Can due date be off by a full month? - Mothering Forums
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#1 of 12 Old 01-23-2009, 02:04 AM - Thread Starter
 
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I had my 20 week ultrasound last Friday, and it estimated the baby to be a 24 weeks 3 days. Therefore, my midwife called me and changed my due date from June 5th to May 5th. What?! A whole month?! Is this possible?

Background: My cycle before my last period I'm sure I got pregnant. Six days after ovulation I got all-day nausea, breast tenderness, and aversion to coffee/wine. I did a pregnancy test several days early, and it was negative. On the day my period was due all my pregnancy symptoms went away, and my period started. It was heavier than usual and lasted twice as long (8 days). I believe I miscarried that month.

The following cycle, the exact thing happened in the beginning. Ovulated, six days later the same pregnancy symptoms started. This time I got a positive test, and my pregnancy is going strong.

I'm planning a VBAC, and the midwives required a 20 week ultrasound for placenta placement. I refused all the other diagnostic tests except for the routine obstetric bloodwork. I'm very opposed to ultrasounds - I believe they are risky to the child, and should only be used when the medical benefits (to us, not the litigation folks) outweigh the risks.

The ultrasound was done at 21 weeks 0 days according to my ovulation date, or 20 weeks 3 days according to LMP. It showed the baby at 1 lb, 9 oz.

My problem is that I truly believe I just have a large healthy baby. Can the ultrasound be that far off? Of course, they will check me for GD because of this. This OB/midwife practice starts pushing inductions at 1 week post-due date, and "requires" a c-section at 2 weeks post-due date. If this baby really is due in June, they will be trying to evict it several weeks early.

My midwives want to do more ultrasounds. I want to let nature take its course and just have my baby sometime in May/June. However, they are not allowed deliver babies beyond 2 weeks post-due date. I would then face having the OB anyways.

Has anyone seen this before? Can you give me any suggestions? Will repeat ultrasounds really help, or just add trauma and more fuzzy pictures? Is it possible for implantation bleeding to last for 8 days and be far heavier than a period?

Thanks!

: DS - June '07 : DS2 - May '09 : (may be delayed a really long time!)
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#2 of 12 Old 01-23-2009, 02:35 AM
 
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PTmorgan, have you considered the possibility that you had a twin miscarriage? It's possible that you conceived twins and lost one shortly after conception, which would explain the period. I've known of women who thought they had miscarried only to find out they were still pregnant and that the baby measured according to the original dates given for the pregnancy. I've also known women that have had periods for the first couple of months of a pregnancy and even one that had it on her normal schedule through her entire pregnancy for all 3 of her kids (which is one way a woman can be pregnant and never know it until she is well into the pregnancy or delivers). So even if it wasn't a twin miscarriage, it's still possible to have a period after conception and still keep a viable pregnancy. So yes, it's possible for dates to be a month off. If the baby continues to be large for dates, I'd consider that as one possible reason.
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#3 of 12 Old 01-23-2009, 03:30 AM - Thread Starter
 
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Thanks!

My mom mentioned this as well. My parents are dairy farmers, and they occasionally see this in cows. Of course, being compared to a cow is not pleasant when I'm feeling as big as one, but I do understand her point of reference!

This seems to be a logical reason for what is going on. It's hard for me to accept because I felt so "not pregnant" for those couple of weeks. (I know this is very subjective)

I consider myself to be low risk for gestational diabetes, and I know I'll be tested in a few weeks. Would GD cause such a big baby so soon? Or would it normally show up later as the baby grows faster and adds padding?

I'm still on the fence about having more ultrasounds. Do you think it's early enough that it'll be somewhat accurate (within a week or two) if I have another one done? I had several with DS (two-vessel cord, abnormality in the heart) and he was so agitated that I still feel bad about it.

Sorry for all the questions. I have an appointment Monday to do the routine VBAC consent with the OB - our only scheduled appt with the OB. I'm trying to wrap my brain around this so I can ask questions. (I wouldn't have thought about a twin miscarriage on my own.)

: DS - June '07 : DS2 - May '09 : (may be delayed a really long time!)
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#4 of 12 Old 01-23-2009, 05:39 AM
 
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I would object to this change -- from 20-26 weeks ultrasound dating can be off + or - 2.1-2.5 weeks ---
so your ultrasound done at 21 weeks your original dating would still be right if the ultrasound showed 17.5 weeks(-2.5) to 23.5(+2.5) weeks--- so the difference is really not quite a week from the margin of error--
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#5 of 12 Old 01-23-2009, 10:01 AM
 
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ITA w/mwherbs. I think with this information from u/s, I would be willing to *entertain the possibility* that you really are a month further ahead (possible 2nd twin m/c, as PPs have said). I certainly would not accept it outright until more time had passed and we could see if other signs seemed to bear up the u/s finding. U/s dates at this point are based on baby's size--and babies do not all grow according to the exact same schedule, all in a tidy, linear way. Many babies grow in 'fits and starts'--expanding rapidly one month, seeming to dawdle later, etc. And it's early enough that there is plenty of time to see how fundal height, baby's growth/size, etc, 'measure up' as far as actual due date. Most often in situations like this, those other signs do help in the figuring (eventually) of a reasonable due date.
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#6 of 12 Old 01-24-2009, 01:38 AM
 
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How do you know when you ovulated? You seem to have it down more precisely than just 14 days after beginning of period, so that should count for something if you were charting or otherwise paying close attention.

In your case, the due date is very important because of the rules they have for VBACs. I would fight them hard on this and not accept the ultrasound based date. At 20 weeks (or 24 according to them), dating is no longer accurate, period.

I would also worry if this is all part of a pretend to be supportive of VBAC while looking for any potential way to get you to have a c-section type of practice.

Single mom to E (2004) and D (2010)
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#7 of 12 Old 01-25-2009, 01:26 AM - Thread Starter
 
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Thanks, ladies, for your feedback.

Most of the women in my family, myself included, have a sharp pain in our ovaries for an hour or two on the side that we ovulate from. In the years past, I've correlated it with temp/mucus, and they always coincide. This year, I was just going by the pain, but it's pretty distinctive. Also, I'm regular as clockwork to within a few hours on Day 10 of my cycle.

Of course, I think that if a woman if familiar with her body the doctor ought to take that into consideration. Last pregnancy they totally disregarded everything about ovulation and went entirely by LMP. It was really frustrating, but because "their" date was later than "my" date and most of the pregnancies in my family run 1-3 weeks late, I just let them keep their date. FYI - the 20 week ultrasound for DS nailed "my" date to the day!

Soso-lynn - you have touched on the source of my frustration. This hospital and this practice are "the only ones anywhere near here" to do VBACs according to the local ICAN chapter. They are supposed to have a meeting tomorrow that I'm going to - I'll get more info. I've researched hospitals, midwives, birth centers, etc. This hospital is the only one, the one and only birth center doesn't allow VBACs. There are a bunch of homebirth midwives. DH gets tearful and practically hysterical when I broach the subject of a homebirth - DS "would have DIED if you were at home!". I don't think so - but this is an incredibly emotional subject. Also, I live in the middle of the plains, and the closest hospital is 25 minutes away with a major VBAC ban. (I know - I work there!)

The midwives tell me that at 41 weeks they start pushing inductions, and at 42 weeks I will be scheduled for a repeat C-section. They are not allowed to attend births beyond 42 weeks.

I'm just so frustrated! With a due date of May 5th, my midwives will walk out on me on May 5th plus 2 weeks. I'll be left with the OB practice. They may be the only ones that allow VBACs, but they're still very defensive-medicine oriented. I work in the medical field and have enough research to back me up and stubbornness to stick with it usually, but it's really tiring bucking the system. And, being in labor is no time for me to be fighting.

A positive: My doula is an apprentice homebirth midwife. I had her last time, and she is great.

MsBlack - I like your wait & see approach, and I hope we can do that.
mwherbs - I was thinking that US would have a large margin of error - thanks for the numbers.

Ideally, I'd like to watch the growth carefully, keep the June 5th date, and be open to having the baby in May.

: DS - June '07 : DS2 - May '09 : (may be delayed a really long time!)
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#8 of 12 Old 01-25-2009, 03:39 AM
 
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Sounds like a good plan. I wouldn't consider (not accept, but consider) accepting the new date unless you were consistently measuring ahead in every way, not just by 1 ultrasound especially since you expect the baby to be 1-3 wks postdates. If you have a true due date of June 5th, the baby wants to go minimum 7 days over (or no less than the 12th) and you're expected to deliver no later than May 17th whether vaginally or by c, then you would be looking at an infant a good month premature. I've had one of those and while not as bad as it could have been, it's still definitely something to be avoided as far as possible.
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#9 of 12 Old 01-25-2009, 07:48 AM
 
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I would be following on the wait and see approach, but also be strongly petitioning the MW to consider putting your EDD at least at the halfway point - say May 19, as a compromise, and to get her on board with being open to changing dates again if other signs indicate that your baby is, as you think, a month younger, like msblack said. Also, being open to the idea that you have indeed concieved and carried your baby from the first conception, and your period was either a heavy implantation bleed or a twin miscarriage, which it may well be. I'd bring that idea up with your MW as well.

and good luck

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#10 of 12 Old 01-27-2009, 06:39 PM - Thread Starter
 
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I had an OB appt yesterday for the VBAC consent. I was surprised at how pro-VBAC it was, and clearly stated many of the C-section risks.

The OB showed me the ultrasound report. All four measurements (head circumference, abdominal circumference, femurs, and head diameter) all report 24 weeks 2 days (I think one said 24 weeks 3 days). She said that is remarkably consistent. If it was poor ultrasound technique and measuring, usually the dates would be all over the place. If one measurement was very large, she would just conclude that I have an asymmetrical baby or poor measurement. She was very nice but firm in saying that this ultrasound was too consistent to allow anything other than a change in due date.

We discussed what may have happened. When I told her that I'm sure that I did get pregnant on the August 5th cycle but miscarried, she asked a bunch of questions. She believes that I did get pregnant and happened to have a subchorionic hemorrhage on the exact date that I was expecting my period. The large flow of blood without preceding cramps helped distinguish it from a period. She said that there was no way this was implantation bleeding. A twin miscarriage was mentioned, but she said she has never seen the blighted twin miscarry but just get reabsorbed.

I ran some numbers. Based on my last ovulation (during the August 5th cycle), I would be due on May 7th. Based on the ultrasound dating, I would be due on May 6th. They are remarkably consistent with each other, I will have to say! Also, I remember my 20 week ultrasound with DS nailed "my" due date based on ovulation!

As much as I was resisting changing the date, there seems to be too much consistency. I think I'll accept the date change. Now, I still have a niggle of doubt, so I think I'll really need proof of fetal distress before I'll allow interventions like inductions of any kind. I still think there's more danger of evicting the baby too early than too late.

The OB said that she does not induce unless the cervix is favorable. Also, if I go past 42 weeks she will strongly recommend a C-section per ACOG guidelines - she can't force me, just counsel me. If I do go past 42 weeks, the midwives can't "attend" the birth (I think that mean they can't sign off or be official), but that they can be there for the birth and catch the baby. The OB will just have to be there at the hospital as well and sign off on it. This approach sound more reasonable and flexible than originally presented.

Do you ladies think a subchorionic hemorrhage could explain this situation?

: DS - June '07 : DS2 - May '09 : (may be delayed a really long time!)
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#11 of 12 Old 01-28-2009, 12:56 AM
 
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A subchorionic could explain your situation. I believe I would be willing to cautiously accept the date change if the baby continues to measure along the lines of the new date (fundal height, etc). I definitely agree that agreeing to an induction would not be in the babies best interest and would avoid that as best as possible. When you and your family history is that the babies go 2 or more weeks past their due date (and taking into acct the possibility that your first date WAS correct), you could end up with a very immature preemie not to mention your chances of a vbac would drop greatly. Just a case in point, my mother was pregnant with her 3rd full term pregnancy 27 yrs ago and my sister went a full month past dates. The dr my mother used (that's right, a DR) at the time was very easygoing and willing to "let the baby come when it came" to an extent. Sis's due date was Aug 11th and she arrived Sept 4th weighing less than 7lbs. Can you imagine how tiny she would have been if she had been induced a wk or two past her EDD? Dr. Bradley actually had a mother that went a full 12mths and ended up delivering a 6 1/2lber. On the flip side of that, I know of a mother that delivered 8 1/2lb twins at 40wks. I can't imagine lugging around 17lbs worth of baby, plus everything else. Anyway, the midwife knew this mothers history was to go 2-3 wks past dates and ended up transferring both infants to the hospital. The doc at the time refused to treat them as preemies (they certainly didn't look it) and they lost one of the infants due to immature lungs. Of course, these cases are the extreme and I'm just mentioning them as background as to why I agree with not inducing.
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#12 of 12 Old 01-28-2009, 04:18 AM
 
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It sounds like a reasonable assessment to me.
and it sounds like the hospital will be flexible with you if you do go past 42 weeks according to their due date.
I'd say keep up with measurements (not necessarily ultrasound - I don't recommend that), but fundal measurements and palpation, and if it still seems like your bub is consistant with the earlier due date, then it's probably right. and as we all know, the "E" in "EDD" is there for a reason
Still, you don't need to submit to an induction or c/s just because you pass the 42wk point. most likely, as long as the baby seems fine (strong FHT, kicks, etc) there's no reason not to wait it out.

enjoy your pregnancy mama!

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