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Induction for small baby

12 replies to this topic

#1 glowlight

Posted 14 February 2014 - 08:57 AM

This is my second pregnancy and first time everything was textbook - went into labour naturally 3 days before EDD and had no major issues. This time up until last month everything was also textbook, apart from transverse position but baby turned at 35 weeks. Then my fundal height measurement started deviating from my dates (same ob measuring both pregnancies). I'm currently over 5 cm behind. I also haven't gained any more weight in the last month. I had a 12kg gain overall but this stalled and I wasn't big to begin with. Ob was concerned and sent me for 2 scans, 2 weeks apart. Both showed baby is small but gaining weight, fluid level is normal and blood flow is normal so no placenta issues that could be identified. Predicted weight at 37 weeks was 2.5kg. DS was 2.95kg at full term and I was born at 2.8kg. Ob said because of the scan results she is ok not to intervene right now but wants to induce me sometime at 39 weeks and definitely not let me go post dates (her policy is usually to go over 10 days before induction). She also wants to do a S&S next week (I'll be  38+3). I'm debating whether to agree to an induction or insist on waiting. DH wants me to insist on waiting to go naturally but there's always that 'what if..'. I know that scans are notoriously inaccurate, but I went to a reputable place where they specialise in pregnancy ultrasound and it makes sense for baby to be about this size at 37 weeks. Does anyone have any similar experiences? I am aware of induction risks.

#2 kristylee21

Posted 14 February 2014 - 09:10 AM

So baby is growing, has plenty of fluid, a good heartbeat and is measuring within normal range?? Why does he feel the need to induce you then? I would be asking for a follow up scan before any intervention and if baby is still growing normally then i would want to wait and not be induced. I've always measured small with both my babies, currently measuring 35 at 39 weeks but have had growth scans in both pregnancies show no reason to induce. dd was born 2.89kg

#3 glowlight

Posted 14 February 2014 - 10:36 AM

Thanks for your reply. The answer to those questions is yes. I already had 2 scans in the last 2 months, both normal. At over $300 a pop I can't afford any more. Baby is tracking to be close to 3kg at full term too which is similar to ds. She is concerned by the reduction in FH and lack of weight gain, that's why she wants to induce. Only because the baby kept on being on the 10th percentile and growth was steady, she is letting me go until over 39 weeks.

#4 Bunsen the feral

Posted 14 February 2014 - 10:51 AM

Wouldn't the change from transverse position explain the irregular fundal height measurements?

#5 glowlight

Posted 14 February 2014 - 11:16 AM

not really, I was only a week off or spot on eve with transverse position, now baby is head down but my FH is more than 5 weeks out.

#6 Bunsen the feral

Posted 14 February 2014 - 11:58 AM

But the change happened around the time the position changed?

FWIW My second baby's FH measurement was all over the place, some weeks up 4 cm, next week under by 2 - he was posterior, not sure if that makes a difference generally - 4.1kg baby. My first consistently measured only 1cm over dates but weighed in at a whopping 4.75kg so I'm not convinced of the reliability of FH if everything else is going ok.

#7 Wellie

Posted 14 February 2014 - 01:04 PM

I'm in a similar position to you, FH started measuring 2cm, then 4cm behind from about 20 weeks. Now am 38 weeks with FH of 31...

I've been sent for regular scans from about 24 weeks to check growth. Even though the FH seems to be lagging further and further behind, the scans have been showing growth (~20th percentile) so my Obs doesn't seem worried about it. Sorry I don't have more helpful information, other than FH not always being a good/accurate measure of growth.

 glowlight, on 14 February 2014 - 10:36 AM, said:

She is concerned by the reduction in FH and lack of weight gain, that's why she wants to induce.

Is she concerned about lack of weight gain for the baby or you?

Good luck!

#8 crocodilessnap

Posted 14 February 2014 - 01:27 PM

I was induced at 38wks due to a small baby (diagnosed as small for gestational age) and as the placenta function had detoriated significantly in a fortnight. My FH started to decrease at 24 weeks but they didn't become concerned til 33wks and I had growth scans every 10-14 days after that til I delivered. Added to this I also had threatened labour at 34wks that they managed to stop and periods of reduced movements. Needless to say there was a lot happening and I was on first name basis with the ladies in the maternity assessment unit.

Personally for you id request another scan at 10-14 days after your last one to see how bub is tracking. Though I understand that the $$ can be hard to part with so maybe you could ask for some ctg monitoring and if bub is doing ok then ask about just waiting for things to start naturally.

I will agree though that the fact the FH issues came to light when bub turned makes me think that may be why bub is suddenly measuring smaller.

#9 glowlight

Posted 14 February 2014 - 01:45 PM

 wellie, on 14 February 2014 - 01:04 PM, said:

I'm in a similar position to you, FH started measuring 2cm, then 4cm behind from about 20 weeks. Now am 38 weeks with FH of 31...

Is she concerned about lack of weight gain for the baby or you?

Good luck!

me. Baby gained 400g in a fortnight which is normal. FH issue only came to light from 36 weeks and I haven't gained any more weight since that's why ob is concerned. If it was FH on its own she would probably not worry so much. Scan was last week and all was normal other than baby in the 10th percentile which given my genetics is not  surprising. Just debating whether I should fight my ob on the induction issue or go with it since I'll be almost at EDD.

Edited by glowlight, 14 February 2014 - 01:45 PM.

#10 Wellie

Posted 16 February 2014 - 05:52 AM

Good luck whichever way you decide. At least your ob is keeping a close eye on things in case they deteriorate.

Fingers crossed you make it close to your EDD.

#11 wannabe30

Posted 16 February 2014 - 08:09 AM

Personally, I'd pay the $300 for another scan in a few weeks.

But if the money is really an issue, can you ask to have the scan done at the hospital on Medicare?

#12 Soontobegran

Posted 16 February 2014 - 08:25 AM

I understand why you are confused. All seems to be progressing normally and some babies are born smaller than average......that is why there is an average BW of 3.4.....some are bigger and some are smaller.

That being said I do not think it is a bad thing that your obstetrician is being vigilant as when term approaches there is a natural reduction in placental well being and amniotic fluid levels which could result in a drop in nutrition for an already small baby.

I'd be arguing the need to induce at 38.8 but I'd definitely want another ultrasound to check things are still tracking along happily.
Can you possibly ask to have it done at an U/S place at a major public hospital to reduce costs?

Lots of luck.....

#13 glowlight

Posted 18 February 2014 - 08:17 PM

Thank you for those replies. Saw my ob today. I've gained a kilo and FH increased by 2cm so didn't have a S&S. Waiting to see how it goes next week. Hoping to go into labour naturally then like I did with ds:)

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