Back from ultrasound - Page 2

[LilMamiBella]

I went to the midwife today and she compared the kids' files with this baby. I measured low with each kid but I didn't start measuring low until I was 30 weeks. I'm almost 25 weeks. So if the baby has grown some by the time I get to the ultrasound then that could mean that my due date is wrong. But If I'm still measuring low week after week then that means I'll have to eventually be induced? What will it mean really? She also mentioned that down syndrome babies usually measure really high and also usually have problems with heart, kidneys,etc.

[mellowyellowmama]

Why would you have to be induced?

[gossamerwindweb]

ok, so if your baby is measuring low and DS babies measure high, what is the big deal? And why induce you early? ....off to ponder this as I am measuring HUGE.... or perhaps she means the fetal measurements, not the fundal height... need to read I guess

[LilMamiBella]

That was a question. I'm just wondering what will happen if I keep measuring low every week. I didn't say I wanted to be induced.

[accountclosed3]

hugs.

i would look at this in this way:

1. if it is the case, then it's a good idea to get the names and numbers of specific community leaders. now, because i had no u/s, i didn't have this situation, but "just in case" i had numbers on hand for families with children with special needs so that i would have community support soon after the birth if needed. btw, my son does not have DS or any other disabilities.

2. as for the testing, the real question is to know the value of the test.

if you do feel that it is likely ds and you also are concerned about specific problems to the infant that might occur during birth or shortly after, then i would continue with medical care and tests to make sure that the baby's needs are met. if it is possible, for example, to have a prenatal heart surgery that could change everything for the baby, then i would ocntinue with testing, etc.

but, more often than not, this is purely for information and peace of mind. there isn't a lot they can do until the baby is born, and you basically have the choice of knowing and bearing a child with ds (or whatever else might have been diagnosed) or choosing to go a eugenics route. personally, i find the second option to be repugnant. and i'm not sure that i would want a more risky test "just to be sure" either way, when there isn't much that they could do about it anyway.

those are just my thoughts on these things. take them or leave them.

but either way, good luck with everything!

[blissful_maia]

Originally Posted by LilMamiBella

I went to the midwife today and she compared the kids' files with this baby. I measured low with each kid but I didn't start measuring low until I was 30 weeks. I'm almost 25 weeks. So if the baby has grown some by the time I get to the ultrasound then that could mean that my due date is wrong. But If I'm still measuring low week after week then that means I'll have to eventually be induced? What will it mean really? She also mentioned that down syndrome babies usually measure really high and also usually have problems with heart, kidneys,etc.

Your midwife was wrong to tell you that DS babies usually measure large... DS babies are usually small for gestational age. Also, MOST babies with DS do not have heart or kidney problems. About 1/2 have heart problems, and while they are at higher risk for kidney/GI issues, it's certainly not the majority.

I agree with some pps that if you have a detailed ultrasound that rules out any major physical issues that make homebirth unsafe, there's not reason you shouldn't UC! I am sorry you are finding yourself in this situation... especially since a NT measurement is not very accurate at 23 weeks. I hope you get some answers and feel at peace while you birth.

[gossamerwindweb]

Originally Posted by LilMamiBella

That was a question. I'm just wondering what will happen if I keep measuring low every week. I didn't say I wanted to be induced.

OK. I couldn't figure out why they would want to induce you early if the baby was measuring small.. I know they freak out about IUGR sometimes but in general I just really believe the baby is better off in the womb than outside it ... especially if there is something wrong with it. Anyhow... good luck! I have an ultrasound tomorrow at 23 weeks and if they tell me something is wrong with the NF, I will tell them it isn't accurate at this time of pregnancy anyhow.

[BroodyWoodsgal]

mama, I'm sorry this is happening to you!

I hate to say it....but it sounds like you are really being messed over by a few people here. Your MW is not giving you accurate information and, unless I'm missing something, is talking about induction for absolutely no reason at all...which, in my eyes, makes her highly suspect. Your doctor is an idiot. Sorry for the strong language...but how DARE he, us a NF test at 24weeks and try to pass it off as ANYTHING. I don't know what kind of u/s tech could perform that scan at 24weeks and keep a straight face!! It's ridiculous!

I say, as long as the major systems/organs check out....completely disregard everything this "doctor" is saying. There is always a chance that a woman will deliver a child who has DS....but as long as there is nothing wrong with the baby's heart, etc....I would much rather deliver a DS baby at home, than deliver by freakin' induction in a hospital setting.

You've got to follow your gut....but your gut sounds confused...because nothing your CPs are saying adds up. In cases like these, we must arm ourselves with information...read read read....and ASK FOR A SECOND OPINION - I would say, your MW is not a good second opinion as, obviously, she is trying to pass off ridiculousness as information....and has gone from "send met he file, let me take a look" to "Yeah, we'll probably have to induce if s/he keeps measureing small" - WHAT?

Oh babe....maybe it's the hormones, but your situation has my blood pressure up. Listen to your heart, read and ask or another opinion.

GL! KUP!

[Lousli]

Originally Posted by gossamerwindweb

OK. I couldn't figure out why they would want to induce you early if the baby was measuring small.. I know they freak out about IUGR sometimes but in general I just really believe the baby is better off in the womb than outside it ... especially if there is something wrong with it.

I have to disagree with this. IUGR doesn't just mean a baby that is small or has a minor problem. If it is true IUGR there is a reason behind it. Sometimes the placenta is completely deteriorating, for example. I agree that often doctors and midwives freak out over something that is unwarranted, a couple of small measurements are probably nothing to worry about.

The people I know who were induced for IUGR were not induced without good reason. Most doctors don't want to bring a baby that is not only small, but many weeks premature into the world unless they have good cause to think the baby needs it. Usually cases of IUGR are monitored very closely with many measurements and ultrasounds, they check the cord blood flow and the placenta as well as the baby's growth. NST's are performed as well. If the baby is born at 34 or 36 weeks and is the size of a 28 weeker, there was something going on that wasn't allowing that baby to develop properly in utero.

[blissful_maia]

Originally Posted by gossamerwindweb

OK. I couldn't figure out why they would want to induce you early if the baby was measuring small.. I know they freak out about IUGR sometimes but in general I just really believe the baby is better off in the womb than outside it ... especially if there is something wrong with it.

???

I agree with Lousli, true IUGR is a perfect example of when a baby is NOT better of in the womb than inside it.... they're not getting the nourishment they need to grow and be healthy.

[fyrebloom]

The trouble with IUGR is you are relying on ultrasound which is a very poor highly subjective instrument in late pregnancy to make the diagnosis. My twins were almost Dxed with IUGR or perhaps TTTS because one was measuring 20% smaller then the other (about a lb different). Turns out breech babies are impossible to measure accurately because they can't get an accurate leg measurement. I didn't listen to them (reccommended section at like 37 weeks) because they showed no other signs of IUGR and they had plenty of fluid. My twins were within 3 oz of each other and totally normal. I've known too many people who were expected to have "huge" babies who ended up with 6 lbers and women with "small" babies who had 10 lbers. They just can't tell very well at that gestation. Ultrasounds are a blessing and a curse, they're great for high risk pregnancies because they can predict some things well, but they can be alot of heartache for normal pregnacies with their rampant false pos rates, ESP for Drs who think they are some sort of word of God prediction and for Drs who choose to ignore reccommended time frames for tests like the OP's Dr.


To the OP. Check for Heart defects, if the babies heart is ok then follow your UC plans. Chances are the baby is fine. Also check fluid levels, if baby has ample fluid then you can pretty much rule out IUGR, because fluid levels are a very good indicator of placental health. If you have a big enough heart to welcome a DS baby you can totally do this on your own.

[gossamerwindweb]

I didn't mean to get a debate on IUGR going... LOL! Anyhow, the problem is that I have seen a lot of people induced because one twin supposedly had IUGR and the other didn't... then they were the same size... or someone supposedly had IUGR but was born perfectly the right size for their age. It just seems like a lot of times ultrasounds bring on problems that aren't warranted, especially when they start saying the baby is too big or too small. They kept telling me with my daughter that she would be ~10 lbs and I needed to be prepared and blah blah blah. She was born at 7 lbs 12 oz. Now I just don't trust their weight measurements at all.

BTW, I am having an ultrasound tomorrow so I am not against them... especially if you have a reason for needing one. I am just saying their weights are really a subjective thing.

[BeanSprout Mama]

I was just reading along and wanted to leave s and also wanted to say that my very first thought reading this thread was that your baby was too big for that measurement to matter. At 12 weeks, the baby's crown-to-rump length is around 2.5 inches and at 24 weeks your baby's crown to heel length is around 12 inches! So your baby is MUCH bigger and at this point I can't imagine that the test would be valid at all. Everything I've ever read about it says the last day they can do the test with any accuracy is 13w6d.

I'm sorry you're dealing with this. I can't offer any advice on whether to get the amnio or not because I haven't been there.

Also with the size estimates, my DD was estimated at about 9 pounds when they measured my fundal height and did an ultrasound in the 3rd trimester. I had a lot of fluid and a 7 pound baby. So I typically don't trust size estimates much at all.

[~bookcase~]

I had a 14 week ultrasound and was told it was already too late for a nuchal fold scan - did you have one previously/ any other signs of any problems earlier?

I don't think they can reliably make such a statement at your gestation.

[tammyswanson]

Originally Posted by aris99

I'm so sorry you're in this position. I don't usually visit this forum but I saw your post. I am unfortunately one of those people who had a bunch of tests come back w/increased chances of this and that. My Dr. encouraged me to have an amnio. I did. They tell you about the risk of miscarriage directly caused by the needle BUT they never mentioned the risk of rupture of membranes otherwise known as Pprom. The rate of rupture is MUCH higher than you'd imagine and at 16-17 weeks I ruptured from an amnio. I was told I would miscarry w/in a month. I stayed pregnant and my dd was born at 26 weeks. She was perfect in every way...so much for all those test results. She suffered terribly from my decision to have an amnio though. Today she is a healthy 3 yo but she still has issues from her early birth.

If I could go back to before the amnio I would ask myself "what would I do with the results from the amnio?" Why do I need this amnio? Is my baby at risk for a lethal defect? Do any other tests I've had indicate 100% positive for some genetic defect? Even if there is risk would I abort?

I cannot answer these questions for anyone but I can ask you to be very sure you know what your answers are before you choose an amnio. The risks are higher than they let you know.

Good luck w/your decisions...they are never easy.

I had to comment on this post. My SIL had an amnio (not sure what the reason was), when she was 5 months pregnant. She was having a difficult pregnancy and had a premature first baby (she had a 'twisted' uterus, not sure what that is). They did the amnio, which caused her to go into labor. The result was that the baby did not make it. I was amazed that they would do an amnio on her, especially due to her previous preterm births and other problem. I don't think they were testing her for Downs Syndrome.

I also just read about the dangers of ultrasound, and I am mad that no one mentions this to you when you go to get them done. They sure never said anything to me about it. : They also say more mistakes are made, and they don't really improve the birth outcome.

[LindyLou]

I am sorry you are dealing with this. I think this doctor is terrible for making you worry like this.

I know others have said this but the window for an accurate Nuchal Translucency is very small. I don't think much past 12 or 13 weeks. Bloodwoork should also have been done as part of the test. My scan was at 12 weeks.

I would definitely not have an amnio based on this. You do what you feel is best for you and the babe.

[soso-lynn]

Just to clarify, the 12-14 week ultrasound looks at nuchal translucency. At that point, the nuchal fold appears transparent on ultrasound. The point of that is to get an idea of the thickness of the nuchal fold which is not yet fully formed because people want results early if they are going to get an amnio or an abortion.

Later in the pregnancy, the actual nuchal fold, which is no longer translucent can be measured and a risk factor can be given based on a different scale than the nuchal translucency.

4% is really not such a high risk. I would just make sure the heart is ok (sometimes babies show an increased risk of DS turn out to not have it but to still have heart defects) and then proceed as normal. Perhaps you can read up a bit on Down's Syndrome, best case scenario being you learn stuff that you do not need to use.

As for the baby measuring small, it really depends on how small he is measuring. If it really is a concern for you, there are ultrasounds that can look at blood flow and the functioning of different organs. I would ask for one before agreeing to a dagnosis of IUGR from a black and white 2D scan alone.

[claddaghmom]

Originally Posted by BeanSprout Mama

I was just reading along and wanted to leave s and also wanted to say that my very first thought reading this thread was that your baby was too big for that measurement to matter. At 12 weeks, the baby's crown-to-rump length is around 2.5 inches and at 24 weeks your baby's crown to heel length is around 12 inches! So your baby is MUCH bigger and at this point I can't imagine that the test would be valid at all. Everything I've ever read about it says the last day they can do the test with any accuracy is 13w6d.

I'm sorry you're dealing with this. I can't offer any advice on whether to get the amnio or not because I haven't been there.

Also with the size estimates, my DD was estimated at about 9 pounds when they measured my fundal height and did an ultrasound in the 3rd trimester. I had a lot of fluid and a 7 pound baby. So I typically don't trust size estimates much at all.

ITA

I had an U/S while in labor and the doctor confidently said 8.5lbs.

She was 11lbs 4oz born 1.5 days after the u/s.

I don't think she gained all that weight in 1.5 days of labor!

[cottonwood]

Originally Posted by aris99

The rate of rupture is MUCH higher than you'd imagine and at 16-17 weeks I ruptured from an amnio. I was told I would miscarry w/in a month. I stayed pregnant and my dd was born at 26 weeks.

Originally Posted by tammyswanson

They did the amnio, which caused her to go into labor. The result was that the baby did not make it.

Anybody know what the stats are of amnio causing premature labor and/or death?

[Lousli]

It varies, depending, in part, on the provider. There are people that specialize in prenatal testing, and some of them have a very low rate of such incidents. Most of the time, if you're looking for someone to provide the test, you can ask around and see who is considered an expert.