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Old 03-05-2010, 07:28 PM   #1
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Unhappy Another IUGR baby???

OK Mamas,

Long story short... My oldest DD (now 2) was born (Induction) at 36w weighing 4lbs. She was in the less than 3% from 20 weeks on. I did take the steroids they pushed at me to make her grow to get her here a decent size. She now has "issues" that are a whole different topic I had low water was the reason for induction. (well that was the reason my BPP/NST scores changed)

2nd DD born 5lbs 8oz Induction @ 36w due to what the OB swore was placenta abruption... It was NOT! Not problem the whole pregnancy, just a induction happy DR at the end.

I am now pregnant (20 something weeks lol, I can't keep it straight, Due July 4th) and already the baby is showing signs of IUGR. She dropped from the 75% to the 18% in about 6 weeks. (had a few repete u/s to confirm this) This is the same thing that happened to DD1... Anyone had low % and carried full term or very close? I have switched OB's this pregnancy b/c old OB and I didn't see eye to eye. I know I'll be having this baby early b/c of my medical nonsense (bicornuate uterus, MTHFR, protien C and S deficiencies, elevated homocystien, ect...) but hope to make it to at least 36w, further would be great. I have to be induced b/c of the meds I am on (Lovenox and then Heparin) I have to be off for X hours before delivery to prevent me from bleeding to death. New OB says 36w is our goal. IF baby thrives. Baby is not thriving at this point.

I will put her health first and if she will "grow better out" as the DR put it last time, that's fine. I just don't want all these unnecessary things done. Part of it is the fact that DD1 is special needs. She has a LIST of medical problems that I can't help but wonder were caused by the IUGR or possibly the meds (steroids) that I had to take. I also don't want to risk her being in the NICU or anything like that. I can't stand the thought of my child hooked up to anything like that and it literally makes me sick to think about it. Both DD1 and DD2 stayed with me the whole time at the hospital thanks to my great Pedi! No medical interventions for either. I can't help but think I'm not going to be so lucky this time

I'm sorry to vent, but I really thought this pregnancy was going to be an easy one Any advice, suggestions, or stories that might make me feel better???

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Old 03-05-2010, 07:44 PM   #2
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Re: Another IUGR baby???

My 5th DD was an IUGR baby. Induced at 35 weeks due to my BPP/NST scores.

I was told that after 36 weeks the rate of death in utero increses dramatically for IUGR babies, so it was NOT an option for me to carry her any further. Of course, some babies would be fine but it was not a risk I was going to take. My DD was born and was healthy but low weight. She is now HUGE at 3 years old and off the charts.

IUGR is a tough diagnoses, but I would ask your doctors LOTs of questions regarding carrying to term. I think 36w is a reasonable goal for an IUGR baby as long as numbers are steady and placenta and fluid levels are functioning normally.

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Old 03-05-2010, 07:58 PM   #3
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Re: Another IUGR baby???

Thanks I am at risk for preterm for multiple reasons 36w would be ok, but like with DD1 they are pushing steroids, which I am refusing. Not saying they caused my DD's problems, but I'm not willing to risk it either.

DD1 they started doing BPP/NST at 22w and at 26 weeks started saying it could be delivery day any time now 36w was a blessing.

New OB hasn't voiced her opinion on all of the IGUR yet (will see her again on the 11th) just wanted to confirm it before worrying me.

We know she will be here early b/c of my history and IUGR. We have even flubbed to family about when I am really due to keep them from worrying that she will be a "burden" as the call DD1 (which really ticks me off) All we say is in June which is likely true. That;s part of the reason I can't remember exctly how many weeks I am. I am due July 4th. If she comes in May they will not panic as much and make me so crazy, you know? Sad that we have to do that but DH's family is a bit.... Well I don't know the nice word for nosey and think know better that I do about my own children...
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Old 03-05-2010, 09:01 PM   #4
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Re: Another IUGR baby???

I was diagnosed with IUGR with my DS at 35 weeks. I have a bicornuate uterus too, so we weren't super surprised by it. He was measuring 31.5 weeks at that point and seemed to not grow over the next week. I had BPP and NST's every 3 days for the rest of the pregnancy. He always passed them great and I ended up having him 2 days after my due date and he was 7 lbs! So obviously I did not really have IUGR. We are not sure why he always measured so small on u/s, but in the end it was fine. You have had a lot more complications than I have and truly did have IUGR, so I don't know how much my story really applies, but in my case, the u/s measurements were not accurate. There is only so much it can really tell you. I hope that your new OB gives you great care and that the rest of the the pregnancy goes easy on you.
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Old 03-06-2010, 01:31 PM   #5
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Re: Another IUGR baby???



What were the steroids for? All I've ever heard them for is to help mature baby's lungs in case (or if) they are born early. I had them with my first set of twins, who were born at 35wks and are perfectly fine. I also had them with these twins, who aren't here yet. Have you researched them to see if there is any link? I would do that. (I didn't.) Since you know baby will come early, you want the lungs to be as mature as possible.

As for the IUGR, I don't really know anything about it. The thing I would suggest is research, research, research. Knowledge is power. You are your baby's best advocate (and your own). So, arm yourself with all the knowledge you can find.
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Old 03-07-2010, 11:33 AM   #6
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Re: Another IUGR baby???

Have you considered seeing a Peri? My DS measured small but OB did a BPP at like 32 weeks and was happy with his results. He was born at 38 6/7 weeks weighing 6lbs 6 oz and 19 3/4" long. DD measured very small too (5% at 36/37 weeks) never measuring above 33 weeks gestation as far as size went. I had several BPP u/s' that all indicated possible IUGR and low fluids. I was set for induction at 37W 4D but was already 4cm's dialted so all my OB had to do was stip my membranes. DD was born at 37 4/7 weeks weighing 5lbs 14 oz and 19 1/2" long.

This time my OB (have had different ones for each pg) sent me to a Peri for my NT scan and after he read my history with my DD he said that at 24 weeks he wanted to do a uterine artery scan to check the blood flow going to the uterus. If it was restricted then we would have several BPP u/s' etc to watch for IUGR and watch the growth and fluid levesl very closely.... He is very proactive in finding out if their is a physiologic reason for my babies to measure small for dates or if it's just genetics. He did tell me at my BIG u/s last week that if you have had a IUGR baby your chances for a repeat IUGR baby are 20%. He also said to start taking a baby asprin a day as it helps with IUGR.

If I were you I'd ask for a referall to a Peri so you can get a specialists opinion and experience.
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Old 03-07-2010, 11:50 AM   #7
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Re: Another IUGR baby???

The steroids are to make her lungs mature to prepare her for a premature delivery I am completely against vax, so this is a hard pill for me to swallow. I saw a peri my DD1 pregnancy and refuse to go back for many reasons. I was told to terminate and try again with her. (I am completely against it and they kept pushing me to do so saying SO many things were wrong. Funny that the prolems she does have are none of those they said she would!) They were completely cold hearted and had BAD bedside manners. They also only want to deliver at a hospital where I don't want to deliver. They are the only ones in our area and people states away are actually sent here to see them.

Please don't lecture me, but I have been doing a little research myself, even found a few threads here, about a DNR for this baby. Of course I want this baby and her to be healthy, but how much intervention is too much? My hubby doesn't express his opinion in any of this so it's kinda left up to me I hate to even be thinking about this at this point, but it's been on my mind ALOT lately.


I don't mind NON invasive testing (u/s, bpp/nst, blood tests) but I don't want to risk her any more than I have to. I also have 2 other children that I am the sole provider for. My husband works LONG hours and only sees them (b/c of bedtime and work conflict) for about 10-15 minutes before bed. They don't stay with sitters and I can't trust his family at all. My mom lives hours away and works full time too I know I'm whining and I apologize.

I almost feel like an idiot for leaving my last OB. He was very proactive in making sure nothing went wrong. He was my primary and I saw the Peri's secondary to him. He was very careful with us, but I just didn't like him jumping the gun an inducing every time. He was great other than that and his office staff (well 1 particular one) was horrible to me. I've only met my new OB once and she wanted to have my anatomy scan done and results before we really talked. I go back Thursday and hopefully will get the answers that I need.


Oh why can't I be normal and have a MW or HB????? That was my plan before I ever found out I was pregnant the first time.

Sorry for venting ladies.
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Old 03-07-2010, 11:59 AM   #8
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Re: Another IUGR baby???

again mama, i know its tough.

The steroids they give you are the same as the steroids naturally produced in your body, they just give your baby's lungs a healthy boost. I am sure no one can say whether the steroids proved to be a part in your other DD's issues. Steroids have been used routinely to save babies lives every day. I was told there was NO difference in the makeup of the steroid shots Vs. the steroids you produce in your own body. The shot they give you is NOT the same steroid as what body builders use.


It just seems that this shot could save your unborn childs life....and you are willing to risk your baby dying by not getting it... I understand that you could be scared that the same thing would happen to your DD as your other DD, but it seem unrelated to me, seeing as this steroid is used every day with healthy outcomes. This steroid is the same as what is produced in your body and the amount your unborn will receive is enough to mature the lungs. Just seems like a small price to pay for a healthy baby...with issues or not, i would want my child living (barring and MAJOR issues like severe brain damage etc.) I can deal with learning/behavioral/minor brain damage etc.


Can I ask what issues your other child have that you think may be related to the steroid shot?
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Old 03-07-2010, 12:13 PM   #9
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Re: Another IUGR baby???

Everyone seems to think the general consensus is that they are 100% safe. Here is a list of side effects from the manufacturer:

Reactions
Anaphylactoid reaction, anaphylaxis, angioedema.

Cardiovascular
Bradycardia, cardiac arrest, cardiac arrhythmias, cardiac enlargement, circulatory collapse, congestive heart failure, fat embolism, hypertension, hypertrophic cardiomyopathy in premature infants, myocardial rupture following recent myocardial infarction (see WARNINGS), pulmonary edema, syncope, tachycardia, thromboembolism, thrombophlebitis, vasculitis.

Dermatologic
Acne, allergic dermatitis, cutaneous and subcutaneous atrophy, dry scaly skin, ecchymoses and petechiae, edema, erythema, hyperpigmentation, hypopigmentation, impaired wound healing, increased sweating, rash, sterile abscess, striae, suppressed reactions to skin tests, thin fragile skin, thinning scalp hair, urticaria.

Endocrine
Decreased carbohydrate and glucose tolerance, development of cushingoid state, glucosuria, hirsutism, hypertrichosis, increased requirements for insulin or oral hypoglycemic adrenocortical and pituitary unresponsiveness (particularly in times of stress, as in trauma, surgery, or illness), suppression of growth in pediatric patients.

Fluid and Electrolyte Disturbances
Congestive heart failure in susceptible patients, fluid retention, hypokalemic alkalosis, potassium loss, sodium retention.

Gastrointestinal
Abdominal distention, bowel/bladder dysfunction (after intrathecal administration), elevation in serum liver enzyme levels (usually reversible upon discontinuation), hepatomegaly, increased appetite, nausea, pancreatitis, peptic ulcer with possible perforation and hemorrhage, perforation of the small and large intestine (particularly in patients with inflammatory bowel disease), ulcerative esophagitis.

Metabolic
Negative nitrogen balance due to protein catabolism.

Musculoskeletal
Aseptic necrosis of femoral and humeral heads, calcinosis (following intra-articular or intralesional use), Charcot-like arthropathy, loss of muscle mass, muscle weakness, osteoporosis, pathologic fracture of long bones, postinjection flare (following intra-articular use), steroid myopathy, tendon rupture, vertebral compression fractures.

Neurologic/Psychiatric
Convulsions, depression, emotional instability, euphoria, headache, increased intracranial pressure with papilledema (pseudotumor cerebri) usually following discontinuation of treatment, insomnia, mood swings, neuritis, neuropathy, paresthesia, personality changes, psychic disorders, vertigo. Arachnoiditis, meningitis, paraparesis/paraplegia, and sensory disturbances have occurred after intrathecal administration (see WARNINGS, Neurologic section).

Ophthalmic
Exophthalmos, glaucoma, increased intraocular pressure, posterior subcapsular cataracts, rare instances of blindness associated with periocular injections.

Other
Abnormal fat deposits, decreased resistance to infection, hiccups, increased or decreased motility and number of spermatozoa, malaise, moon face, weight gain.
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Old 03-07-2010, 12:16 PM   #10
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Re: Another IUGR baby???

Also during pregnancy :
Pregnancy
Teratogenic Effects Pregnancy Category C
Corticosteroids have been shown to be teratogenic in many species when given in doses equivalent to the human dose. Animal studies in which corticosteroids have been given to pregnant mice, rats, and rabbits have yielded an increased incidence of cleft palate in the offspring. There are no adequate and well-controlled studies in pregnant women. Corticosteroids should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Infants born to mothers who have received corticosteroids during pregnancy should be carefully observed for signs of hypoadrenalism.
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