Intrauterine growth restriction

Mm.

When we are doing, say, V for caesars, or we have IUGR baby-

Mm

... that needs their histology done.

That is great news.

However, there can be a slightly increased risk of lower birth weight, although these children have not actually been diagnosed with FGR.

They just tend to be like 10 to 15, maybe 20% fetal growth on the lower end of the growth tables, but not officially FGR.

and there maybe is a slight bump in preterm birth, but that's not really a signal.

So short of it is, no, MS does not seem to increase miscarriage risk, stillbirth risk, or congenital anomalies, and this by itself is not an indication for surveillance unless there's something else going on.

And there's times when that hasn't been the case, but one of my children I was induced with for, uh, suppos- or not supposed, s- what am I, suspected? [laughs] That's what I'm trying to say/supposed because now after having a whole lot more perspective, I don't really think I had any problems.

But because they thought she had IUGR, I was induced early, so I can't count her into the data set because I didn't go into labor naturally.

Now, the other children I went into labor naturally, except for, um, two of them.

I have a theory about red raspberry leaf tea and starting it very early in your pregnancy and drinking it by the gallon, that babies actually come a bit later, and I, my sister has a bunch of children, same exact experience.

Yeah.

i think we drove home from that appointment in canberra just in silence in the car um just really processing um what she had sort of said i guess it was just like so did she give you reasoning behind it i think the reasoning was that they were looking at him and thinking this looks like a growth restriction um so Later down the track, he was diagnosed with a stage three growth restriction.

But I think they just prepare you for the worst, you know.

So they sort of were saying, were you moving to Canberra to be here for all of your appointments? And I said, well, no, I wasn't planning on moving to Canberra.

And he was he said, like, you have to stay.

and i didn't have a bath in hospital like i had to stay in

canberra um thankfully harl was with me so we we just talked over to dfo and grab some clothes but afterwards in the afternoon we had a meeting so we had a meeting with our specialist um with a surgeon the pediatric doctors and they kind of sit you down and say like guess because he had so many problems so one of the things that he had was at his 20-week scan you know that's the big one for measurements and they kind of check for fluid in the stomach so aside from the growth restriction he also had this issue where he had no fluid in his stomach on the 20-week scan which meant there was an esophagus issue i think the name that they used for that is esophageal fistula that he had so we had the surgeon come in and speak to us after our 20-week scan and say um He's got this, but they never really like spoke too much on that with us.

I don't remember really having a conversation around that until we were there for the 23-week scan when they made me stay.

Okay.

However, there are times, as we've already mentioned, where you're like, am I missing something here? What if I redate her backwards and I'm missing FGR? Or your head circumference, as we already mentioned, is just not adequate.

If your head circumference is off, it's not going to throw off necessarily your ear.

I mean, if your BPD is off, it's not going to throw off your head circumference, but it may throw off your headlock.

That's phenomenal.

You have a marker that is kind of sheltered from this variation all right so while hadlock has the one week uh off in first trimester two weeks off in the second and then three weeks off in the third as a general rule that discrepancy rule the the trans cerebellar diameter is immune to that meaning you can use that all the way up until like 34 to 35 weeks after around 36 weeks it starts getting a little bit more you know a little bit more curvy linear and you throw off a little bit of the accuracy But that's phenomenal.

So like in our case where the patient was, you know, around 28 weeks, maybe 29 weeks, and we're just not sure if we're going to redate her and potentially miss FGR, that cerebellum, which agreed that she was less pregnant than she thought she was, that's the win.

Now, you still need to do rate of growth to follow that up to make sure that the trend is correct.

Something that my OBGYN had told me when I was having my first one, because we did end up doing an induction for that baby.

He was an IUGR baby.

And so, you know, for him, it was a low and a slow.

But for me, he was like, I don't want to get you above a six to an eight.