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
Sorry, I understand. It sounded similar to my situation and from what I've heard, many doctors can miss certain placenta issues. I just wanted to make sure her doctors were crossing all t's and dotting all the i's!
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.
Yes we could see the red and blue lines on the ultrasound going in and out. That means I had a high level ultrasound right? I had the panorama test which came back negative (low risk) for Ds early on. I'm sorry everyone, I know I sound really obsessive about this. The doctor I am seeing is well regarded and specializes in fetal intervention. I wish I could just trust his diagnosis of short baby and move on.
I believe so, yes.
I'm going to back out of this thread now. I'm sure you are under great care.
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.
Yes we could see the red and blue lines on the ultrasound going in and out. That means I had a high level ultrasound right? I had the panorama test which came back negative (low risk) for Ds early on. I'm sorry everyone, I know I sound really obsessive about this. The doctor I am seeing is well regarded and specializes in fetal intervention. I wish I could just trust his diagnosis of short baby and move on.
I believe what you're referring to is actually called an umbilical arterial doppler assessment. It's done during an ultrasound. Everything you're describing indicates that you had a high level ultrasound done by a MFM (doctor who specializes in a field called maternal and fetal medicine - basically high-risk obstetrics - but MFMs screen most normal pregnancies in our medical system).
EDIT - I know there is some conversation above about the medical details not being helpful, but for me personally understanding the medical process and what my doctors were doing actually helped alleviate some of my stress, so I hope I can offer some help in that regard.
Late to the game (and I haven't read all the posts) but I probably wouldn't seek a second opinion at this point. I'm sorry this is causing you so much anxiety. If I remember, your doc didn't want you on meds to treat your anxiety - I would push back on that.
Related to baby size, I've been on a roller coaster lately. At my 32 week appointment my fundal height measured 3 weeks ahead so my doc recommended an ultrasound at 34 weeks to check growth. That ultrasound showed that while the baby was 20th percentile for weight, the abdomen and head measurements were less than 10th percentile (red flag for IUGR). I had a follow up ultrasound last week at the hospital (MFM). The cord & placenta looked good and the baby's measurements were mostly around the 25th percentile. They were not at all concerned. Remember that all measurements have an error associated with them, baby's growth isn't necessarily constant, and different techs/docs can get different measurments from the same machine.
Just to note I didn't have the panorama or harmony tests; just the sequential screen and 20 week anatomy scan.
@bigreddog Thanks! I actually feel much better after visiting the MFM doc (my docs are regular obgyns). I even asked the MFM doc how I reconcile all the conflicting information I've received over the past few weeks and she basically said not to try. She didn't see any red flags with the ultrasound (she double checked the tech's measurments) and didn't recommend any follow up scans or interventions.
It sounds like you have wonderful care. I hope that you can find a way to reduce your anxiety. I can be an anxious person too and it sucks. ((Hugs)) to you!
Popping in to give lots of hugs and throw in my two cents.
I would not seek a second opinion at this point. The road we went down was awful and I wouldn't wish it on anyone. The distinction was that our MFMs kept telling us that they were concerned about what they were seeing. Your MFM (who you describe as highly regarded) is telling you that s/he isn't concerned.
At the end of the day, despite everything that they were seeing, nothing is wrong with DS*.
An early concern was placenta function, but that was ruled out after my SD ratio came back normal. Btw, the MFM never mentioned the SD ratio until I pressed, they just told me everything was fine. I am positive that your MFM has reviewed that. It's basic.
You had the panaroma and everything came back normal. Your OB thinks everything is fine. Your MFM thinks everything is fine. Nothing is altering the medical professionals to believe that you have anything but a healthy baby!
Maybe your therapist can give you tips to focus on something else?
*i will say that DS has a couple of lingering issues common in premature babies. They can't be directly linked, but I am so mad at myself for not trusting my gut that everything was fine during my pregnancy and telling the doctors that unless they had a definitive answer, they were not delivering me when they did. I was SO wrapped up in the numbers and in the what ifs that it consumed me and clouded my judgment. Your doctors are all telling you that everything is fine. It will all be fine.
I'm so sorry. I know what it's like to be told something isn't normal, but that there isn't anything to do to figure out why or whether it is indicative of/will cause issues.
I spent a good part of my pregnancy super anxious about things, googling and crying about the possibilities. It all turned out to be nothing, but it was still very stressful.
I would definitely let your doctor know how much anxiety this is causing you. Even if they could just take some time and talk through it with you, that might be helpful. I would write down questions after seeing the MFM and take them to my OB because I felt like I connected with her better, and she was willing to take more time with me.
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 from the first appointment, since I went off antianxiety meds to TTC at the suggestion of my doctor. The NP offered me an occasional med I can take for a panic attack but doesn't recommend starting me on anxiety meds this late in my pregnancy. lol. trust me, it's a catch 22 because I've gone in to every appointment and basically said "I'm really anxious about the affect my anxiety is having on my pregnancy.. is the stress affecting the baby? am I going to have PPD/PPA?" I've discussed with my doctors a few times now and there's really not much treatment being offered.
I'm just reading this thread and this is a huge red flag to me. Uncontrolled mood and anxiety disorders in pregnancy are the biggest risk factor for PPD/PPA. Honestly I would INSIST on a perinatal psychiatry consult or seeing a psychiatrist who specializes in women's mood and anxiety disorders as soon as possible. OBs and PCPs are not very aware of the risk/benefit profile of psychiatric medications in pregnancy and tend to overstate the risks and understate the benefits.