that
    indeed my babies lungs were mature and how about induction the next
    day.  This was at 6pm and they wanted me to come in the next morning
    around 6am!!!!!  How's that for short notice?!!!  I was scared to
    death.  I was admitted the next day and they gave me prostoglandin gel
    to begin with as I was only 1cm and 50% effaced.  I got two doses of
    that and it didn't do anything so they started the pitocin early
    afternoon.  Never got far that day and they stopped at 6:30pm.  Started
    up the next morning bright and early by breaking my water and cranking
    up the ole pitocin.  By 6pm I was only 3cm and 100%effaced and couldn't
    take it any longer so I got an epidural.  The whole time the baby did
    fine until about an hour after that when his heart rate dropped way
    down.  Doctor's and nurses came running from everywhere.  I was pretty
    much out of it by then so I didn't realize that something was wrong but
    my husband did.  Anyway, they checked me and I had dilated to 10 cm in
    about an hour.  Couldn't believe it.  Good thing too because, had I not
    been ready to deliver then, I would've had a c-section.  I was wheeled
    down to a special room used for high risk deliveries and at 8:49pm on
    March 22nd, 5 weeks before he was due, Roderic Lowell Carmichael was
    born a whopping 3lbs 2oz.  He was rushed to intensive care where he
    stayed for 2 weeks and then was transfered to a hospital closer to home
    where he stayed for two weeks.  It was 2 weeks before he had enough
    strength to eat from a bottle.  Today he is 9 weeks old and finally
    around 6 pounds.  He is perfectily healthy.  They blame it on a fibrous
    placenta and had he gone to term he probably would've been a still
    birth.  I am so glad that everything turned out ok and I am enjoying to
    the FULLEST having him here with us.
    
    
    Sue.
725.17great newsTIPTOE::STOLICNYFri May 24 1991 16:169
    
    Sue,
    
    Congratulations!   and welcome Roderic!
    
    3lbs 2oz...the technology that helps these small babies survive
    is amazing and precious!
    
    Carol