oligohydramnios & IUGR

I'm 25 wks, and just had a very scary ultrasound today.

One of the babies looked fine. But the other had low fluid and was measuring behind. They said that with twins they like to see a fluid depth of at least 3 cm; his was 1.9 (other baby's was 5). His measurements were also 3rd-10th percentile (and they consider anything from 10-90 normal; other baby's were 50th-90th percentile). Until now, both babies had always been measuring ahead of dates.

We have no idea what's causing this. His kidneys look fine, anatomy scans have all been perfect, and blood flow through the umbilical cord was also fine. Each baby has their own placenta, so there shouldn't be any TTTS issues.

Lots more ultrasounds coming up, and I'll get to see a maternal-fetal medicine dr. soon. My OB is having me get a course of betamethasone shots in case we have to deliver really early. She says we're probably not going to know what the outlook is for a couple weeks.

Anybody have any experience with this stuff? What are the chances that we'll actually have a happy ending to this story?

 

I'm 25 wks, and just had a very scary ultrasound today.

One of the babies looked fine. But the other had low fluid and was measuring behind. They said that with twins they like to see a fluid depth of at least 3 cm; his was 1.9 (other baby's was 5). His measurements were also 3rd-10th percentile (and they consider anything from 10-90 normal; other baby's were 50th-90th percentile). Until now, both babies had always been measuring ahead of dates.

We have no idea what's causing this. His kidneys look fine, anatomy scans have all been perfect, and blood flow through the umbilical cord was also fine. Each baby has their own placenta, so there shouldn't be any TTTS issues.

Lots more ultrasounds coming up, and I'll get to see a maternal-fetal medicine dr. soon. My OB is having me get a course of betamethasone shots in case we have to deliver really early. She says we're probably not going to know what the outlook is for a couple weeks.

Anybody have any experience with this stuff? What are the chances that we'll actually have a happy ending to this story?

 

I've had a similar issue - Twin A currently in the 24th percentile, Twin B in the 4th. B has been much smaller all along, kind of growing on her own growth curve. My issue seems to be with the placenta (just not as healthy as A's). Did they compare the size...of each placenta? They also used the doppler and found poor blood flow through the cord. Did they use a doppler to analyze the cord blood flow on you? During my early U/s's, they did not detect this, it appeared around 22 weks. The dopplers detected an intermittent absent diastolic rate (I'm probably saying all this wrong, please don't quote my medical terms) But my amniotic fluid levels have remained stable (and they have defintiely been watching that). So, I don't know, some similarities here but if they said your cord blood flow was fine, it's hard guessing. I can tell you this - each week there have been so many changes. Some weeks that absent diastolic rate appeared totally normal, other weeks it did not. I think a lot can change with every visit! And I KNOW I have read from other posts about people's amniotic fluids returning to an acceptable level. Your MFM doctor will check all that stuff. It sounds like they are being proactive, so hang in there! As far as the happy ending, you should feel better that you are past that crucial 24 week mark. I understand that is the point of viability - I wish you the absolute best! Let us know what you find out...

 

I don't have the fluid issues, but I do have IUGR for baby B - my boy.

Basically i've been on modified bedrest since 25 weeks and a high protein diet to help him grow. And he has grown, on his own growth curve, just smaller than his sister.

IUGR is a very general diagonsis for a baby being small. The causes can be everything from genetic to placental (mine is likely placental). Like Really Tired Mom, I had a doppler study on his cord and everything was fine.

Try to rest and ingest as much protein as possible. Rest should also help with the fluid.

Miriam

 

Keep us posted! You are in my thoughts and prayers!

 

I'm sorry, I don't have any experience with it but I wanted to give you a hug. I'm so sorry you're having to go through this. We had similar symptoms at 19 weeks due to TTTS except there were also problems with the larger baby. I carried all the way to 35 weeks though so you definitely can be okay. Just rest up, drink tons of water, and sip 2-3 Boost/Ensure drinks a day. Sometimes those 3 simple things really help fluid issues resolve themselves.

 

We had excessive fluid around Ian and they used meds to decrease it. Otherwise, I don't have any experience with this. But I do know the fear of things of going wrong and I know that I would be out of my mind with worry. So I am going to tell you that I am going to pray for your babies and for God to comfort you. I pray that God will help your sweet little baby boy catch and that he will even out the fluid levels. I pray that you will be comforted right this very minute.

Big Hugs Sweetie.

 

Thank you so much for the encouraging stories & prayers & support. It really means a lot during this stressful time.

Had another doctor visit, ultrasound and a biophysical profile today. The bad stuff:

-boy is measuring small - head is about 20th percentile (not too bad), femur about 8th percentile (bad but not alarming), abdomen is less than 2.5th percentile (YIKES!)

-fluid is low (though at least not catastrophically low) - they measured a 2 cm pocket once, and a 3 cm pocket another time

The good stuff:

-membranes seem intact - I'm not leaking fluid

-heartbeat is strong

-blood flow through cord is normal

-kidneys & bladder look normal

-he scored 6 out of 8 on the BPP - 2 points for finding a 2cm x 2cm pocket of fluid; 2 for muscle tone; 2 for movement. (He was actually moving like crazy!) The only thing missing was breathing movements, but they weren't concerned about that at all - I'm only 25 wks, and it's really hit or miss.

So pretty much the same thing: he seems healthy, does not seem to be in any distress, we just don't know why he isn't growing well.

Lots more stuff is scheduled for next week - more fluid checks, doppler cord scans, BPPs, OB visit; I'm seeing a MFM dr on Tuesday. But we won't have a growth check until 2 weeks from now. They said it doesn't make sense to do one before then, since measurements can be so subjective.

Today my OB said that we won't even think about delivering unless 2 things happen: poor cord blood flow, AND no growth. And by the time we know about growth, I'll be 27 weeks - and of course the odds of survival get better every day.

In the meantime, just have to rest up & chug water...

 

Just wanted to say I'm thinking of you and hoping that things will get better for your little one. Sounds like there are a lot of positive things, but I know it can still be scary. Just keep resting and getting in water and protein. My doctors have also told me that growth scans aren't very useful without waiting two weeks. Keep up the good work and keep us posted.

 

Oh, sounds so scary! Thanks for the update! I'll keep you in my prayers! My Sabrina measured smallish all along, then dropped off the charts the last month. But we were a lot farther along and she was still over 5 lbs at birth (almost 38 weeks). Take it easy, and relax as much as possible.