Growing TOO quickly? - Mothering Forums

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#1 of 16 Old 03-19-2005, 12:52 PM - Thread Starter
 
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Hi everybody,

I've got a question for anybody who feels like they can respond. I have been large for dates since I started seeing my midwife at 10 weeks. I was about 15 cm. at that point. I stopped seeing the midwife at 17 weeks, after a traumatic experience with her at a sonogram appointment. Don't need to discuss that debacle at the moment.

However, by the time we had scheduled that sono, I was measuring 6 cm over what is expected. The sono showed one healthy baby with no problems, so I was inclined to ignore the fact that I am large for dates. For the record, we know the dates because I had IUI so there is no chance of confusion with the dates.

Well, since I stopped seeing the midwife, I have been measuring myself weekly as well as checking my BP and urine for glucose and protein. My blood pressure and urine tests are fine–no problems whatsoever. However, rather than staying 6 cm over where I should be or having the rate of growth slow down, it has increased. In the past 2 weeks I have grown 3 cm each week which now brings me to 35cm fundal height at 24 weeks (no, I'm not kidding).

If I'm not having multiples, this seems to indicate SOMETHING is wrong or at least going on that I should be aware of. I am tempted to go to a doctor to have just a consultation, but I really don't want to end up in an argument about my deciding to UC. And most of the stories I've read on-line here about trying that do not have happy endings as far as experiences with professionals. But I'm wondering whether I should see an OB or perinatologist anyway and whether I simply hear more about the disasters and frustrating experiences of those who have consulted with professionals.

Also, if any of you have any ideas of what the problem might be, I 'd appreciate your speaking up. I don't think I have pre-eclampsia because my blood pressure is generally around 90/50 and I've had no other signs of it. Nor do I have any swelling. I am slightly worried about gestational diabetes despite the fact that there isn't sugar in my urine. Any other ideas?

Thanks for your help.
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#2 of 16 Old 03-19-2005, 01:50 PM
 
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missed twin, or polyhydramnios because it was detected so early it is important to follow up - was the baby dated at or around your due date?
you can look up polyhydramnios to see what it could mean or just go in and find out what they think-- the reason I say this is not everyone wants to be told all the possibilities until there is some confirmation a Level 2 ultrasound is probably what is in order.

Woops I should have also said is if they find a problem that is fixable if handled carefully would you change your plans? There is no sense in going to get information or advice from someone if you are already decided to only do UC no matter what.
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#3 of 16 Old 03-19-2005, 03:54 PM - Thread Starter
 
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The sono at 17 weeks said there wasn't polyhydramnios which is why I've assumed that's not the problem. In addition to which, I started measuring large before that problem usually shows up–by 10 weeks and polyhydramnios is usually because the fetus isn't swallowing amniotic fluid. But at 10 weeks, the fetus usually hasn't started swallowing the fluid yet.

Since it is an IUI pregnancy, we know the dates are correct, but I know that some babies mature faster than others. It is possible that because I am small, if I have a baby who is growing and maturing at a faster than average rate, that it would account for the disparity of measurements. I'm just not sure.

As for being determined to do UC no matter what, I'm not sure. If it's gestational diabetes or something like that causing the growth, I could take action to control the condition and do a UC if the baby went full term and wasn't already too large. If it's twins and I am prepared, I could still UC although I would have to be much more careful and ready to call for help. As for other problems, I can't say what I would decide without knowing what options I would have.

At this point I would prefer a doctor to the midwives I've seen, but I'm not real thrilled about hospitals. Doctors can be reasonable, but hospitals seem to play this little game: staff blaming policies, procedures, and regulations for disrespectful and interfering processes, while the administration blames the staff.
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#4 of 16 Old 03-19-2005, 08:42 PM
 
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there are other things besides swallowing but 50% of poly babies have no physical problem-- but are at greater risk for pre-term labor.
I guess you could be short but how short waisted are you? this is a big difference from dates. And if it was just a level 1 ultrasound how do you know how good the tec was? since you may change what you would do depending on what the dx is go to someone to get another ultrasound-- do you have a copy of your other one and a copy of the records? get them so you can have them in hand when you go to the next doc
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#5 of 16 Old 03-19-2005, 10:31 PM
 
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I've had many clients be way ahead of weeks on the centimeter. It's a poor measurement of women's uterus's, by the way. Seriously, around 30 weeks, things seem to even out within 4cm or so.

The fact that we keep assigning strict linear measurements to women's bodies and babies seems to create more fear than reassurance. Perhaps it's time to re-think the ruler!

I would also like to add that it is really hard to measure your own belly - and the position of your baby will change, which will change measurements. If you're really concerned, perhaps you should think about another u/s. Otherwise, just assume what your body is doing to be normal.

I don't know about the urine testing. I think sometimes, in an effort to remain uncontroversial, many UCers will test their own urine, their bp, etc. I think that if you are healthy, there is little reason to do this. In fact, I think it may take away from what you intuitively know to be true about your body (this whole measurement thing is a good example of that). I don't even do urine testing in my own midwifery practice - I think it's a bunch of hogwash.
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#6 of 16 Old 03-19-2005, 11:36 PM
 
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the biggest measure I have ever had over dates that was not twins or poly was 5 cm off and involved a fibroid, I also do not measure with a tape before 20 weeks.


OT part[so Pam do you UA everyone? I find probably 2 silent infections a year via dip sticks confirmed by follow up UA but we are treating before we even get the results back by increased water and blueberry juice. and go over hygine. some women will even be a bit symptomatic like back pain... but how many pregnant moms do you know have that? VBG]
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#7 of 16 Old 03-19-2005, 11:48 PM
 
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nope, I don't UA anyone. with signs and symptoms, I'll do a UA or a liver panel, but I don't think routine dips are helpful at all. nearly every single time, we're saying, "oh, don't worry about those leukocytes....don't worry about that trace or plus protein.....don't worry about...." it's just so confusing to people as to why we're doing it if results dont' really mean anything.

i've seen some interesting studies coming out about routine UAs. I definitely wouldn't do dips just for glucose & protein - those are the two that are overused and don't mean anything for trace and plus amounts (not to mention the belief that glucose in the urine of a preg woman MUST mean diabetes, which I don't believe is true). Maybe just dipping for blood and nitrites, but nothing else would be helpful. ?

The largest measurement I had was a mom who at 24 weeks was measuring 36cm. By her 42 week visit, she was measuring 52cm. The reason? A 13lb 6oz baby.
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#8 of 16 Old 03-20-2005, 12:03 AM
 
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I don't get many false positives of anything to tell a mom to ignore it... hummm several years ago I remember a mom who had leucocytes with her other pregnancies and first dip had them with us so I went over clean catch with her and no more leucocytes. I think we serve a different region and population---
for instance our water is probably harder and a different pH and we have quite a lot of kidney stones here in the general population we have alot who know what all goes into a person's health...

as far as testing glucose it is a waste all it tells you is your kidneys are spilling some sugar or you are taking vitamin C or... in the old days when people did not have another way to test diabetes sugar control it was a tool now...... not so but now to get rid of them is some work....
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#9 of 16 Old 03-20-2005, 12:12 AM
 
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but most of the time (all of the time) leukocytes are normal. i don't view leukocytes as any sign of infection. now, nitrites would concern me, as i feel they are more indicative of infection, esp with occult blood.

we were getting leukocytes and trace to plus protein all the time. leukocytes, normal vaginal discharge in pregnancy. trace to plus protein without high BP - more than likely concentrated urine from not drinking enough water. Proteinuria is a LATE sign of pre-eclampsia - you're not gonna see it with normal blood pressure.

I just dont' feel that they're helpful at all, but that's my opinion, I guess. I defintely wouldn't do Glucose & Protein, as I feel that without any other symptoms of PIH, that it's a waste of money.
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#10 of 16 Old 03-20-2005, 12:13 AM - Thread Starter
 
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Thanks for all the feedback. It's a relief to know that I might be worrying about nothing. Up until this week, that's what I assumed, but I just felt that maybe I ought to ask. And I've really been keeping track of all this stuff just to have a kind of record to show the baby in the future, like the weekly belly photos.

I never did get a copy of the result of the u/s because they were sent directly to my midwife whom I fired. She never passed the results on to me. However, I should be able to get a copy of the report from the doctor's office without too much trouble.

It's a relief to hear from other people and be reminded that we often put too much emphasis on these tests and measurements rather than on listening to our bodies which are usually quite reliable. And I haven't had any problems or twinges or concerns on that level.
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#11 of 16 Old 03-20-2005, 02:57 PM
 
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completely ot, but pamamidwife, i always love hearing your pov. you make me critique my own standard of care.

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#12 of 16 Old 03-20-2005, 03:17 PM
 
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Was cruising along and just happened to see this topic, I measured large for my dates during my last pregnancy. Around 25 weeks, I too was measuring about 12 weeks ahead. Things began to slow down a bit after that and besides I got so fed up with measuring big, I just quit paying attention. I just had one baby, no complications. I like to think that my body just made a nice big house for her. She was really active... maybe she just needed more room!

Wishing you a happy healthy rest of your pregnancy and a wonderful UC! Yay UC!

Spark and her four firecrackers.
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#13 of 16 Old 03-20-2005, 03:18 PM - Thread Starter
 
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Quote:
Originally Posted by homemademomma
completely ot, but pamamidwife, i always love hearing your pov. you make me critique my own standard of care.

I agree! You are grounded, realistic, respectful, and incredibly knowledgeable. You add a lot to our forum and I'm glad you are here.
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#14 of 16 Old 03-20-2005, 11:46 PM
 
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omg, thank you all so much. really, I just feel like a freak sometimes because so much of what I really believe goes against so much of what I was taught about midwifery. I feel a bit lost and often wonder if I'm just jumping off the deep end. I really appreciate hearing that I'm not a kook.
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#15 of 16 Old 03-21-2005, 09:29 AM
 
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I think that even the protein is useful if you are getting plus 2. dipsticks are a screening tool not diagnostic and if you are doing the screening yourself it helps to clarify how far down the road you are. I have seen UC women who have "ignored" blood pressure and blood pressure can be very silent --- so if you are using dip sticks and you get a plus 2 it is a real thing to act on. Also not too often but one woman who came to use years ago she was on prednisone--and she turned the urine glucose stick black- now this is far beyond normal spilling of sugar and she indeed have a glucose problem because of the prednisone- we discussed with her the possibility of still assisting her at a home birth but that she would need to work with her doctor to get off the drug and to change her diet. We had said no sugar and she said I don't eat sugar- and then when I said that means cakes and cookies... she said she baked a cake or brownies every day and ate them herself, and she didn't know if she wanted to change that!!!!!!
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#16 of 16 Old 03-21-2005, 09:36 AM
 
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There is a lot of great advice here, but one thing I wanted to mention- if you wanted to have a MD consult/opinion without debating UC than just go "looking for new care" and leave "because you found new care" They don't need to know that you are your own caregiver. I personally don't think it is any of their business, but you should still ahve the right to medical opinion if you are concerned.

That said, this pregnancy is the first one I've measured *below* the "norms". I've always been far ahead... I had two easy simple births. One at 8.8 and one at 11.
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