4 cm, small for dates, biophysical profile

[BananaBreadGirl]

I went in today to my ~40 week appt., feeling great. Very surprised to be at 4 cm, and the dr. was surprised that I hadn't been feeling any (painful) contractions (just Braxton-Hicks). The dr. is concerned that I have not measured any growth for the past month. He said normally he would recommend to induce since sometimes it is just better to "get the baby out and start feeding it" (and since I was already 4 cm, he thought that an induction would be successful/reasonable), but he knew I'm going for a natural birth and I opted for his other choice of having a biophysical profile later this afternoon. Besides heartbeat and amniotic fluid levels, what else would they be checking for? How likely is a problem?

I'm going for a long walk.

[lexbeach]

I think it's fairly common for the fundal measurement not to change (and/or to decrease) at the end of pregnancy, due to baby moving lower. My dw measured 37 cm at 36 weeks, and then 36 cm at 38 weeks, and was still at 36 cm at 39 weeks (and I imagine she won't get any bigger!). It made perfect sense to us!

Hope you're holding your LO soon!

Lex

[amandaleigh37]

I think it's fairly common for the fundal measurement not to change (and/or to decrease) at the end of pregnancy, due to baby moving lower. My dw measured 37 cm at 36 weeks, and then 36 cm at 38 weeks, and was still at 36 cm at 39 weeks (and I imagine she won't get any bigger!). It made perfect sense to us!

Hope you're holding your LO soon!

Lex

This is what I thought as well, that sounds normal to me...

Hope everything comes back a-OK and labor starts on its own soon enough

[BananaBreadGirl]

I honestly told the dr. that "no, I haven't noticed my belly getting any bigger in the past month", but now that I think about it, there have been a lot more baby "stretches" that extend into my ribs, so maybe baby is just getting longer?

Hehe, or I checked babycenter.com. It lists one possible cause of "small for dates" as well-conditioned abdominal muscles. I do sing a ton (several hrs. a day during the school year), but other than that my abs don't get too much of a workout.

Thanks for your words of calming and encouragement.

[MangoMommy]

How's the fluid level?

I also was not having much change the last few weeks, and one evening/day I didn't have as much movement so I dropped by my midwife. The h/b was fine and baby was moving fine but when she did an u/s the fluid was very low and she commented on the baby being small too. She induced me that day and I had a natural drugfree birth several hours later. I mostly labored in the tub, once we got a good baseline heartbeat,etc she let me off the monitors for 30 mins at a time.

Baby was 5 lbs 13 oz at over 38w, so she was right, baby was a peanut for some reason.

[rivkah]

Must agree with other posters--slow or no growth is perfectly common. I can't say my abs are spectacular or anything, but i was measuring 36 weeks for the last 4 weeks of pregnancy. Baby girl was 7 lbs 4 oz--well within a healthy weight.

[BananaBreadGirl]

Good to know that the signs I was experiencing are fairly common. The ultrasound and NST seemed to turn out OK although the baby was not very awake/moving while I was on the monitors (despite water, juice, special buzzer thingy). I kind of freaked out a bit because I could overhear the nurses talking to each other (did the juice work?), calling radiology to ask about ultrasound, calling my dr. to see if they should "keep me for a while", etc. I think the results were not quite as confident as they wanted, but they took my word that baby is much more active at other times of day, and the baby's heartbeat did race after they put the buzzer to my tummy, and that was good. I have another appointment with the doctor Monday if the baby hasn't been born by then, just to keep a close eye on things.

On one hand, better safe than sorry (and I got some really cute pictures of the baby's face!). On the other hand, I just had a long (and expensive) day to check out symptoms that are probably only rarely an indicator of a problem.

[annekh23]

But when they are an indicator of a problem, it's not just oh your baby might be a bit small, it's a case of the baby being small because the placenta isn't functioning as well as it should, which ultimately leads to fetal demise. Growth restriction in the uterus is a leading cause of term stillbirth, so it's not something to mess around with.

When I had my first, the lack of increase in the height of the fundus towards the end of pregnancy was always blamed on the baby engaging more. He was only delivered when he was because my waters broke at just past 37 weeks and I didn't go into full blown labour, so had an induction, when he was born, he showed clear physical signs of relatively severe IUGR, he was probably 2lb less than he otherwise would have been at that gestation. If my waters hadn't broken when they did, we easily could have lost him. For some percentage of women, what to you was an expensive day could save their babies lives and until you do the further testing you don't know whether you might have been one of them.

[BananaBreadGirl]

Thanks for sharing, annekh23. I'm thankful that the tests turned out looking OK and that they were not invasive or risky as far as tests go. You're right, my doctor wanted to check not because a "small baby" is a problem, but just in case the baby wasn't getting enough oxygen or something, resulting in a lack of growth. Thanks for reminding me that there are definite cases where the testing turns out to be lifesaving- I shouldn't complain so much!

MangoMommy, I'm assuming the fluid levels were fine???? The ultrasound technician didn't give much indication, she just sent me on to the OB section of the hospital for the NST. I think the OB nurse called her to consult, though, before calling my doctor again. I'm guessing they would have kept me there if she saw any indication of a problem.