BPP - Umbilical Resistance Question

I had my first BPP today and most of it went well.....until the end that is. Baby A gained 7 oz in the last week and is now weighing 4 lb 5 oz. Both babies are practicing breathing and look like everything is working well. Then we got to the measurement for Baby B and she hasn't gained an ounce. The tech measured Baby B twice and got weights of 4 lbs 3 oz and 4 lbs 1 oz. At the last ultrasound she was 4 lbs 3 oz. There is also an elevated level of umbilical cord resistance. She said that it is a concern, but that next weeks ultrasound will be much more telling and will give us an idea of if there is an issue.

So, of course, I am freaking out a bit. I left a message for my doctor so I can get some questions answered after he has a chance to look at the ultrasound. My major concern is if there is little or no growth NEXT week. And how can I wait that long? Anyway, has anyone dealt with this? What was the end result and how did your doctor address it? DId you deliver early because of it? I guess my biggest thoughts and concerns are what does this mean for us in the next couple of weeks?

Thanks!

 

I am not sure about deliverin early, but I have been told by my midwives, OB, MFM, u/s techs, etc... that for growth measurments, they should be done every 4wks for more accuracy. Even having them every two weeks isn't very accurate. But with BPP it may be different. Hope all goes well!

April

 

Around 20 or 22 weeks we were told that the diastloic flow in baby A's cord was diminished and she was suffering from severe growth restriction. We were told that she would not survive. I'm now 29 weeks and she's still alive, she is smaller but she's still gaining. I've been on hospital bedrest since 26 weeks and I get daily NSTs and BPPs. Her cord flow has fluctuated from diminished to absent to reversed on many occaisions. Now that we've past 28 weeks, if she becomes distressed they will deliver both babies. The fact that you're past 33 weeks is great, so if you do have to deliver early, your babies will likely do well. The little one can survive inside you like this for quite awhile and the longer it stays in the better. Another member, 807426, experienced a similar situation and had her babies at 33 weeks. Her bigger baby went home after a few weeks in the NICU, the smaller one is still there but doing well. Good luck, feel free to PM me if you have any questions.

 

They should be conducting weekly doppler studies on your babies. Early on in my pregnancy ~24 weeks or so they thought there was a big size discrepancy between my 2 babies. Weekly they check the umbilical cords and placentas via ultrasound (they call it doppler), they do the growth every 2 or 3 weeks otherwise it's a false reading on the growth.

I'm 32 & 4 days and there hasn't been an issue with any cord restriction - the specialist have told me that I have 2 different pregnancies. The girl is 9 oz less than the boy and they are around 4 lbs right now.

Hope everything works out for you.

 

Anthony was diagnosed with absent end diastolic flow at late 25 weeks. It did limit his growth, but not severely and his resistance did not progress (except temporarily when I received betamethasone). Your babies are such great weights and you've made it so far that I would try hard not to worry about it (I know, easier said than done ).

I delivered at 34w6d for pre-e and Anthony was 4lb8oz & 15", so the weights you're listing sound great

Did the u/s tech do doppler studies on the cords? I don't know how they could assume there's resistance without a proper doppler study. A BPP doesn't include doppler.

 

QUOTE(Fay @ Jun 6 2007, 08:26 PM) [snapback]282085[/snapback]
Anthony was diagnosed with absent end diastolic flow at late 25 weeks. It did limit his growth, but not severely and his resistance did not progress (except temporarily when I received betamethasone). Your babies are such great weights and you've made it so far that I would try hard not to worry about it (I know, easier said than done ).

I delivered at 34w6d for pre-e and Anthony was 4lb8oz & 15", so the weights you're listing sound great

Did the u/s tech do doppler studies on the cords? I don't know how they could assume there's resistance without a proper doppler study. A BPP doesn't include doppler.


I just wanted to add that I agree with Fay, BPPs do not include doppler studies, but they have been doing doppler studies on my babies everytime on both the unbilical cord and the ductus venosus, which I am told is a realtively new study that is a better indicator of blow flow within the baby.

 

She did do a doppler study of the cord because of the indication of lack of growth. She said that at my last ultrasound the resistance level was a little high and that in the last week it had gotten higher.

I talked to my doctor and he is currently not concerned. He said as long as they stay within 20 percentile points of each other, and are growing at the same rate overall, he won't be concerned. If they get out of that range, he will start to look at what the options are. He also said that with a lot of twins the growth will slow down towards the end of the pregnancy. So now we're just on a wait and see game. I'll have another BPP with a check of the cords next week and we'll go from there.

Please keep us all in your thoughts or prayers.