IntraUtarine Growth Restriction.
A baby that is not growing as it should be.
Not just small.
Not just on the last percentile.
Not just the bottom of the average, as some babies must be.
A baby that is not thriving where it should be.
A baby that is deemed to be better out than in.
A baby at risk.
A high risk pregnancy.
When I was born, I was SGA. Small for Gestational Age. The doctors sent my mum for an x-ray as they were convinced she had her dates all wrong. I was born one week later, smaller than I should have been. My eldest was SGA. My third baby was SGA. These facts put me at risk for another SGA baby, or for an IUGR baby. For the record, SGA does not mean IUGR, but IUGR babies are all SGA. Still with me?
At my booking in scan, my consultant booked three growth scans for us and gave us a personalised growth chart. No more plotting my baby on the national average. This baby was to be measured according to what is normal for me. This was reassuring, but we were convinced that the growth scans were unnecessary. We’d had them with all three previously, one for each, and were told each time that baby was well. On the smaller side, but healthy and thriving and gaining weight well. We decided that we’d attend the first growth scan, but we’d probably request for the others to be cancelled. The biggest thing was that we wanted a VBAC. So we wanted to do what the doctors seemed to think was important. But if, as we were sure would happen, the doctors agreed that baby was growing well, we felt subsequent growth scans were pretty pointless.
So the first growth scan arrived at just over 29 weeks and from that point onwards everything changed.
IUGR had been mentioned in previous pregnancies, but always dismissed. This time though, we were told that baby might not be ok after all. There was no question that follow up scans would be necessary. Four weekly appointments were changed to two weekly, with a view to reaching 34 weeks gestation. Considering our first two were both born post 40 weeks, the idea of an early baby was a huge shock to us. We’d honestly assumed we’d be told all was ok, that baby was small but perfectly fine. Not so.
The second growth scan was devastating in many ways. It was found that baby was still small, and that blood flow from the cord was reduced. Baby was not receiving enough oxygen. Baby was starving inside of me. Not thriving. Not just small. Not just at the bottom of the percentiles. Not just SGA.
Appointments were amended again, this time to weekly and we were sent home with even more questions than before. We’re still unsure what it all means, and the only thing that is super clear now is that there will be no VBAC. There may be an early baby. There may be special care. There may be health issues later in life. There are so many may bes. There are no certainties.
During all of this, the one thing that has been drilled into me is to monitor baby’s movements closely.
I have never ever felt concern over this before. Three previous pregnancies and I had always felt confident that baby was well and kicking as it should be. This pregnancy has always been different though, even before we knew anything was wrong. Movements were late; later than previous pregnancies. Movements were scarce for a long time. We put this down to the position of the placenta, and we’re still told that the fact that it’s anterior could be the reason why movements are still not as noticeable as they are supposed to be. Following the second growth scan, I was put onto the monitor and everything seemed fine.
The next scan did not measure growth. Instead the fluid around baby and the flow from the cord was scrutinised, and all found to be within normal parameters. Hooray! Good news, at last. Although the doctors were careful to advise me that weekly scans were still necessary, and that baby was still small. It was also made clear that the results from the scan were normal today and may not be the same next time. Again, I was put on to the monitor to check baby’s movements and although they were definitely reduced from the last time, they were still sufficient enough for me to be allowed home. No decelerations and totally normal readings all round.
And so here we are. Days away from another scan, where I will be 33 weeks and 5 days pregnant. Potentially days away from delivery. The magical 34 week mark. And so many questions.
Is baby really IUGR? Or just SGA? Is 34 weeks really a suitable gestation for delivery? With each week that passes now, the risk of stillbirth increases, and yet there are risks associated with premature birth if they take baby too early. It is still hard for doctors to accurately diagnose and in many cases this can only be done once baby is here. If the birth day is at 34 weeks and baby is not IUGR, the chances of a fast recovery and minimal issues are great. If baby is IUGR, more help will be necessary. So many ifs!
We wait, and yet the waiting is excruciating. People keep saying that the longer they leave it, the more weeks that baby stays in, is better. But there will come a point where that is no longer true. There will come a point where baby is not moving as it should and they will decide to deliver. And I am so scared that they won’t make that decision at the right time.