When is growth restriction significant?

Hi,

I'm a little stressed because my baby girl's growth has slowed. She had always measured a little ahead of the boy until two weeks ago. My doctor doesn't seem too worried but of course I am...we had a growth scan two weeks ago and her abdomen was measuring 2 weeks too small, otherwise she was normal and she weighed in at approx 4-6 (plus or minus a lot!). The boy was 4-13 at that time. Today they did another scan and her abdomen is now measuring 3 weeks too small, and her weight was estimated at 4-13. The boy's is now approx 5-11. I get myself worked up because it's harder for me to know when I'm feeling her. The boy is obvious, way on the left, and I don't feel as much centrally or on the right. I go for NSTs twice a week which is reassuring and so far they have been great. But they're always telling me to do my kick counts and honestly I don't know when she's kicking. My OB says if her growth restriction becomes severe or if she hasn't grown by next Tuesday's growth scan, they will deliver them. But I don't really know what severe growth restriction means. It makes me sad to think she might not be getting what she needs.

Any thoughts? Thank you!

Edited to say: I forgot to mention she's in the 16th percentile whereas she used to be around the 50th...

 

I have no advice... I can just say I relate to your worry and hope all is well with the little one. kick counts are a pain with twins... I know your frustration!

take care and hope all goes well. Keep us updated.

paige

 

My doctor has told me that they don't really worry about it until it is over 25% difference between the two babies (which it doesn't look like it is 25% yet with your babies). I don't know what the reasoning behind that percentage is exactly. Mine have been measuring way apart for a while (over a pound), but the doctors keep telling me it is okay. Sounds like your are being closely monitored, so that is good.

 

I'm so sorry you're having to deal with this. She could just be in a difficult position to get a good u/s. Dax was estimated by u/s and four different midwives feeling my tummy to be 7.5 lbs. He was actually 2 lbs larger than that. Since you are almost 36 weeks I would go ahead and deliver if things don't look better on the next u/s. There is a very, very good chance your twins are just fine to come out. My 3.15 lb girl born at 35.3 weeks had to stay in the hospital for 7 days to prove she was growing but she was perfectly healthy. We'll be keeping you in our thoughts and prayers. I know it's so, so hard not to worry about a baby that is smaller than the other. :hug99:

 

Thanks so much for your support. Ali, your little girl was so small, how fortunate that she gained weight well once she was born. That has me feeling hopeful. Today's NST and AFI were really positive, although she has now turned transverse which explains why I can't always distinguish her kicks. I'll let you know how my growth scan goes Tuesay

 

Definitely keep us posted. I have found that Baby B is always more difficult for me to feel. Sometimes, it seems like he is on the side/in the back and that is why. The DR says it's just the positioning that makes it harder to feel him. It's still scary.
I'll be thinking of you and can't wait to hear how the apt. goes next week!
You're almost there!!!
~Erin

 

Growth scans are estimates and can be around a lbs off. Jessy had a 40% difference from Jazz

 

At my 25 week growth scan, Jake was diagonsed as IUGR - he had a 8 ounce discordance from Becca (which was quite significant at that point) and I was put on bedrest. She kept me pregnant as long as he kept growing (which he did, more or less). As you can tell from my signature I delivered at 36 weeks and Jake was quite small (so was Becca) - but he is just fine.

At this point in your pregnancy it's not surprising growth is slowing - those weights sound good and your gestation is great. Also, the NSTs are quite important and as long as the kids aren't showing signs of distress it all sounds good. I agree w/Ali though, if she does stop growing, I would discuss whether the dr thinks it's better to deliver her. At 36 weeks (or almost there) you are in great shape.

Overall, I wouldn't really worry to much - sounds like everything is going great.

 

Akameme,
Did you go into labor on your own or did they deliver the twins early because of the growth issue?
Thanks for the help!

 

We had a big discordance. At my 35 week u/s my boy (B ) measured 7lbs. My girl (A) was 4lbs 1oz. That was a one ounce increase from two weeks earlier. The way they explained it to me was that the further along you are, the harder it is to get accurate measurements. She did gain so they waited. I delivered exactly two weeks later. She was 6lbs 2oz. Her brother was 8lbs 3oz. It's hard not to worry, but the odds are in your favor!

 

QUOTE(jenanne @ Jan 27 2008, 04:15 AM) [snapback]591422[/snapback]
Akameme,
Did you go into labor on your own or did they deliver the twins early because of the growth issue?
Thanks for the help!


At my 35 week appointment she did a growth scan and i said can we discuss delivery? She said sure, what's good for you and I said how is next Thursday I'll be 36 weeks exactly? She called the hospital and scheduled my c-section. Other than b-h contrax I never experienced labor.

Miriam

 

We3 delivered at 34 weeks because of our size difference and growth rare. Jess was almost 2 lbs smaller

 

I just wanted to post a little update. Things sounds better today. In comparison to the scan *three* weeks ago, her abdomen is still measuring a couple weeks behind, but it has maintained growth, so the perinatologist is not concerned at this point. I'm 36 weeks now, so today was my last growth scan (wow) but we'll keep doing the twice per week NSTs and AFIs to make sure they are happy and healthy. I'm relieved, but still wishing the C date were closer to 37 than 38 weeks.

 

You're almost there - hang in and take it easy. U/s estimation of weight is OFTEN not very reliable. Fingers crossed that evrything goes smoothly for you!
Angela

 

Thanks Angela,
You're so right about the u/s weights. Today mine were 5.7 and 5.11 plus or minus 13 ounces!!!!! So little girl could be 4.10 or 6.4. Crazy.