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#31 of 48 Old 04-01-2009, 11:32 PM
 
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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.

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#32 of 48 Old 04-02-2009, 01:03 AM
 
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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.

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#33 of 48 Old 04-02-2009, 03:23 PM
 
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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.

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#34 of 48 Old 04-02-2009, 07:09 PM
 
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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.


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#35 of 48 Old 04-02-2009, 09:26 PM
 
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Originally Posted by aris99 View Post
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.

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#36 of 48 Old 04-04-2009, 01:50 AM
 
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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.
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#37 of 48 Old 04-04-2009, 01:18 PM
 
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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.

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#38 of 48 Old 04-04-2009, 02:11 PM
 
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Originally Posted by BeanSprout Mama View Post
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!

Mama to expecting Babe 2
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#39 of 48 Old 05-09-2009, 11:57 PM
 
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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.
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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?
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#40 of 48 Old 05-10-2009, 12:04 AM
 
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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.
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#41 of 48 Old 05-10-2009, 05:28 PM
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i hope everything goes well at the mw's appt. good luck!
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#42 of 48 Old 05-10-2009, 07:18 PM
 
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Originally Posted by fourlittlebirds View Post
Anybody know what the stats are of amnio causing premature labor and/or death?
Last time I looked (and its been a while) I think the risk is 1 in 200 with amnio. It's part of the reason amnio isn't supposed to be offered for Down Syndrome unless the risk factor comes back higher than that.

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#43 of 48 Old 05-11-2009, 11:13 AM
 
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Originally Posted by LilMamiBella View Post
Yep no other problems and they spent lots of time looking over every little thing. The doctor says I have a 4% chance its ds. But when he says 1 in 27 it makes it sound worse.

1/27 = 0.037037 which is actually 3.7% ... so a little less than 4 percent meaning that less than 4 kids who get this diagnosis during pregnancy actually have the disorder! I'd like to see a study on the effects of increased stress on mothers and babies who get ambiguous test results during pregnancy. Here's hoping for the best possible outcome for you! Try to relax and enjoy the rest of your pregnancy



ETA: and it sounds like you may have been too far along for these test results to be accurate anyway. Do your research! If it were me I wouldn't want a bunch more tests at this point, b/c there are risks associated w/ them and it doesn't really sound like they are warranted at this point. Good luck w/ everything!

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#44 of 48 Old 05-11-2009, 12:38 PM
 
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Originally Posted by fourlittlebirds View Post
Anybody know what the stats are of amnio causing premature labor and/or death?
They have revised this pretty recently, since the 1:200 seemed to be outdated.

Quote:
Last month, the top obstetrics journal, Obstetrics and Gynecology, published an article by Washington University at St. Louis researchers reporting that over 16 years, among more than 50,000 of their patients, amniocentesis appeared to cause a miscarriage in only 1 out of 769 procedures. And in 2006, a similarly large study known by the acronym FASTER estimated the miscarriage risk at just 1 out of 1,600 procedures.

Those numbers remain hotly debated because of methodological issues in the studies. But already, obstetricians and genetic counselors are beginning to change the general risk picture they paint for patients.
Full Boston Globe article

I have had amnios done with all but my first pregnancy to do genetic testing and see if our baby carries the kell antigen, so we would know how best to proceed with each pregnancy. Of the two doctors that have my amnios, upon asking what their personal statistic were with losing babies/ causing miscarriage, the 1:1,600 number seems more accurate. But the chance is there, and unless the benefits of having an amnio absolutely outweighed the risks (and we discerned that for us, it did) I wouldn't do it.

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#45 of 48 Old 05-11-2009, 01:29 PM
 
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A few years back on c-birth, a woman gave birth to a perfectly healthy baby boy, he was small, I remember, maybe 3-4 lbs? It wasn't until he was about 4 weeks old that she started to notice some physical characteristics of down syndrome. She had him tested, and sure enough, he was positive for downs. But her uc was a success!
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#46 of 48 Old 05-11-2009, 02:55 PM
 
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DH and I forwent any of the tests because as you said, even if there was DS or other disability, it wouldn't change anything and we were afraid if something came up it would just stress me out more in my pregnancy.

We have two friends that were given EXTREMELY high chances of having a DS baby - one of them the doctors all but guaranteed she would be born with DS. Yeah, no. Perfectly healthy and no DS. That was our deciding factor because from the research we did, we found that false positives are highly likely.

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#47 of 48 Old 05-11-2009, 07:43 PM - Thread Starter
 
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I wanted to update that I never ended up going to the second ultrasound and haven't seen former midwife since then either. It made me stressed out and I just decided I didn't want to know.

eta: I did visit midwife after first ultrasound and she said I was feeling/measuring behind and recommended that I come back at 30-32 weeks to see her. I don't think I will though.

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#48 of 48 Old 05-11-2009, 08:43 PM
 
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Not sure if this helps at all, but I had many, many U/S w/ my twin pregnancy, my first pregnancy. Each led to another possible problem which never was. I came to the conclusion that the U/S's caused more worry than they relieved.

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