worried...IUGR, small babies, 32 weeks

Hi

My Baby B was just diagnosed with IUGR this week. Both babies have been running small and baby B has always been smaller but she is below the cut-off now. The weight estimates are 2lb. 11 oz. and 2lb. 14 oz, which are quite small when you look at the chart of expected weights. We are sure on the gestational age since these are IVF babies.

I am doing weekly NST/BPP and every other week growth scans. My doctor feels that it is very likely that we will need to deliver next week or the week after. Plus, he doesn't feel like they would do well with a vaginal delivery so we will do a c-section.

I know most babies at 32-34 weeks do well, but I wonder how the fact that they will be so small plays into it. Does anyone have any similar experiences? How long of a NICU time should I expect? Advice on c-sections? Reassurances?

Thanks - this site is great!

Suzanne
32 weeks with g/g twins

 

Hi

My Baby B was just diagnosed with IUGR this week. Both babies have been running small and baby B has always been smaller but she is below the cut-off now. The weight estimates are 2lb. 11 oz. and 2lb. 14 oz, which are quite small when you look at the chart of expected weights. We are sure on the gestational age since these are IVF babies.

I am doing weekly NST/BPP and every other week growth scans. My doctor feels that it is very likely that we will need to deliver next week or the week after. Plus, he doesn't feel like they would do well with a vaginal delivery so we will do a c-section.

I know most babies at 32-34 weeks do well, but I wonder how the fact that they will be so small plays into it. Does anyone have any similar experiences? How long of a NICU time should I expect? Advice on c-sections? Reassurances?

Thanks - this site is great!

Suzanne
32 weeks with g/g twins

 

First thing, have you had the steriod injections to mature their lungs?

Second my girls were 32+3, M wieghed 2 lbs 12 oz and B wieghed 3 lbs 12 oz. My girls were breathing on their own from birth, I had the steriod injections at 24 weeks with them. B spent 19 days in the NICU as a feeder/grower, basically she just needed to learn how to control her body temp and take all meals by mouth, she was 4 lbs 9 oz at discharge. M was in for 22 days, she was also a feeder/grower. She left the NICU at 3 lbs 7 oz, we had to buy a car bed for her since she was too small for a regular car seat. The only special precautions are that they cant be in really crowded areas for their health, just because all preemie are more likely to get ill and end up in the hospital.

Good luck and feel free to send me a PT if you need someone to talk to

 

Don't have any advice to give you. But just wanted to give you

 

Gestation is more important than size so your girls will probably be just fine. My littler one was 3 lb 15 oz at 35.3 weeks and she was born healthy. She did have to go to the Special Care Nursery for 7 days to prove that she could eat and grow but then she was discharged before her bigger sister who was in the NICU. Your girls will probably need a little help eating and keeping warm at first and they may even have slightly immature lungs but that is probably as difficult as it will get. Since you are 32 weeks you should ask your doctor about getting the steroid shots to help mature the babies' lungs before delivery. They are two shots taken over two days and the best time to deliver is 3-7 days after the first shot although the effects last up to two weeks.

I'm sorry you are having to deal with IUGR. It's one of those things that can make you feel as if you are doing something wrong but, believe me, you are not. It just happens sometimes when the placenta is functioning properly or the cords are inserted a little off to the side.

 

Just wanted to say keep your chin up! 32+ weeks is great! My baby B was diagnosed with IUGR at 20 weeks - right after we found out it was twins! And he's still growing! He's very small, but that's been 8 weeks ago and he's still growing! So there is hope!

My peri always reassures me that their weeks of gestation are way more important than weights.. hopefully that helps some.

good luck hun!

 

I am guessing you received the steroid shots when you had your initial bout with PTL but if not, like the others have said, I would talk to your doctor about them. I do believe they are helpful and the goal is to keep the babies in for 24 hours after the second shot which I don't think would be dangerous for you since you are currently doing weekly checks. If you have not received them I would call your doc today!

I am sorry to hear the stress you are under but please know that 32 weeks is a great accomplishment and sometimes in some situations the babies do better on the outside than in and that is ok. Like Ali said, it is not your fault and nothing you could have controlled. Modern technology and great medical care are wonderful things and notice things that I believe previously would have gone unnoticed/treated.

There are some recent threads on c-sections, if you have a few minutes you might want to check them out. In regards to NICU, it really all depends but rest assured that generally speaking there are likely to be little to no long term effects of their prematurity if they come soon. My guess would be NICU feeders and growers which means it will just take a little time before they are home! We do have a NICU forum here on TS that will provide you with a wealth of information from member's who have BTDT or are experiencing the NICU life now. You can find that forum here.

Please let us know about the steroid shots when you get a chance and we will be watching for an update after your next appointment!

 

quote:
First thing, have you had the steriod injections to mature their lungs?


If not I would ask for them.

My babies were born a lot earlier than you are, but not much smaller, well my son, in size. My DD was born at 25w3d and was 1 lb. 10 oz. and my son was born at 26w6d at 2 lbs. 7 oz. I did have the steroid shots 10 days before my DD was born. They were a lifesaver. My DD, even though born so early, was only on the vent for 4 days and my son never went on a vent at all!!! I attribute this to the steroid shots!!!

They both came home from the NICU together my DD was in for almost 10 weeks and my son was in for 8 weeks and 2 days (since they were born 10 days apart). They came home when I would have been 35 weeks pregnant with them weighing 4 lbs. 2 oz. and 5 lbs. 1 oz. We had a very easy NICU ride with my DD having an infection and needing 3 blood transfusions and my DS only needing 1 blood transfusion.

Today they are doing great. At 11 months both are eating well and crawling and getting into everything. As of right now they have no issues, except being on the low end of the weight chart, but they are on it!!!

I just wanted to reassure you that even the littlest babies can do so well. I think the smallest babies are the biggest fighters!!! Good luck.

 

I definetly agree with getting the steriod shots. My babies were 34 weekers and were in the NICU for 4 weeks( I personally think that they could have came home sooner also we kept them there longer since our son was sick with croup). They were in there as growers and feeders. They were good size for their gestational age though. I would think that size wouldn't nessecarily matter, but how they eat and breath on their own. I hope this helps.

I forgot to add that I had a c-section with these guys due to baby a being breech. My advice would be to take the pain medicine before the pain comes. Don't try to tough it out. I would also recommend getting up and walking (asap and a lot) around to get the bowels moving. My hospital offered me a stool softner and that was great to help things get going again. Also, one of the drinks I requested with my meals was cranberry juice. Last, but not least rest as much as possible! I know tough with new babies and especially if you have other kids. Good luck with everything!

 

I also recommend the steroid shots. I had my first round at exactly 24 weeks when delivery seemed somewhat imminent. But we held on a good long while and made it to just shy of 31 weeks before baby A PROM'd. I had a rescue dose of steroids and delivered 48 hours later, at exactly 31 weeks.

Lily (A) was 3lb4oz, and was on room air from the very beginning. Just needed to get over her A's and B's and learn how to feed and grow. She was in the NICU 34 days.

Grace (B) was 3lb8oz, and had to get some oxygen support via canula, then c-pap, then 2 days of vent. After that she was just on canula with pressure off and on. She had a PDA but it didn't affect her breathing or growth, so we just watched it and they think it is now closed. She spent 41 days in the NICU.

Today they are in the 25-50th percentile on growth, and you'd never know they were born so early or little. They are doing great.

GL!

 

My Jessy was an IUGR baby. The girls were born at 34 weeks because of Jessy's cord defect(2 vessels). At 34 weeks she was 2lbs 13oz{Jazz was 4lbs 9oz}. She was only on Canula for a couple of hours(I had steriod shots at 26 weeks){Jazz was on oxygen for 2 days}. She was in the Nicu for 25 days as a grower (she left at 4lbs 4oz in a carbed){Jazz left weighing 5lbs and some oz @ 17days}.

Jessy does have a heart murmur but otherwise she is a happy healthy 14 month old(she weighs 18lbs 6 oz). She has been a bit slower on her milestones and isn't walking yet. Jazz is 21 lbs and walking.

 

quote:
Originally posted by Babygus0:
Don't have any advice to give you. But just wanted to give you


Same here!

 

We went through this exact scenario, except our Baby B was diagnosed at 28 wks. We went to every appt wondering if that would be the day the peri/OB decided to deliver, or would we go another 3 days. As it turns out, we made it to 35 weeks on the day! This was a huge accomplishment. I ended up with pre-eclamsia and Baby B dropped to 0th %tile at the end.

They were born at 4.0 lbs and 3lb3oz, even smaller than estimated. Due to getting to35 wks, however, they had no respiratory or cardiac problems whatsoever. They were in the NICU for 3 weeks, just until they gained weight and strength enough to take all their feedings by mouth, rather than by nasal tube. They are PERFECTLY HEALTHY now.

Please feel reassured, follow your docs advice and stay in bed eating adn drinking protein shakes as long as possible.

The link in my siggy leads to our website and you can read the journal entries there. Also, click on my screen name in the top left and go to "view recent posts" if you want to follow our story through my posts and others' replies.

YOu can PM me anytime if you want to chat. Don't worry! 32 weeks is great already!!

 

Hi Suzanne,

Congrats on making it to 32 weeks!!!

We are survivors here of PTL, IUGR and Pre-eclampsia. Our girls, born at 35 weeks, 4 days, were 4 lbs., 10 oz., and 3 lbs., 2 oz. I had the steroid shots at 29 weeks. The pp are correct, gestational age is so much more important than size! It is good that you are being monitored so closely. The technology is so wonderful now. If problems are detected, you can be induced early. I know that concept is scary--I was induced at 35 weeks because they just weren't sure that little Reese was getting enough nutrients anymore, and since I was pre-eclamptic, it was no longer a question of just my life. I agreed to the inducement, and was so glad that I did. Once out, she was able to get the nutrients she needed. Our girls only did 2 weeks of NICU time. Granted, it was the longest two weeks of my life, but the wonderful Drs. and Nurses were able to do for her what my body was not capable of. As is normal, both girls lost some weight initially, but by the time they came home, our littlest girl was exactly 3 1/2 lbs. That is a tiny baby to take home! Riley has almost caught up with where she should be for her age, she is probably on the small side of average. Our Reese (nicknamed "shrinky-dink") is about 2 lbs. smaller than average, but doing wonderful! Neither one of our girls has had any major development delays and are progressing just fine!

Best of luck as you finish out the rest of your pregnancy...we'll be waiting for you on the first year board!

Robynn

 

I know some of our members have had to deliver at 32 weeks for IUGR with one or both twins with good outcomes. Make sure you have the steroid shots and if its been a long time (month or so) ask about getting one more booster shot.

C-SECTION ... Make sure you have panties that are going to fit you snugly. That helps a lot. Take the meds they offer, don't be super woman! As soon as you can get up and move around, the better. It's not that bad but it takes some time to recover. Make sure you have help for a few weeks.

Best of luck!

 

Thank you so much for all the responses! They really do make me feel better. You know how it is, you get the diagnosis, then get online and do research and find out about all the worst possible outcomes. It's really good to hear about all the good ones.

I did have the steroid shot series at 24 weeks due to PTL. My doctor has decided not to redo it since one of the side effects of the steroids is to slow down growth.

My next appt. is Wednesday for an NST. If that is normal, they will let me go 1 more week, but will probably not let me go any longer than that. I will keep you updated, and again thanks so much!

Suzanne
32 weeks w/ g/g twins

 

sorry i'm joining this thread late...but here is my story.

My boy (baby b) was diagonsed as IUGR at my 25 week u/s (my peri did them in her office). She agreed to keep me pregnant as long as he showed growth every two weeks. I started my NSTs at 28 weeks (I think, it's already a blur) and I got the steriod shots. I was also on bedrest due to high bp and we felt it might help Jake.

At my 35 week u/s she measured the kids, Jake was est. to be 4 lbs 4 oz and Becca was 5 lbs 5 ounces - we delivered at 36 weeks and as you can see from my sig, they were both smaller. However, Becca was given to me right away and while Jake spent almost two weeks in the NICU, it was as a feeder/grower. Also, I think he would have come home sooner if they had dealt w/his low blood sugar earlier. While it was sad to come home with only Becca, it gave us some time to adjust (we are first time parents). What killed me was going back and forth to the hospital while recovering from the c-section. Although at 2 weeks post-op, I feel much better.

As others have said, gestional age is key - Jake and Becca are in great shape and I attribute that to their being 36 weeks.

Good luck and feel free to PM me w/ques!
Miriam

 

I was told that my girls were only 3 lbs the week before my delivery. The doctor told me that I must keep these babies in as long as I could because they were just too small. I was scared to death when I went into labor. Was expecting the worse, but you can see from their weights that they were much bigger than expected. They had no problems whatsoever. I hope that your babies weigh much more than expected as mine did.

 

Thanks. I would like to think that my prenatal weights are wrong and they weigh more. That would be great. I don't find out for awhile still.

Thanks again,
Suzanne

P.S. Utopia 122 - Our baby B is to be named Grace Allison! I thought that was a funny coincidence.

 

Well done on getting so far. 32 weeks is a brilliant milestone. Mine were born at 32.4 weeks and weighed in at 3lb 4 and 4lb 5 they didnt need any oxygen at all and basically all we had to do was to wait for them to grow so they could get out. x

 

We found out at 24 weeks that one of the twins is IUGR. Since then, we've been going for weekly u/s and our 'goal' is to get to 32 weeks. I will keep you in my thoughts & prayers and hope that your little one continues to grow!

Keep us posted and good luck-

 

I am new to this site. I am also preggo with identical twin girls. I am only 31 weeks, 32 wks this Friday. Last Tuesday I went in for my reg check up & baby B was diagnosed with IUGR. The doc said that she had been around 18-20% thru out the preg & baby A had been around 28%, but since Dec 28th, she had dropped to 10%. They went ahead & gave me the steroid injection & scheduled me to see a specialist this Wed & then back to see him on Thurs. I have been so scared all weekend. He obviously wants me to go until 36 wks, but I'm so afraid it will be this weekend. I'm glad to hear that gestational age is more important than weight. On the Dec 28th appt Baby A (kaylee) weighed approx 2.9 & Baby B (Sarah) weighed approx 2.3 lbs. I didn't even ask what the weights were last week. I was to shocked!!! Everything had been going so great so far & then last week it was like a ton hit me when he said she wasn't growing as well & we might have to deliver after the 18th. I know I will be 32 wks by then, but it just scares me so much! I can't stand the thought of something happening to one of them. And I can't imaging seeing them in the NICU. I knew that was a possibility from the start, but I was hoping it wouldn't happen. Anyway, thank you all for the positive remarks. It's comforting to know that others have went thru this & all should be ok.

Jessica P

 

32 weeks is a great point to be if you have to deliver early. My girls were delivered at 32 weeks 4 days and spent a little over 3 weeks in the NICU, mostly as feeders/growers. The first few days they were on a cpap but did very well after that. Now they are almost a year old and are doing very well. They are both very healthy and on the growth charts for their ages. When they were born they were 3 lbs 3 ozs and 3 lbs 13 ozs.

Seeing your children in the NICU is HARD. I never imagined how hard it would be. I just felt helpless but you just have to remember they are in the best place so they can get strong enough to come home. And talk to others who have been there. It really does help.

And FYI - girls are supposed to do better if born early than boys.

c-section - I too say take the pain meds BEFORE you feel the pain. I made the mistake of not doing that and regretted it. Also move around asap to help you heal faster.

Angela