26 week appointment and question about growth/IUGR

We had an appointment with the peri today...26 wks. 3 days. The weight difference between our girls has increased to about 18%, and it has me pretty worried. Baby A is about 2 lbs. 1.6 oz. and Baby B is about 2 lbs. 8.9 oz. So basically A is about normal with her tummy being a bit behind while B is measuring a little ahead. Fluids, bladders, cervix, etc. looks good. After talking with the doctor, he had us go back in to get a doppler scan and BPP. Both girls dopplers seemed normal and they both easily got 8/8 on their BPP (within 30 seconds). The doctor doesn't seem concerned, but it's hard for me NOT to be. It seems like he was looking more at how the babies were acting rather than their weights. For those of you who have dealt with IUGR, what was the size difference and how far along were you? How were the babies' dopplers, BPPs, etc.?

 

dang my computer ate my last response

M slowed in growth somewhere between 22-24 weeks, her doppler flow had decreased as well. I started NST, BPPs, doppler 2xs a week. That is when I went on strict home bedrest. the discordinace grew and grew and grew. The last ultrasound at 32 weeks showed them at about 1 1/2 lbs difference, they ended up exactly a lb apart. The IUGR was caused by the umbilical cord placing funny (same thing happened with ds, 27+4 weeks, 1 lb 12 oz) and with M she had a smaller share of the placenta. I kept in contact with Dr. De Lia and as the discordinace grew he suggested I push my docs for 3xs a week NST/BPP/dopplers. They didnt get really concerned until M failed her BPP and that is the point I went into the hospital.

So try not to stress (i know its impossible, but had to say it anyways), do your kick counts, if you feel off call in, push for appts, do bedrest and drink your Boosts and eat and drink alot.

I will keep you all in prayer

 

Hi Melissa,

I don't have advice for you but I just want to give you big hugs. I know it's pretty stressful for you. My doc says anytime the weight differences are 20% or more they get concerned. Also the U/S estimates may be off as well. As long as they are keeping an eye on you. Are you being seen more frequently now? Best of luck and take care!

 

Oh sweetie, I am going through the exact same thing with mine right now. my peri said that they definately needed to be monitored regularly (I go in for NSTs 2xs a week now starting today) but he said that since the smaller baby is right on target and as long as the fluid looks good he isn't too worried. If the smaller one was way behind there would definately be more concern. Hang in their I know it is tough but it sounds like you are getting great care and are doing everything right.

 

Thanks. I have a couple more questions now. As far as kick counts, how do I know which baby is which? Right now baby A is vertex and baby B is transverse, but their feet are close together, so it's hard to tell who's kicking. Some other movements I can tell though.

NSTs have not been mentioned at this point. Is this maybe because the dopplers/BPP was normal? Kimber074, did you have dopplers done? I'm sorry you're goinig through a similar situation. I know how you feel! The peri felt I could wait 2 weeks between appointments still, but I see my OB in between...so I'm seen weekly. He does an ultrasound as well.

Now I'm worried that I should maybe be having NSTs. I know I should focus on all the positives, but it's still hard sometimes. I've emailed Dr. DeLia and hope to hear his opinion soon.

 

I could never really tell who was kicking, well I thought I could but then Id realize that it was both of them. I was told to count 10-12 kicks and then I would know both were ok, whereas with a singleton I think its 6-8 kicks.

As for the NSTs, bring it up to your peri or OB. Alot of doctors dont want to do them so early because they are hard to do, their is just so much wiggle room still. Push your doctors, Im sure they will understand with your history

 

I can only imagine how stressful this is for you; i am so sorry you are going through it. I agree w/pp: push your docs to do NSTs - at least ask the question. I don't know if there is a medical reason they don't do them this early, but w/your history if there isn't it might make sense to do it.

Hang in there, TRY not to worry about what you can't control (DEFINITELY easier said than done, but = any stress you feel translates to the babies.) So - just try and visualize strong, healthy babies growing inside you, sending them all the love you have and knowing that lots of us out here are rooting for all three of you.

 

I guess I'll wait and see what Dr. DeLia says about the NSTs and go from there. I guess I would be more concerned with things if the dopplers weren't normal or something. Trying not to stress too much. Babies are moving around a lot. Kick counts are supposed to be during their active times, right? I mean there are obviously times when they're resting. But there are definitely more than 10 to 12 movements within an hour (during their more active times).

 

Just wanted to tell you that when our boys were born they were 2lbs 8oz and 2 lbs 13oz and that difference had nothing to do w/TTTS - the donor was the big guy...and we didn't know about the TTTS until after they were born early because of PTL - NOT because of TTTS - and before they were born, they were not worried at all about the weight discrecpancy - which, by the was was what the u/s showed them weighing at 28 weeks - a full week before they were actually born.

Don't know if that helps - but based on everything we found out - it sounds like your guys are doing just fine!

 

Jake was diagonsed as IUGR around week 25 - he was 1 lb 3 ounces and Becca was 1 pound 11 ounces.

The dr. put me on modified bedrest (I also had high blood pressure) and I started the whole protein regiment (which I know you know). Based on what you are saying, your weights are good, so I would personally worry less about the discordance.

I was given steriod shots as a precaution - as long as Jake showed growth at his bi-weekly u/s measurements, I could keep cooking the kids. Obviously TTTS wasn't a concern with boy/girl twins. We also did the doppler study and it was fine. For the NSTs, the most important thing was to show that Jake was active - which he was. I never did kick counts, I just tried to notice them moving. It was easy to feel them move separately because of how they were positioned. Becca was breech with her feet in my bladder and Jake was head down at the top of my belly.

We ended up delivering at 36 weeks because Jake had stopped growing and 36 weeks is a good milestone. He spent 12 days in the NICU, but we weren't concerned at all.

One word of caution, at the 35 week growth u/s, Jake measured 4 lbs 4 ounces and Becca was 5 lbs 5 ounces - obviously both weighed less at birth.

 

Hey there! I am almost exactly in the same boat as you--found out today at our apt. I am 26 wks. 6 days along and at our ultrasound today, baby A was 2 lbs. 9 ounces and baby A was 2 lbs. Our doctor didn't seem overly concerned at this point, but we will be having another ultrasound in 2 weeks. Same as you, everything looked good, cervic, fluid, etc. so I am doing my best not to worry about it at this point. Let's keep in touch though, I am curious to see how things progress for you! Hang in there

 

My girls were discovered at 26 weeks, the IUGR was found then too. Jessy was 3 weeks behind Jazz. I can't remember the exact weighs but I think Jessy was about a 1lb and 1/2 and Jazz was over 2lbs. Jessy went on to gain 3 oz every week(no more no less) till she was born at 2lbs 13 oz. She had a 2 vessel cord causing the problem.

We did biphysical profiles(done with u/s) twice a week instead of NST because A) they are more precise with twins B) They would always kick the monitor off C) They could check cord flow