What could cause small baby, small placenta, intrauterine growth retardation? - Page 2

[mom2hannah]

Just my 2 cents.... check your thyroid. Most women think they are 'normal' when they are not. A healthy woman should have a TSH below 2. closer to 1 is fine as well. If your thyroid levels are not right during pregnancy, it can slow growth and cause many issues for the fetus, if you are even able to carry it to term. I am convinced that many 2nd trimester miscarriages are the result of thyroid problems in the mother. Mine was low and my OB put me on meds before I got pregnant. I had to increase my meds after my 2nd trimester. dd was small, (4 days late) but otherwise seems fine. My mom was not diagnosed until she was in her 40's... when she was pregnant with my younger sister at 22, she was induced at 10 months (this was over 30 years ago). The baby was barely 5 pounds and showed signs of being premature. She died the next day from a lung issue normally found in preemies. I don't know about some of the other physical issues (such as the wrinkling). I, on the other hand, weighed over 8 1/2 pounds. I believe my mom's thyroid slowed after giving birth to me, and that's where the problem occurred. I have these same issues now, so I'm very careful to monitor my thyroid and watch my symptoms.
I don't know exactly what this means for your baby, if this is in fact the reason for the characteristics you are seeing. But you might want to do a little research in this area and see what you can find out.
I wish you the best in your journey--

[mom2hannah]

Originally Posted by That Is Nice

I have always had terrible periods, lots of intense cramping, pain, and heavy bleeding.

Any ideas?

by the way, forgot to mention above... THIS REASON ALONE is enough to suspect hypothyroidism. other symptoms would be... dry, flaky skin, cracked heels, constipation or hard stools, fatigue, depression, difficulty managing anger, brain fog, hair falling out, sparse hair on outer third of eyebrows (yes!), low or no libido, heart palpitations, difficulty conceiving, rosacea, acne, the list goes on and on....

[That Is Nice]

Originally Posted by mom2hannah

Just my 2 cents.... check your thyroid. Most women think they are 'normal' when they are not. A healthy woman should have a TSH below 2. closer to 1 is fine as well. If your thyroid levels are not right during pregnancy, it can slow growth and cause many issues for the fetus, if you are even able to carry it to term. I am convinced that many 2nd trimester miscarriages are the result of thyroid problems in the mother. Mine was low and my OB put me on meds before I got pregnant. I had to increase my meds after my 2nd trimester. dd was small, (4 days late) but otherwise seems fine. My mom was not diagnosed until she was in her 40's... when she was pregnant with my younger sister at 22, she was induced at 10 months (this was over 30 years ago). The baby was barely 5 pounds and showed signs of being premature. She died the next day from a lung issue normally found in preemies. I don't know about some of the other physical issues (such as the wrinkling). I, on the other hand, weighed over 8 1/2 pounds. I believe my mom's thyroid slowed after giving birth to me, and that's where the problem occurred. I have these same issues now, so I'm very careful to monitor my thyroid and watch my symptoms.
I don't know exactly what this means for your baby, if this is in fact the reason for the characteristics you are seeing. But you might want to do a little research in this area and see what you can find out.
I wish you the best in your journey--

Thank you so much for this. I thought about this possibility, too. I had my thyroid checked prior to conceiving because I have always had unusually bad periods (debilitating actually) and heavy bleeding and clotting. The levels checked out fine, however, they were never re-checked during pregnancy. It's something I'll add to my list to discuss with my doctor.

[mom2hannah]

Originally Posted by That Is Nice

Thank you so much for this. I thought about this possibility, too. I had my thyroid checked prior to conceiving because I have always had unusually bad periods (debilitating actually) and heavy bleeding and clotting. The levels checked out fine, however, they were never re-checked during pregnancy. It's something I'll add to my list to discuss with my doctor.

They told me for years that mine were 'fine' too, when in fact they were not. They were within range for the labs so nothing flagged, but after seeing an endocrinologist 4 years ago I found out my 'normal' TSH was only normal for a 70 year old woman! If they just TOLD you it was normal and you don't know what your numbers were, request a copy of your labs or pull them out and take a look if you already have a copy. It's really apallling how many doctors are unaware of this issue. So many women are suffering needlessly, and I think many many women who are on antidepressants actually would benefit from thyroid treatment.

I also wonder how many women suffer a thyroid drop during pregnancy... I wouldn't have known either if we weren't already aware of my situation and monitoring it. My doctor told me it's not uncommon to have to adjust thyroid medication during pregnancy, so I would think if someone is subclinical (borderline) that they should also be monitored. In fact, I think ALL women should have this test at least once during pregnancy as part of their routine visit. A basic test through my lab is only $46 without insurance. Not much in the grand scheme....

And, If I were you, I would absolutely get tested again. MANY women suffer a drop in thryoid production after having a baby, so if you were subclinical to begin with, you might have crossed the line now.


feel free to PM me if you have any questions about this.

[That Is Nice]

Originally Posted by mom2hannah

They told me for years that mine were 'fine' too, when in fact they were not. They were within range for the labs so nothing flagged, but after seeing an endocrinologist 4 years ago I found out my 'normal' TSH was only normal for a 70 year old woman! If they just TOLD you it was normal and you don't know what your numbers were, request a copy of your labs or pull them out and take a look if you already have a copy. It's really apallling how many doctors are unaware of this issue. So many women are suffering needlessly, and I think many many women who are on antidepressants actually would benefit from thyroid treatment.

I also wonder how many women suffer a thyroid drop during pregnancy... I wouldn't have known either if we weren't already aware of my situation and monitoring it. My doctor told me it's not uncommon to have to adjust thyroid medication during pregnancy, so I would think if someone is subclinical (borderline) that they should also be monitored. In fact, I think ALL women should have this test at least once during pregnancy as part of their routine visit. A basic test through my lab is only $46 without insurance. Not much in the grand scheme....

And, If I were you, I would absolutely get tested again. MANY women suffer a drop in thryoid production after having a baby, so if you were subclinical to begin with, you might have crossed the line now.


feel free to PM me if you have any questions about this.

Thank you so much for this!

I am going to make an appointment and have my thyroid retested. I totally see what you are saying. I had a mild medical condition a few years ago that was measured two different ways...well, one measurement was normal and one was off and for years the doctors looked at the main measurement with lab work, even though I had persistent symptoms. Then, finally, I had an appointment with a really great doctor and she noticed the other number was way off, ordered some tests, and guess what, the problem I'd suspected for years was confirmed even though multiple doctors had told me otherwise.

So, yeah, I think doctors are overworked and don't spend enough patient time discussing the problems and checking your lab results...and you're right...you really need to see a specialist and not a general practioner.

Thank you so much!!!

[That Is Nice]

Originally Posted by mom2hannah

A basic test through my lab is only $46 without insurance. Not much in the grand scheme....

Isn't that crazy? Such a simple thing to test.

[That Is Nice]

Originally Posted by mom2hannah

My mom was not diagnosed until she was in her 40's... when she was pregnant with my younger sister at 22, she was induced at 10 months (this was over 30 years ago). The baby was barely 5 pounds and showed signs of being premature. She died the next day from a lung issue normally found in preemies.

This is so sad. What a tragedy.

[ericswifey27]

I wish you well on your journey.

thank you to pp about thyroid info- I may benefit from looking in to this issue as well...

[A&A]

O/T to MotherDuck: I'm so tired of the left-handedness discrimination. You know, being homosexual used to be seen as "evidence of damage to the brain," as well. Obviously science doesn't think that way any more. Being left-handed is a normal variation, too.

[major bedhead]

Just wanted to add my story, and also refute the suggestion that ultrasounds might be the cause of IUGR. In my case, my youngest was IUGR, born at 37 weeks at 5lbs. Placenta showed multiple thromboses and calcification sites and was significantly smaller than average. I, like the OP, had consistent prenatal care and no known risk factors prior to pregnancy. My first u/s was at 18 weeks, which was AFTER the initial questionable AFP test. In other words -- there was already something going on before the u/s took place. (And, FWIW, I did a significant amount of research about u/s before agreeing to have one).

Interesting correlations though -- my youngest, who was my second, was much less active all the way along than his older brother. I rationalized later that he was conserving all of his energy. I've also symptoms of hypothyroidism, though my TSH levels show in the clinical "normal" range.

Thanks for the info, and to That is Nice -- I can appreciate how hard your situation is. I've been told that my situation was ideopathic, which is completely unsatisfactory, but what other way is there to say "we just don't know"?

[hislittlelambs]

my first DD was termed "IUGR" as well. I have combed my birth records after reading this post and can find NOTHING about the placenta or my thyroid levels during pregnancy...(this was 6 years ago, so i am unsure if it was even checked!)

basically, she was born at 38w,4d at a weight of 4lbs, 11oz. where my story differs from the others shared so far, is there was no mec, no heart murmer, no nicu, no trama of any other sort. apgars of 8/9. she has never had any developemental delays, just always very very small. always was in the 0-3% percentile, many times falling off the chart. but very healthy. had several peds "check her out" at the hospital when she was born, and they deemed her very healthy, just small. told me not to worry, that she'd catch up eventually. at 6 years old she is barely 3 feet tall and weighs 30 lbs exactly.

i had a very healthy pregnancy like each of you...took prenatals religiously, never smoked, drank, never missed an appointment, did prenatal yoga, ate healthy, stayed hydrated, stayed physically active...etc. she always measured right on for dates until the 7th month when fundal height started to measure "off" abit....she was still growing, just slower. u/s ordered around 30 weeks to check on growth.moved her edd 9 days forward, but said she was otherwise growing well. doctor said i would have a small baby like her small mama. (i was 6lbs even at birth. my brother 6.7. i am 100 pounds and 5 foot tall non pregnant.for the last 4 generations no woman in my family has ever been taller than 5 foot 2)

i have had 2 other baby's since then. all in the 6 pounder range.

her sister, who is 1 year younger than her, was 6.7 at birth and even now at age 5 is only 3 foot tall and 32 pounds. both girls have stayed the relatively same size. dd#2 has always been in the 5% since infancy.

DS was 6.11 at birth. he is almost 2 now. he has always stayed in the 7th %.

all my kids have been "Small"...only dd#1 was termed with IUGR. also...all my pregnancies at the 30th week "slow down"....i had u/s ordered for each of them at that same time in pregnancy, all u/s's came back "baby normal for dates"...

Julia,my oldest and the "IUGR" baby is now being seen by a pediatric endocrinologist becuase of her lack of height. they have run blood test after blood test and bone scans to rule out Turners syndrome. they say her growth hormone level is within normal range, yet still keep us coming back every 6months for checks on her standing and sitting height. (seems her legs are normal size for her age, she "loses" her height in her torso) i was put through tremendous testing and screening for "being small" as a child.truth was, i didn't hit any real growth spurts until purberty, but having the kids teasing at school reenforced by the numerous doctors appts and mymom forcing me to drink protien shakes that body builders drink just reinforced in my mind that i was "unusual, different, not good enough".....because of these scars I am very untrusting of docs and thier "concerns" for height. DH says i walk into every ped appt with my dd "with loaded guns"...i don't mean to be so defensive...i think if she showed other developemental delays or other tests came back even borderline, then i was feel more of a need to be there. as of now, if they want to shoot her up with growth hormones because they predict her at being 4 foot 10 inches tall at the age of 18 (mind you, only 2 inches shorter than me as an adult) with no evidence whatsoever her body or organs are being put in jeopardy by other underlying conditions, then no. being short isn't a disease. IF there is another disease causing her to be short, that is a whole other ballgame....but as of now i am about ready to punch some docs out. sorry...i didn'tmean toget into all of that. her next appt is coming up and i am pregnant and hormonal and just tired...i feel like i have been fighting the "short battle" since my own childhood. (which is another thing, i have a picture of me with my brother. i am 5, almost 6 years old, my brother had just turned 3. we are the exact same size. and that is with me being born at 6 pounds! dd was born at 4...of course she is never going to amount to "thier normal" charts.)

i am very curious about the thyroid connection though. i know they specifically checked my thyroid in my second pregnancy and TOLD me it was normal. i have looked through the records and i can't find the thyroid numbers on the lab results. what exactly do they appear as when written in "doc/lab code"?

[carmenfr]

small placenta & severe IUGR

Originally Posted by That Is Nice

What could cause a low birth weight baby, small placenta, and intrauterine growth retardation?

My baby was unexpectedly low birth weight (5 lbs), the placenta was quite small (half the normal weight) and showed other abnormalities (abnormal shape, color, sheen), and the doctors later said there was intrauterine growth retardation.

Interestingly enough, we had mutliple ultrasounds because we had some soft markers for other problems that turned out to be false. None of the ultrasound measurements or manual abdominal measurements (other than one that was on the low side) were off or abnormal. I measured small but always within the normal range.

In addition to the small size and small placenta, the baby had a lot of heavy meconium, low Apgars, a heart murmur, and had trouble regulating body temperature and blood sugar.

It was a planned pregnancy, I had good pre-natal care, I ate well, I've never smoked. I was not on birth control of any kind for years before pregnancy. I did not take any medications. I did not drink any alcohol. I took prenatal vitamins.

We have no known genetic conditions in either family. Cousins of my baby have all been above 6 lbs, most are in the 7 to 9 lb range.

My baby was not early (was full term) but did show signs of post-term (wrinkled skin, etc).

Any ideas for causes? Anyone else been through something similar?

Also, I want to add that my child now as a toddler has hypotonia (low muscle tone), significant speech delay, mild motor delay, and has had poor growth overall (low on the growth charts, less than 5th percentile), as well as multiple food allergies and sensory issues. I have always had terrible periods, lots of intense cramping, pain, and heavy bleeding.

Any ideas?

Hi

this is just my theory on what cld have possibly caused this problem, but I will give you a bit of background on my own experience and why I'm doing research. My daughter is 4 years old, no problems during the pregnancy. My problems started after the labour when my placenta didn't detach(blood loss 2.5l). I have been told by a midwife that it can be a complication from being induced on syntocinon. I had a manual placental removal, bled for 6 weeks, no pain or smell. At my 6 week review I was sent for a scan, there was still some placenta inside me, I then had a d&c, during which they perforated my uterus(blood loss 1.5l). I was then monitored for about 4 weeks until all the blood behind the uterus had been absorbed. The test for placenta accreta came back negative.

My next pregnancy had endless placenta problems. Placenta previa, placenta percreta, placenta abruption. I was pregnant with id twins they had assymetry of the placenta(uneven placenta share, with one having +-25% and the other 75%) velamenous cord insertion, succenturiate lobe, small placenta 230g at 25 weeks when I lost them. The usual size of a placenta is 400-600g for a singleton and twins is usually 1.5 times larger. Abnormally shaped "freaky" placenta and TTTS(disease of the placenta, the progression of this was in the reverse order of the usual progression) My boys passing was recorded as severe IUGR (535g & 850g) and TTTS. I have related all these problems either back to scarring from uterine surgery and an implantation problem (because my uterus was too badly damaged)which causes placental problem other than 1 problem TTTS which I'm now doing research on.

I think the d&c and mpr damaged the lining of my uterus. I think I might have had an infection but not realised because I didn't have pain or a smell or temperature. I don't think my twins could implant properly, which is why they had so many placental problems.

I think you have had damage to your uterus, either by uterine surgery, there are certain infections(herpes group B, varicella zoster, human herpes 6&7) and pelvic infection(chlamydia, gonorrhea, gardnerella vaginalis, bacteroides, streptococcus b, forgetting to remove a tampon). The other thing I would consider is a retroverted uterus, leads to painfull menustration, higher chance of pelvic infection & endometriosis. Other uterine problems are fibroids, uterine synechia, lesions, tumors, ovarian cysts.

A friend of mines child was born at approx 34 weeks, weighing 1.7kg. He has occasional convulsions (she has to be carefull of putting him in cold water)and is not growing very well(both his parents are large build). She has lesions in her ovary.

I hope this might be of some help

[MsBlack]

A&A--

thanks for pointing this out--from another Leftie!

After all, the brain's cross wiring being what it is....we Lefties are born in our Right Minds And most often, due to living in a Right handed world, we are forced to learn to do a lot of things with our right hands...stimulating development of the left brain....leaving us in the end, in our Whole Minds, not just stuck in one side or the other! Just why that is considered a form of 'brain damage', I'll never understand.

[BugMacGee]

Did they check for CMV?

[That Is Nice]

Originally Posted by BugMacGee

Did they check for CMV?

What is CMV?

[BugMacGee]

http://www.emedicine.com/MED/topic504.htm

[That Is Nice]

Thanks for the info. I had pretty thorough pre-conception testing. I'm not sure if I was tested for that or not, but I'll look into it. Thanks!

[BugMacGee]

We often test our IUGR babies for CMV. It's a urine test collected over 3 days.

[carmenfr]

small placenta & IUGR

Hi

I was just wondering if you were on a progestin only pill or contraceptive or if you took an emergency contraceptive pill (immediately) before you fell pregnant?
Progestin only contraceptive
implants norplant & jadelle, intrauterine systems (progestasert&mirena)
Cerazette, implanon, depo-provera and Noristerat.

As these could have an effect on the endometrium, which cld affect implantation (theoretcially it says here).

i don't have the web address but if you look under google
clinical significance of subchorionic & retroplacental hematomas detected in first trimester (sometimes there is no vaginal bleeding, its behind the myometrium)
by american college of obstetricians & gynae - elsevier
implantation problems - placenta abruption, placental separation abnormalities, IUGR, more operative delivery from fetal distress, placental insufficiency, preeclampsia, gestational diabetes & meconium-stained amniotic fluid

cheers

[That Is Nice]

Originally Posted by carmenfr

Hi

I was just wondering if you were on a progestin only pill or contraceptive or if you took an emergency contraceptive pill (immediately) before you fell pregnant?
Progestin only contraceptive
implants norplant & jadelle, intrauterine systems (progestasert&mirena)
Cerazette, implanon, depo-provera and Noristerat.

As these could have an effect on the endometrium, which cld affect implantation (theoretcially it says here).

i don't have the web address but if you look under google
clinical significance of subchorionic & retroplacental hematomas detected in first trimester (sometimes there is no vaginal bleeding, its behind the myometrium)
by american college of obstetricians & gynae - elsevier
implantation problems - placenta abruption, placental separation abnormalities, IUGR, more operative delivery from fetal distress, placental insufficiency, preeclampsia, gestational diabetes & meconium-stained amniotic fluid

cheers

No. Never did any of those things. Thanks for the information.