I have a friend who is just over 36 weeks pregnant and she is measuring small. She had an ultra sound done the beginning of this week and the "specialist" said the baby was perfectly healthy just small, guessing around 4 pounds. She is now taller than 5 foot and is 90 pounds soaking wet and her DH is 160 pounds and is just under 6 foot. So both on the smaller side. Between 35 and 36 weeks she was measuring 33 weeks and at her appointment today she measured 32 weeks.
Let me back track a bit. At her first appointment she was measuring big as well as baby so they moved her due date up by nearly 2 weeks and the doctor told her she would probably have a big baby and need a c-section.
Okay now the baby is measuring small and they are still leaving her due date the same rather than moving it back, where it most likely should be in the first place i'm sure, but anyways her doctor is inducing her a little before 38 weeks because he is saying the baby will grow better on the outside than the inside. Her doctor is an a$$ hole IMO and is just doing what he wants in his convenience. It just sounds far to fishy for me. You would also think that if baby was measuring smaller you would either move the date back to where it was at first or at least keep baby baking as long as possible. But nope her doc wants to get the baby out. At her appointment today they set the date for August 9th to induce and he checked her and she is dilated to a 2, so he says. I don't know if i believe a word he says. I just wish I could say more to her to get her to see but she has been so brained washed. I don't want to jeopardize our friendship either because they are really good friends of ours. IT JUST THAT THE SITUATION IS SO WRONG!!!!!
I don't know what to do. I just pray and hope all goes well and baby turns out healthy and fine. Please pray for these people.
Two things I know of: When the baby descends into the pelvis, it can make your fundal height measure slightly smaller, and most babies grow at the same rate up until the 20th week of pregnancy. As far as the growth rate, that is why they do dating u/s before the 20th week and typically don't move the EDD after that point b/c the bigger the baby gets, the less accurate the u/s is, and they also have spurts and slower growth periods that are different for each baby until birth.
Now, is induction the right answer? I can't tell you that. I don't know her medical history or the specific history of this pregnancy, and there are so many factors playing into the scenario that she has given you, that you have to remember you are only hearing her interpretation of what has/is happening.
It does sound a little odd, and if it were me, I would DEFINITELY be demanding a second opinion. They will definitely be in my thoughts, and I hope everything turns out for the best.
Ariel & John: Military Family since May 17, 2006
Sylvia: 12/18/08, Justus: 9/17/10, Bunni: 5/11/12, Surprise Baby: Guess Date 11/5/13
Her doctor's logic for inducing now (baby will grow better on the outside) seems a little off. If that's really what he said and her history doesn't suggest any other reason to induce I'd be very wary. I'm certainly no doctor, but I'd think if baby were measuring "small" then you'd want it to continue baking until it at least measured term unless there were other reasons to think the baby's health were going to be compromised. I don't know what I'd do in your situation. I think the best you can do is casually present her with some information. If she resists, you're more likely to damage your relationship than get through to her.
She has had a very healthy pregnancy so far. She was measuring right on up until 35 weeks and then she started measuring behind, that is also when she started to dilate.
The thing that gets me is right from the beginning her doctor has been coming up with "potential problems" and when one is resolved he "finds" another. I never expected her to have a big baby, generally two small parents don't = a big baby, and it's not uncommon, this being her first baby, to drop early. Which from all the evidence she has given me is the case, along with the fact that she is going to have a smaller baby anyway.
I guess I just really don't get how much trust she is putting into her doctor especially with the fact that baby is doing fine inside her and very healthy just small but the doctor wants to take the baby out because it's not growing as fast as "he" wants it to.
See this is one thing that has me concerned. If she was just measuring ahead at first because baby was growing a little faster than normal, at 20 weeks was measuring a little behind on u/s, and now measuring a few weeks behind, I'm wondering if she may not just be 34 weeks along now just like she had initial thought by her dates. She is too nice to question her doctor so she is just going to go along with what he is saying so no matter what she will be induced on the 9th. I just pray everything turns out okay and baby is healthy and doesn't need NICU.
Oh I also forgot to mention that from her u/s with the specialist on Monday her doctor wanted to see her 3 times a week from then on and this was her FIRST appointment sense the u/s and he is making a judgment already. Seems a little premature to me. Hopefully with in the next week the baby will grow lots and lots and they can cancel the induction.
When you say "measuring ahead at first" what type of measurement did they use? Palpation could definitely be wrong by 2 weeks that early. Some uteruses (uteri?) stretch out faster, some grow more slowly, and you can't feel the baby yet, plus the baby itself is so small that 2 weeks of growth wouldn't feel much different from the outside! Fundal height isn't an accurate measurement at any time, and as a guideline for growth the "centimeter per week" doesn't start before the third trimester; before that, it's generally "out of the pelvis" by the end of the first trimester, and "at the belly button" at 20 weeks. An ultrasound done before 8 weeks is the most accurate dating measure, but the later it gets after that, the less accurate an ultrasound will be because genetics start playing. A naturally small baby can be perfectly healthy, but a small baby who is also born too early might not be! IMHO, if she's fairly sure of her dates, I would strongly encourage her to NOT allow them to induce early. Of course, I wouldn't have let them change my EDD in the first place, but that's me & not her.
Now if there is truly IUGR then that's another story, and baby might be better on the outside, but that's a completely different issue than just having a naturally small baby. IUGR requires an accurate diagnosis, which in turn requires at least two full biophysical profile ultrasounds, including Doppler cord blood supply. They should NOT be with her regular doctor, but with an ultrasound tech who is specially trained to recognize IUGR. I would encourage my friend to seek a second opinion immediately, and if the BPP findings indicate that IUGR is a possibility, they will schedule another BPP a few days later. For IUGR you usually get BPPs every other day and schedule induction immediately when baby starts dropping.
David Letterman is retiring. Such great memories of watching him over the past thirty-two years!
The first u/s was at 7 weeks and baby was measuring around 9 weeks. I've tried explaining all these things to her but she trusts her doctor too much. I asked her if she was sure about her dates and she said she "thinks" she was but once again trusts her doctors judgment.
As for the u/s she had on Monday, she was sent a specialist that checked everything out and just said she had a small but very healthy baby. So far they have only done one u/s with the specialist and like I said before sense her u/s with the specialist she has had one doctors appointment and at that appointment he told her he was scheduling her to be induced because baby isn't growing as fast as he wants and it will grow better on the outside. She has had 3 u/s in the pregnancy, one at 7 weeks, 20 weeks, and then the one at 36 weeks with the specialist. All have concluded a very healthy baby.
I'm scared that she is really only around 34-35 weeks right now and they are going to cause the baby to come prematurely, because their dates from the first u/s at 7 weeks said she was further along. Right now she is on cloud nine because she knows she will get to meet her baby in a little over a week. What she isn't realizing is that the baby, being small, and IMO born early, will most likely have to stay in the hospital till he weighs enough.
I will agree that if it is IUGR things will be better off if she has him sooner rather than later. But to me it just doesn't seem like that's the problem. To me it sounds more like the doctor just trying to find a problem to deliver this baby early. He never wanted her to go to the end of August. From the beginning he has been pushing her to have the baby earlier.
If it were my friend, I would voice these concerns (hopefully in person) in the "I want you to have a healthy baby" kind of way. Delivering a premature baby because labor can't be stopped is one thing, forcing a baby out too early is entirely another, and IMHO it's not only dangerous, but it's unethical and medically negligent. I would strongly encourage her to get a second opinion, for the sake of her baby. And then leave it be, it's in her hands. You can lead a horse to water... Just send out good thoughts, good energy for her, say a prayer if you're inclined, and know that you did what you could.
Unless she's one of those "just get the baby out, I don't care how," kind of moms, you might also want to point out that she's a lot more likely to end up with a c-section if she induces at this point. Remind her that, if it doesn't feel right, she can always get up & leave unless she's let them break her water, and then she's on the clock, so she would be wise to avoid that.
David Letterman is retiring. Such great memories of watching him over the past thirty-two years!