Trust the doctor or ask for another opinion?

[spankswife]

It's so hard not to obsess.

Maybe get a second opinion? It will either put your mind at ease, or maybe diagnose something your doctor missed. Hugs. Being pregnant is stressful.

[AmyRI]

Where are the ultrasounds being done? I'd be more likely to ask for a 2nd opinion if these numbers are from quick measurements in your OB's office, vs a standalone imaging specialty place. (For example, my NT scan was done with higher precision equipment by a better trained tech at a specialty MFM specialty practice.)

If there was an issue with the placenta, no part of the baby would be growing appropriately. It would not just be the long bones. I would also try to forget about the virus exposure. Even if there is a problem, there is no way to know if the exposure is what caused it.

If a second opinion is what will help you process the information, then by all means get it. But measurements are often wrong, especially when you get later in pregnancy. It's why weight estimates (usually based on estimated head size) are way off most of the time.

[Deleted]

I would go to an MFM at this point. They typically have better ultrasound equipment. They had to do a high level ultrasound on me last pregnancy and it took like 90 minutes so yes I would want to get a second look.

[miamigirl]

I'm sorry you're so worried. I'd get a second opinion if it makes you fell better.

[Deleted]

Mar 7, 2016 12:20:50 GMT -5 @bigreddog said:

Mar 7, 2016 12:19:45 GMT -5 @notquiteblushing said:

I would go to an MFM at this point. They typically have better ultrasound equipment. They had to do a high level ultrasound on me last pregnancy and it took like 90 minutes so yes I would want to get a second look.

my last two scans are from the MFM

And did (s)he address your concerns?  Is there a plan for another ultrasound in a few weeks? If you're still not feeling comfortable then I would try to either get a second opinion or schedule a followup appointment.

[laurenh]

It's really hard not to focus on stuff like this, first pregnancy or not!

ETA: sorry, hit send accidentally. I don't think it would hurt to have a conversation with your doctor to let them know you're concerned and ask if it could be worthwhile to have a higher level ultrasound done at an MFM. I don't know enough about Strep B but I did have a toxoplasmosis screen done at 34 weeks because of how small DD1 was, but I had also travelled to France earlier in my pregnancy. They told me it was unlikely but because my placenta was totally fine, we just used it as another piece of information. Hugs, I know this is hard.

[bearbaby]

It sounds like a second opinion would at least help ease your mind - and at this point, I think that seems reasonable.



Also - please be very clear to your OB how high your stress and anxiety levels. I say that with a lot of understanding and love - we have all experienced the stress and pressure of the 'unknown' in pregnancy, but strictly from reading, it appears your anxiety level has reached a point where you Dr should be made very aware.

Best of luck to you!

[Brie]

Mar 7, 2016 12:27:06 GMT -5 bearbaby said:

Also - please be very clear to your OB how high your stress and anxiety levels. I say that with a lot of understanding and love - we have all experienced the stress and pressure of the 'unknown' in pregnancy, but strictly from reading, it appears your anxiety level has reached a point where you Dr should be made very aware.

I agree.

If you are already seeing an MFM, and getting satisfactory answers to your questions, I would leave well enough alone.

Many, many parents on this board have birthed babies disproportionate to the size of the parents.  I myself had one very large baby and one small baby.  Additionally, growth is not linear in babies and children--one day my kid is all legs, the next day his shirt is too short because his torso stretched out.  Just pointing this out to say that there are many, many variations of normal.  Don't borrow trouble.

[kershnic]

You're obviously having a really tough time with this, I'm sorry. Have you gone back to talk to your doctor about your anxiety yet?

If you truly believe that seeing another doctor will help you calm down, then sure, go for it. But from what I remember from your previous post you've already been seen twice by an MFM. I strongly suspect they measured the pressure of the blood flow in the umbilical cord and didn't mention it to you because it was normal - plus there was no other indication of any issues. Growth restriction problems usually present with a restriction in the abdomen first, so having only the femur measurements be small is not consistent with placental breakdown.

Genetics are really complicated and weird. Babies do not just take on the average height of you and your husband. It's entirely possible for two average or tall people to have a short child.

You can't get tested for a virus because if you had one in the past it's out of your system.

I hope you can get some relief from your worries soon.

[glinda]

I agree that at this point, I would trust the MFM. They did a repeat ultrasound and told you it was perfect, yes?

It's hard not to stress when it feels like something coild be not quite right with our kids. I really think you need to be clear with your doctor about how much anxiety and worry you have. I know you said previously they thought it was insomnia related-did they give you something to help you sleep?

At 20 weeks DS2 measured in the 30th %ile. DH is over 6' and I am 5'. At 6 months he is now measuring in the 80th %ile. Don't obsess over how big he "should" be at this point--small newborns can still turn out to be big kids.

Hugs.

[bearbaby]

Mar 7, 2016 12:31:30 GMT -5 Brie said:

Mar 7, 2016 12:27:06 GMT -5 bearbaby said:

Also - please be very clear to your OB how high your stress and anxiety levels. I say that with a lot of understanding and love - we have all experienced the stress and pressure of the 'unknown' in pregnancy, but strictly from reading, it appears your anxiety level has reached a point where you Dr should be made very aware.

I agree.

If you are already seeing an MFM, and getting satisfactory answers to your questions, I would leave well enough alone.

Many, many parents on this board have birthed babies disproportionate to the size of the parents.  I myself had one very large baby and one small baby.  Additionally, growth is not linear in babies and children--one day my kid is all legs, the next day his shirt is too short because his torso stretched out.  Just pointing this out to say that there are many, many variations of normal.  Don't borrow trouble.

Furthermore to Brie's excellent point above, I am of higher-average height (5'7") and DH is 5'11". 

There has been NO baby on either side of the family born under 8lbs in 2 generations.  Almost every baby is closer to 9lbs, in fact.

DS was born at 6.8lbs.  He had measured very small at later scans - and every 'part' had a different % (larger abdomen, smaller legs, etc etc).  He went home at 6 lbs.  It will be the thing of family legend - everyone was in awe, as NO ONE in the family had ever experienced an actual skinny/scrawny newborn. 

So, assumptions regarding sizes with babies, particularly in utero, based upon parents/family etc are just guesswork.

For the record - DS is now ginormous.  GINORMOUS.  Babies just all develop a bit differently.  If the MFM/OB continue to be happy with your scans, possibly the best thing you can do for yourself is to step away from Dr. Google.

I sincerely hope that a) everything is fine (which, indications seem to be it is), and b) you are able to reach some measure of comfort.

[boiler717]

I would probably be worried, too, but trust the MFM. I would be upfront with my worries and ask for what I needed to help ease my mind -- a second opinion, more information, repeat scans.
I had a lot of pregnancy anxiety, specifically around stillbirth. My OB and I talked about it and he recommended twice weekly NSTs starting at 34w to help ease my mind. They did, and we also kept a close eye out for PPD/PPA as my risk was greater with pregnancy anxiety.
I hope the baby is okay and your mind is eased as well.

[undecidedowl]

Honestly? I would trust the doctor but let them know that I was feeling obsessive about the numbers.

[karinothing]

I understand being worried. If a second opinion will give you peace of mind I say go for it. For what it is worth, I don't think parents have much of an impact on the baby at birth. DH and I are both 5'6, DS1 was not even on the charts he was so small. DS2 is in the 80th percentile for height and weight.

[soozy87]

I think that this is one of those things that is so hard to get an accurate measurement for. Is there anything that can be done about it now anyway?

[soozy87]

Mar 7, 2016 14:16:12 GMT -5 @bigreddog said:

Mar 7, 2016 13:45:06 GMT -5 soozy87 said:

I think that this is one of those things that is so hard to get an accurate measurement for. Is there anything that can be done about it now anyway?

Well that's the thing.. if it's a chromosomal issue no they cannot but my doctor feels it's not.. if it's something related to the placenta or maybe even something I'm doing or not doing in my pregnancy, then it seems like there are some things that can be done like taking aspirin to increase blood flow or maybe my diet needs to be changed.. I've heard a few people say they had an infection/virus and it was treated with antibiotics or they were monitored and delivered early. I just don't want to ignore it and then find out later the baby has stopped growing completely. What is alarming to me is that the percentages keep dropping when they were average in early pregnancy. They aren't consistent either which is why I thought originally maybe it is dwarfism/SD but the doctor said there are other markets are not present and the percentage is not low enough to be concerned with this, it would have to be much lower.

Ok. Sounds like you are informed. \Both of my kids measured small stomachs and the doctors were worried they would be small. My first was, my second wasn't. But at 5 months my first weighed more than my second does at 5 months. What they told me was that someone has to be the first, tenth, fiftieth, ninetieth, etc, percentile. 

[mekia]

I hate worrying, I'm sorry. At this point I would bring up how worried I am and I would get a second opinion just for ease of mind. It'll be worth it to me rather than to worry for the next 12 weeks.

[redheadk]

I'd ask for your ob to go through everything with you from the tests and have her walk you through how she arrived at her opinion. Tell her that you are very concerned and want to be sure you are proactive about this. Just talk to her.

[jessnpaul]

I'm obviously not a doctor, but this sounds like what my son had: asymmetrical IUGR. His head was on track but his body ended up being 4 weeks behind in growth. As far as IUGR, asymmetrical is the better one to have... it means that the body is conserving energy to shunt the blood to baby's brain (which is obviously most important!)

I did have a placenta issue which was found early on. It's called velementous cord insertion, where the cord does not attach itself correctly to the placenta. They found it early on for me (17 weeks) but from what I hear many places miss it until after birth.

My son ended up being delivered at 32w because the cord blood started reversing... so if you do have a placenta issue, I'd make sure they checked for that. It's a higher level ultrasound machine that not all places have.

ETA: They did recommend baby aspirin during my pregnancy. I was also on hospital bedrest, but I think my doctors were overly cautious! 

ETA2: It was not a genetics issue in our case either. But we did do genetics testing after birth to rule out some other things! 

[NandaB]

Mar 7, 2016 12:27:06 GMT -5 bearbaby said:

Also - please be very clear to your OB how high your stress and anxiety levels. I say that with a lot of understanding and love - we have all experienced the stress and pressure of the 'unknown' in pregnancy, but strictly from reading, it appears your anxiety level has reached a point where you Dr should be made very aware.

Best of luck to you!

Quoting this again because its important

[kershnic]

Mar 7, 2016 14:38:57 GMT -5 jessnpaul said:

I'm obviously not a doctor, but this sounds like what my son had: asymmetrical IUGR. His head was on track but his body ended up being 4 weeks behind in growth. As far as IUGR, asymmetrical is the better one to have... it means that the body is conserving energy to shunt the blood to baby's brain (which is obviously most important!)

I am not a doctor either, but I did have an IUGR baby who was carefully monitored for potential cord flow issues and a lot of pregnancy anxiety - which translated to a whole lot of time learning about this with the help of my pediatric hematologist sister.  I just want to clarify that it is my understanding that what @bigreddog is describing is very different from what jessnpaul went through because jessnpaul's baby had a small abdomen, which is the initial presentation of these issues.

[jessnpaul]

Mar 7, 2016 14:50:00 GMT -5 @bigreddog said:

Mar 7, 2016 14:38:57 GMT -5 jessnpaul said:

I'm obviously not a doctor, but this sounds like what my son had: asymmetrical IUGR. His head was on track but his body ended up being 4 weeks behind in growth. As far as IUGR, asymmetrical is the better one to have... it means that the body is conserving energy to shunt the blood to baby's brain (which is obviously most important!)

I did have a placenta issue which was found early on. It's called velementous cord insertion, where the cord does not attach itself correctly to the placenta. They found it early on for me (17 weeks) but from what I hear many places miss it until after birth.

My son ended up being delivered at 32w because the cord blood started reversing... so if you do have a placenta issue, I'd make sure they checked for that. It's a higher level ultrasound machine that not all places have.

ETA: They did recommend baby aspirin during my pregnancy. I was also on hospital bedrest, but I think my doctors were overly cautious! 

ETA2: It was not a genetics issue in our case either. But we did do genetics testing after birth to rule out some other things! 

I spoke to the doctor and he said he thinks my only option at this point is an amniocentesis for peace of mind but he doesn't think I need it and that's for chromosomal issues which it doesn't matter, we will not change the course of pregnancy in any way. I don't want to take the small risk w the procedure. My doctor says the placenta seems fine. They did the scans at the MFM. They seemed to be 3d and my doctor is highly regarded. Is there another higher level ultrasound or are my scans coming from the high level ultrasound? How do they check the placenta? they said the blood flow looks fine.

My placenta issue was actually found during my amnio! I came back with a high risk for Down's (1 in 9 or 1 in 11... I forget) and I was so anti-invasive testing, but I felt I had to know if he had Down's so we could prepare. No Down's. But they doctor who did my amnio is the head of MFM and she was the one who noticed the cord issue. She had said sometimes it corrects itself, but in my case it didn't. 

Can they tell cord blood flow from the u/s machines they're using? Mine were in color... I could see red and blue on the screen. 

[jessnpaul]

Mar 7, 2016 14:58:35 GMT -5 kershnic said:

Mar 7, 2016 14:38:57 GMT -5 jessnpaul said:

I'm obviously not a doctor, but this sounds like what my son had: asymmetrical IUGR. His head was on track but his body ended up being 4 weeks behind in growth. As far as IUGR, asymmetrical is the better one to have... it means that the body is conserving energy to shunt the blood to baby's brain (which is obviously most important!)

I am not a doctor either, but I did have an IUGR baby who was carefully monitored for potential cord flow issues and a lot of pregnancy anxiety - which translated to a whole lot of time learning about this with the help of my pediatric hematologist sister.  I just want to clarify that it is my understanding that what @bigreddog is describing is very different from what jessnpaul went through because jessnpaul 's baby had a small abdomen, which is the initial presentation of these issues.

Yes, this is true. Sorry, I didn't realize @bigreddog's baby's abdomen was on track!

[kershnic]

Mar 7, 2016 14:50:00 GMT -5 @bigreddog said:

Mar 7, 2016 14:38:57 GMT -5 jessnpaul said:

I'm obviously not a doctor, but this sounds like what my son had: asymmetrical IUGR. His head was on track but his body ended up being 4 weeks behind in growth. As far as IUGR, asymmetrical is the better one to have... it means that the body is conserving energy to shunt the blood to baby's brain (which is obviously most important!)

I did have a placenta issue which was found early on. It's called velementous cord insertion, where the cord does not attach itself correctly to the placenta. They found it early on for me (17 weeks) but from what I hear many places miss it until after birth.

My son ended up being delivered at 32w because the cord blood started reversing... so if you do have a placenta issue, I'd make sure they checked for that. It's a higher level ultrasound machine that not all places have.

ETA: They did recommend baby aspirin during my pregnancy. I was also on hospital bedrest, but I think my doctors were overly cautious! 

ETA2: It was not a genetics issue in our case either. But we did do genetics testing after birth to rule out some other things! 

I spoke to the doctor and he said he thinks my only option at this point is an amniocentesis for peace of mind but he doesn't think I need it and that's for chromosomal issues which it doesn't matter, we will not change the course of pregnancy in any way. I don't want to take the small risk w the procedure. My doctor says the placenta seems fine. They did the scans at the MFM. They seemed to be 3d and my doctor is highly regarded. Is there another higher level ultrasound or are my scans coming from the high level ultrasound? How do they check the placenta? they said the blood flow looks fine.

They look at the placenta on ultrasound, and they measure the pressure of the blood flow in the umbilical cord. As I guessed earlier in this post, you have already had the testing people in this thread are suggesting.

[NandaB]

Mar 7, 2016 14:38:57 GMT -5 jessnpaul said:

I'm obviously not a doctor, but this sounds like what my son had: asymmetrical IUGR. His head was on track but his body ended up being 4 weeks behind in growth. As far as IUGR, asymmetrical is the better one to have... it means that the body is conserving energy to shunt the blood to baby's brain (which is obviously most important!)

I did have a placenta issue which was found early on. It's called velementous cord insertion, where the cord does not attach itself correctly to the placenta. They found it early on for me (17 weeks) but from what I hear many places miss it until after birth.

My son ended up being delivered at 32w because the cord blood started reversing... so if you do have a placenta issue, I'd make sure they checked for that. It's a higher level ultrasound machine that not all places have.

ETA: They did recommend baby aspirin during my pregnancy. I was also on hospital bedrest, but I think my doctors were overly cautious! 

ETA2: It was not a genetics issue in our case either. But we did do genetics testing after birth to rule out some other things! 

I think in this particular situation, where the OP has extreme anxiety and is obsessing over numbers and percentages it is not helpful and probably detrimental to her mental state to start guessing what we think it is or comparing it to us or someone we know. She is under a doctors care. She has had multiple scans. If there was a placenta or cord issue it would have been detected by now.

*I dont mean this to pick on you, but I'm worried that this is just going to give her something new to obsess about

[bearbaby]

I keep coming back in here, and getting concerned that you're continuing down the rabbit hole of obsession over these results despite the tests/etc (and I understand the stress of pregnancy worries - I really, truly do) but aren't acknowledging concerns about your anxiety level, at least outwardly.

You do not owe us anything in regards to updates/confirmations, but please, PLEASE hear the advice in here to seek treatment for your anxiety.

[glinda]

Mar 7, 2016 14:25:12 GMT -5 @bigreddog said:

Mar 7, 2016 12:37:07 GMT -5 glinda said:

I agree that at this point, I would trust the MFM. They did a repeat ultrasound and told you it was perfect, yes?

It's hard not to stress when it feels like something coild be not quite right with our kids. I really think you need to be clear with your doctor about how much anxiety and worry you have. I know you said previously they thought it was insomnia related-did they give you something to help you sleep?

At 20 weeks DS2 measured in the 30th %ile. DH is over 6' and I am 5'. At 6 months he is now measuring in the 80th %ile. Don't obsess over how big he "should" be at this point--small newborns can still turn out to be big kids.

Hugs.

I'm pregnant and worried the baby has stopped growing on schedule. If the growth was trending up (30 to 80) I wouldn't be concerned but the growth percentiles are dropping by quite a lot and they seem to be inconsistent with the head and abs in the high end 95 percent that people start to keep an eye on for other issues and the bone growth going lower and lower, now under 10 percent. I don't think it's the same as just jumping around in the average range.

I'm sorry, I must not have been clear--my story was more to say that the percentiles are not definitive in utero. DS2 trended at 20-30th %ile the entire time i was pregnant and is turning out to be a large baby. It was more to speak to your thought that the baby should be somewhere in the middle based on your height and your DH's height.

[speckledfrog]

You need to tell either your OB or your therapist (if you are seeing one) about what you are experiencing right now. You have a specialist telling you that things are okay. Your doctor can help you with the anxiety you are feeling.

[longtimenopost]

Based on everything you've said, I would trust the doctor.

[bearbaby]

Mar 7, 2016 15:20:15 GMT -5 @bigreddog said:

Mar 7, 2016 15:12:01 GMT -5 bearbaby said:

I keep coming back in here, and getting concerned that you're continuing down the rabbit hole of obsession over these results despite the tests/etc (and I understand the stress of pregnancy worries - I really, truly do) but aren't acknowledging concerns about your anxiety level, at least outwardly.

You do not owe us anything in regards to updates/confirmations, but please, PLEASE hear the advice in here to seek treatment for your anxiety.

I have seem my OB office for my anxiety and they are aware of this

I'm glad they are aware - and I wish you the very, very best as your pregnancy continues - hopefully with some answers that help ease your mind

(ETA: Edited your quote to just what I'm responding to - happy to edit out entirely if you'd prefer)