40% Size Difference at 31 weeks

The babies didn't have a great ultrasound yesterday. Baby A has only gained 7 oz in a month and Baby B has gained about 2 lbs 3oz. Now they have about a 40% size difference. My doctor is concerned and I am being sent to a Peri to see why Baby A isn't gaining weight. Hopefully, there is nothing terribly wrong but I won't know until I see the specialist (they are calling today to schedule the appt.) I'm trying not to worry since I haven't seen the specialist yet and I don't know how severe the situation is, but of course I am freaking out. Any one else have this situation? Any positive stories?

 

I don't have any advice or anything, but my last Ultrasound I was told I needed to terminate a baby because of the size difference. They were measuring 3 ounces apart. We had another ultrasound this week and they were both fine.

How often are you having ultrasounds? Maybe the measurements were a little off?

I'll keep you in my prayers.

 

Your baby may have Intra Uterine Growth Restriction (IUGR). Read up on it to educate yourself before you see the specialist. The good news is that you are 31 weeks along and if it is life threatening, chances of having healthy babies delivered is greater. That's the worse case scenario. My Baby B had IUGR for the entire pregnancy. We didn't think he was going to make it in the beginning. He grew slowly b/c he wasn't getting enough nutrients from his placenta. I went into labor at 33weeks and both my boys are healthy happy toddlers. Baby B has been 2 lbs bigger than his brother ever since they left the NICU. Feel free to PM me if you have questions. One of the leading IUGR specialists in the country was one of our doctors. She has the worst bedside manner, but the brains to make it all better.

:hug:

 

My baby A measured way off at 30 weeks she also had a low fluid level. up until that point they were basically the same and no fluid problems. My peri put me on bedrest and told me to drink (including 2 or 3 Boosts a day) and eat all I could. I did and she was fine - she ended up weighing a touch more than Ava - she was 6.9pounds!! Ava was 6.8 at 38 weeks 4 days!

now that she is here - she is my smaller twin weighing 3 pounds lighter than Ava - I think she was just ment to be a smaller person!

you are in my thoughts and prayers! :hug:

 

Hope everything will go well for your appt, you're in our thoughts. Keep us posted.

 

We have a similar situation. I am now 29 weeks and my boys (mo/di) have always had a size discordance that was constant at about 20% until 2 weeks ago. The initial concern was TTTS, but we've never had any decrease in amniotic fluid or bladder size with the little one. My peri now says that it is IUGR. I was placed on bedrest and instructed to increase protein intake. Right now, the little one is measuring at the 19th percentile, and we've been warned that if he drops below the 10th percentile, he may recommend delivery. I received my steroid shots this week just in case we need to deliver soon. Some important questions to ask at your peri appt have to do with the cord diastolic flow, ductus flow and middle cerebral artery flow, amniotic fluid measurements, and visibility of both bladders, which should all be measured on ultrasound. Those are important indicators of the placental resistance and adequacy of blood flow to the smaller twin. What we've been told is that as long as our smaller twin maintains good cord flow, we can continue to closely monitor his growth, but that if he develops reversed diastolic cord flow then that is another indicator of the need for delivery.

The good news is that you are 31 weeks and even if they had to deliver, odds are certainly in your favor that you'll have a good outcome. Your peri should also be starting more frequent ultrasounds if they plan to observe you.

Good luck and feel free to contact me if needed. I'm a physician and have several friends in the ob/peri world.

 

We had a 24% difference about a month ago and go for our next growth scan next Tuesday. About 2 weeks ago, my peri did a quick u/s just to check the fluid levels and all was well. His best advice to help my little one was bed rest. It's important to give them the best chances to grow. Did your doctor put you on bed rest until you see the peri? If not, I would put myself on bed rest if I were you. It can't hurt. As another poster said, make sure you're getting protein and taking your vitamins. My peri focuses more on the vitamins than protein intake, but again, it can't hurt.

Keep us posted about your peri appt. Thinking of you and your little beans!

 

My mono-di girls were born at 34 weeks 2 days due to IUGR (and me having pre-eclampsia). At 30 weeks they had a 28% difference on U/S and Baby A wasn't growing much anymore. I was told to rest as much as possible on my left side, drink tons of water, and up my protein intake. No formal bedrest, just taking it easy.

At birth my girls had almost a one pound size difference; Piper weighed 3 lbs 11 oz and Cricket was 4 lbs 9 oz. They each had about 12 hours in the NICU for monitoring after birth, but no medical intervention necessary. My bigger girl (Cricket) spent 10 days in the step-down nursery learning to eat and grow. My smaller girl (Piper) spent 30 days in the same nursery eating and growing. She was also diagnosed with reflux and aspiration of thin liquids due to prematurity and IUGR. Both girls are now happy and healthy toddlers with no medical issues. Piper caught up to Cricket in weight and length by three months and ever since then has weighed just a few ounces less. At their last weigh in Piper was 8 oz smaller than Cricket, barely noticible on a 23 pound toddler!

Hang in there. 40% size difference sounds huge, but remember that if your twins are di-di, they're probably fraternal (not necessarily, but chances are...) and are genetically predisposed to being different sizes. So a 40% size difference might not be as concerning as if they were ID. Also, U/S are notoriously inaccurate the further you get along in pregnancy. That 40% size difference might really be only 25% or 30% but due to measurement inaccuracy it looks bigger.

Good luck, and keep us posted!

 

They are doing the growth scans once a month. My last one was Sept 23rd.

 

QUOTE(bdhtwins @ Oct 22 2008, 10:12 AM) [snapback]1036847[/snapback]
They are doing the growth scans once a month. My last one was Sept 23rd.


You should have growth scans every two weeks if there is a question of size difference. When do you see the Peri? She or he will probably put you on a more aggressive scan schedule. Good luck!