eep. measuring 7 cm ahead!

[MamaFern]

i just went in for my first prenatal visit with my midwife yesterday and im measuring 30 weeks at 24 weeks......

i measured 2-3 weeks ahead with my daughter who was born at 42 weeks. she weighed 10.5lbs.. i never had an ultrasound and was never concerned.
but now my MW is insisting that i have an ultrasound to rule out twins.
like ARE YOU CRAZY! there is no way i'm having 2 babies.. right? :
so now i'm freaking out because if its not twins (help me goddess) then is something else wrong? i'm SURE on my dates. i had my LMP on april 6th. it wasn't super light..it felt like a normal cycle. im worried but i dont want to be.

i'm scared of ultrasounds.. i've never been one to go for medical procedures though i know that they are a pretty normal thing in pregnancy, but not for me...but i feel like if she really thinks its necessary i should do it.

[misskerri]

There are other things that can cause you to measure ahead, besides twins. When I was pregnant with my son, I had polyhydramnios (excess amniotic fluid) that had me measure a several weeks ahead for most of the 2nd half of my pregnancy.

[MamaFern]

thats one of the "other reasons" she mentioned..

was there any reason why you had excess amniotic fluid? i know that there are lots of possible reasons, i guess i just want to get some insight on it.

[Fruitful4Him]

Well, maybe things will even out? I had a prental today also..25 weeks and I am measuring 29. Last appointment was 19ish weeks and I was measuring right below navel.. sooo that is a large jump but I have had an u/s at 19 weeks and there is one normal sized baby ..apparently, LOL. I also had not eaten anything so I could rule out full stomach/full bladder.. but it is possible for baby to be in a postion to make fundal height larger..fluid levels, ..etc. I hope that some others have some more BTDT wisdom for ya.

[faithfulmama]

I have consistantly measured ahead with this pregnancy. With ds a measured a few weeks ahead for a few months, but this time the discrepancy is much greater. At my last appt. I was 21 weeks measuring 29cm. My midwife even caught 2 different heart rates in there, although she said it could have been one baby in two spots because there was a lot of movement. So we went in for an ultrasound and saw only one baby, measuring exactly right for my dates. Normal amount of fluid, normal placenta, no fibroids, nothing out of the ordinary at all. We were all a little baffled.

Anyway, all that to say, it isn't necessarily anything. Of course, I'm still kind of baffled and we'll see how the next month goes for growth for me. If I continue to grow at this rate, I think she'll want me in for another ultrasound.

[hadassah]

Well I too am measuring big-very big I think......at my last appt. at 21 weeks I was measuring 30...! But I usually do measure big so.....but that is quite a bit. My midwife wasn't too worried at all. She said there is a chance that I could be having twins or be farther along....needless to say I am looking forward to my next appt.

[bryonyvaughn]

Polyhydramniosis causes increased fundal measurements and there are many causes of polyhydramniosis. It can coincide with many birth defects as well as perfectly healthy and normal babies. My friend had it with her daughter who was born with 20+ amniotic sacs. (Her only ongoing 'problem' is an auditory processing disorder.)

Obviously twins will cause increased fundal measurements over the second half of pregnancy but not so many realize a placenta at the fundus will also give larger fundal heights. A skilled MW (or even birth junkie) can often determine placental placement by listening to heart tones. The placenta will sound slower than the baby's heartbeat and be "whooshy".

I recognize your username from the UC board. During your UP time did you ever measure your fundal height? It can be significant if you were consistently measuring larger than with your previous pregnancy or if it just started shooting up recently.

When you measure yourself, do your numbers match the MW's? Different HCPs can use different tension on the tape, measure the surface of the skin or push back deep over the fundus, and begin their measurement at various points on the pubic symphysis. Suddenly shifting numbers from a single measurer would get my attention long before shifting numbers from many different measurers.

So far as the U/S goes, as your MW is insisting on it "to rule out twins", I'd assume that would greatly impact the care she'd give you, no? That is definitely something to consider when evaluating the risks and benefits of U/S in your case. I'd also be evaluating a MW getting freaked at the possibility of twin birth *but* I recognize some areas are very limited in choices when it comes to MWs and OOH birth attendants.

Another option is going to a chiropractor and asking him/her to test your innate force. It's similar to muscle testing but more direct. You can inquire about singleton/twins, gender, position, and number of eggs, bags of waters, placentas, etc. A benefit is it can give you information that isn't considered binding at all to the sort of HCPs who would insist on U/S for confirmation.

I'd also suggest you quiet yourself, reflect upon your symptoms so far this pregnancy, and listen to your body... how you feel now and what picture seems to reflect your sense most accurately.

Wishing you the best,
BV

[Free Thinker]

I am PG w/ twins and my fundal height at 23 weeks was 30. With my last baby I measured small the whole pregnancy, I think the 'biggest' I got was about 36 or 37 (had an US to rule out IUGR b/c I was measuring 4+ cm small consistently), so obviously measuring big was not normal for me. I knew by 12 weeks that I was way too big and asked for an US b/c I just knew it was twins. I don't have a problem w/ US, though I normally just get the one at 20 weeks, but I felt that I needed to know if it was twins and so did my HCP. The nutrition information for twins is a lot different (lots more protien!) and I wanted to know if I should be taking care of myself differently. Like the other posters said, there are other reasons for measuring larger, so it may or may not be twins, but I"d definately want to know. Also, the US is not an invasive proceedure and at this point in your pregnancy you don't even need to have the 'full bladder' you need to have earlier, since baby(ies) are up so high. Good Luck!

[majazama]

:

[StrawHatBrat]

You should have the ultrasound. I know lots are against ultrasound for non medical reasons, but this IS a medical reason.

[bobandjess99]

I'm in the same boat. With dd, I always measured right on, which I thought eas funny, because I was all prepared to be off a few cm's without panicking, but nope! always right on, LOL. Thia time, I was very small in the beginning, my fundus didn't even pop over my pubic bone until like 16 weeks, and then by 20 weeks it was at my belly button, and i was measuring 20 exactly, and at 25 weeks, I'm measuring 30-34 depending on position, but never less than 30. I believed at the beginning I was having twins, but none of my symptoms matched that feling, so we dismissed it, and now I'm starting to suspect again...but I think it must just be wishful thinking or whatever, because I think if it were really twins, I'd have to be a lot bigger by now....

[MamaFern]

i feel like i'm not big enough to be carrying twins.. i have a totally out the front basketball belly already but i am 6 months along. plus i have a belly with baby or not anyways, i never even thought about twins till my MW mentioned it. with my daughter i wondered but i was pretty sure not (in retrospect she could have been since she was 10.5 lbs of baby) i was HUGE at the end with her though.

i hope that we both figure out whatever the reason soon and put our heads at rest! its stressful.. but im trying to be more zen about it today. whatever the reason is its meant to be..

[To-Fu]

Maybe you've just got another big baby in there!

Think you'll get the u/s to find out?

[majazama]

Originally Posted by MamaFern

i hope that we both figure out whatever the reason soon and put our heads at rest! its stressful.. but im trying to be more zen about it today. whatever the reason is its meant to be..

What could it be that would be worrysome? I'm scratching my head on this.

[MamaFern]

well, i don't know about you but for me the idea of two babies is kind of scary! and there are other medical reasons for measuring large, like a previous poster mentioned such as Polyhydramniosis. this sometimes can be caused by kidney problems or other health problems in the baby.. i find that a tad bit concerning. it could be nothing at all, but i'd rather know i guess..

[kati_kati]

The good thing is that they should be able to tell if it's twins really quickly - so just ask them to keep the ultrasound short. Also I would want to know what they will do differently _right now_ depending on what the ultrasound says. If nothing, then there's no point in doing an u/s unless not knowing will drive you crazy. You could just wait a few weeks and see how you're measuring then.

[bryonyvaughn]

Originally Posted by kati_kati

The good thing is that they should be able to tell if it's twins really quickly - so just ask them to keep the ultrasound short. Also I would want to know what they will do differently _right now_ depending on what the ultrasound says. If nothing, then there's no point in doing an u/s unless not knowing will drive you crazy. You could just wait a few weeks and see how you're measuring then.

My DH and I are fighting over this right now. I think attentive people don't need U/S to diagnose twins or determine fetal position. Maybe I naturally have "good hands" but I don't it should be that big of a deal. That being said I do need to be especially grounded and focused when palpating a uterus for number and position when there is an anterior placenta (imagine feeling for objects in your pocket with a wet sponge between your finger and the objects) but massaging the mother's belly with oil really helps to feel *through* the layers to what's underneath.

Once twins are diagnosed I'd completely support a mom's decision to forgo U/S or to U/S for number of placentas and amniotic sacs... but then again I'm big on patient autonomy and informed consent.

BV, who realizes she's not answering one post specifically

[Free Thinker]

Actually if it is twins there are certain things that should be done differently. If the twins are identical they could be diagnosed w/ TTTS, which is when one twin gets more blood/nutrients than the other twin, so one twin grows and the other doesn't. If there is for sure one placenta, the twins should be watched closely for TTTS as it can be fatal. I will start weekly NST in November to monitor the babies HR and US monthly to chart their growth. If one is not doing well, it could mean an early delivery. Of course we are hoping for no problems, and twins do not automatically mean problems, but they can and do have more risks than a single pregnancy. As far as what a HCP would recommend at this point (24-ish weeks) for a twin pregnancy, most of this is nutritional. Twin mamas need more protein. My OB care has been just like my singletons up till now, and will be the same until I think 30-32 weeks, then we start the NST and extra US. I haven't had any extra appts. or tests yet and I'm doing just fine! I do need to rest a lot more and I feel much more pressure than I did w/ my singletons. I am also not pushing myself like I might w/ one, since I am more concerned w/ preterm labor this time around. I *must* get to at least 34 weeks in order for babies to be kept at our local hospital. That's just really important to me that I do everything I can to prevent them from coming early! I would prefer them to be at least 36 weeks.

[bryonyvaughn]

Aha! The final post cleared up for me the unspecified unease I was having with this thread (Bolding mine.)

Originally Posted by StrawHatBrat

You should have the ultrasound. I know lots are against ultrasound for non medical reasons, but this IS a medical reason.

I agree it is medical reason but that does not mean the OP should get an U/S. IMO if anything the OP should take it into consideration when she makes her decision based upon her comfort level with testing, potential results of the tests, and whether that would change her decisions regarding her birth plans, attendant, location, etc.

Originally Posted by Free Thinker

Actually if it is twins there are certain things that should be done differently...

I am well aware of the potential complications unique to multiple pregnancies. Check out my new sig line if you doubt it.

That being said I think there are certain tests and options that should be offered to women carrying twins who would be free to accept or decline after being informed what they're looking for, how that could impact the pregnancy health risk wise as well as HCP coverage wise, false positive an negative rates, and the likelihood of specific complications from the testing itself.

~BV

[DoulaLMT]

Wow BV are you expecting twins!!??? I missed that if it was mentioned earlier. Congrats!!!!!!!