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What Does Lagging Growth Of Fetus And Excess Fluid During Pregnancy Indicate?

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Posted on Thu, 4 Dec 2014
Question: Hi .. i would like to ask a question ..

Am 31 weeks and 6 days pregnant according to the doctor calculations .. but it shows at the ultrasound that am 29 weeks .. 20 days different .. the doctor told me that the water around the baby had increased to 30cm .. and the baby is small she weigts 1 kilo and 300 grams .. also they did ultrasound twice and they couldnt see the stomach .. the dr told me that they might need to deliever the baby earlier ..
Please let me know whats going on .. I'm worried .. shall i have to deliever ealier?? Is there anything wrong with my baby girl???
doctor
Answered by Dr. Timothy Raichle (46 minutes later)
Brief Answer:
Growth problems and extra fluid

Detailed Answer:
Well, I am sorry to hear about this situation, but my goal is to help you get a better understanding and decrease your anxiety about this situation. First, I have a few questions:
1. Have there been any other problems in this pregnancy?
2. Diabetes? High blood pressure?
3. What specific medical problems do you have?
4. Is there any significant family history?
5. Why were they doing this scan? Were they concerned about the growth before the scan was done?
6. Did you have a scan at 20 wks and was it normal?

Thank you
Dr. Raichle
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Timothy Raichle (1 hour later)
I dont have any problems .. dr told me that everything was fine .. my blood pressure normal.. i dont have any medical issues and no family history .. she asked for the ultra sound because the baby smaller and she wanted to check why there is a different .. the difference started on 12 weeks .. before that evwrything was normal .. i had 20 weeks ultrasound and everything was fine
doctor
Answered by Dr. Timothy Raichle (2 hours later)
Brief Answer:
Fetal concerns.

Detailed Answer:
So, you had a pregnancy that is uncomplicated and you went in for a regular visit at which time you were felt to be measuring smaller. The ultrasound showed lagging growth of the fetus and excess fluid, as well as the finding of difficult visualization of the fetal stomach. As far as you know, there are no concerns about you specifically, and all of the concerns are regarding the baby.

Fetal growth restriction (called IUGR) has many causes. Some of these are related to diseases of the mom, and some are related to problems with the baby. You have not been given much information and the "we might need to deliver early" is not a good enough answer. The following needs to happen:

1. You need consultation with a high-risk OB, called a Perinatologist
2. They need to repeat the scan and go through the entire anatomy with you
3. Specifically, babies with GI abnormalitites can present with IUGR and excess fluid - this should specifically be addressed.
4. You might be a candidate for an amniocentesis to check the chromosomes of the baby
5. In the meantime, you need to be followed at least twice weekly to perform testing on the baby until this gets sorted out

Please let me know what other questions you have.

Dr. Raichle
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Timothy Raichle (1 hour later)
Thanks a lot for your kind response its really appreciated ..

Does this happen often to pregnant women?? I mean is it something that can happen to anyone??

And if so.. do you think that things can be normal later on? I mean they can be wrong ??Or there will something??

Does this effect my baby when its born ?? Or its something easy and it can be resolved ??

Doctor told me if the baby is not growing well.. they might need to deliver the baby earlier .. so is this fine ?? Do you think that's necessary to do an early delivery? I mean before i reach my due date ??
doctor
Answered by Dr. Timothy Raichle (1 hour later)
Brief Answer:
Many questions - see answers below:

Detailed Answer:
1. These problems are not uncommon, the causes are varied
2. Yes, these problems do not discriminate and they can happen to anyone
3. If the baby is falling off of the growth curve, unless the ultrasound is wrong, this will not correct later. Babies, though, may start to grow normally once they are born in many cases
4. Yes they can be wrong, but it clearly sounds like the baby is lagging in growth and the fluid definitely sounds like it is in excess
5. Depending on the cause, your baby may or may not be affected after the birth. It could be anything from nothing to the extreme of needing surgery after birth - you just will likely not know until the birth
6. In IUGR pregnancies, the ultimate goal is just to make it to 37 weeks and go ahead with delivery. So yes, your baby will be born early.

Again, I will recommend that you seek a consultation to discuss the results of the ultrasound better. It is not uncommon to see extra fluid and it does not mean anything, but I think there are concerns regarding the baby because its growth is lagging. This is still your child and you will love them no matter what, and in all likelihood they will do just fine. You just need to be informed so that you know what things to expect.

Let me know if I can help further.

Dr. Raichle
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Timothy Raichle (35 hours later)
Am sorry but i have one more question .. am 31 weeks and 4 days .. but my baby measures 20 days smaller.. but the doctor told me that she's growing and gained weight .. doctor told me that she gonna keep the baby at least until 34 weeks and then she will see if its necessary to make me deliver earlier or to keep the baby inside ..

My question is .. if the baby born on 34 weeks ... would it be as same as babies that born on 34 weeks or 20 days smaller ??
doctor
Answered by Dr. Timothy Raichle (58 minutes later)
Brief Answer:
The gestational age matters more

Detailed Answer:
That is actually a great question. The gestational age of the fetus is what matters the most. A small kid at 34 weeks will always do better that a large kid at an early gestational age. Typically, at 34 weeks, babies do the same, long-term, as babies born at term (37-41 wks). They just necessarily spend some time in the neonatal ICU.

Again, I will reinforce my prior plan for you as stated in my prior answers. I wish you the best of luck. It sounds like you are otherwise receiving appropriate care.

Dr. Tim
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Timothy Raichle (31 minutes later)
Yeah because I went to abother doctor .. i think she's better than the one i used to go to ..

But still she didn't see the stomach .. she saw a small black spot.. a very small ..

So what do you think dr?
doctor
Answered by Dr. Timothy Raichle (13 minutes later)
Brief Answer:
No change in answer

Detailed Answer:
My answer is exactly the same. There is some concern about the lack of something in the fetal stomach and extra amniotic fluid. Babies normally swallow the fluid and this fills the stomach. If they cannot swallow appropriately, then the fluid accumulates and the stomach does not fill. That is why I suggested that there may be some problems with the baby. These are called GI tract abnormalities. With this new doctor, you should specifically ask about this issue. Given that I cannot see the pictures, I am only guessing about possibilities.

Dr. Tim
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Timothy Raichle (5 minutes later)
This means that there is a stomach ??

And if there's a problem in swallowing .. does it dangerous ?? And needs difficult operation? Or it easily can be solved??
doctor
Answered by Dr. Timothy Raichle (1 hour later)
Brief Answer:
Yes there is a stomach

Detailed Answer:
I would prefer not to go through the "what if's" if this situation. I am a general OB/GYN and you need a consultation with a high-risk OB. There may be absolutely nothing wrong with this baby, and it is likely that none of this will be sorted out until after the birth.

It sounds like you have a great new OB Provider. Please ask them if they have any input on these specific questions. The benefit of our interaction is that you now have a framework for thinking about this situation and formulating questions. Try not to worry too much - you appear to be getting appropriate care.

Thank you for the question and I wish you and your baby well.

Dr. Tim
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
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Answered by
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Dr. Timothy Raichle

OBGYN

Practicing since :1999

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What Does Lagging Growth Of Fetus And Excess Fluid During Pregnancy Indicate?

Brief Answer: Growth problems and extra fluid Detailed Answer: Well, I am sorry to hear about this situation, but my goal is to help you get a better understanding and decrease your anxiety about this situation. First, I have a few questions: 1. Have there been any other problems in this pregnancy? 2. Diabetes? High blood pressure? 3. What specific medical problems do you have? 4. Is there any significant family history? 5. Why were they doing this scan? Were they concerned about the growth before the scan was done? 6. Did you have a scan at 20 wks and was it normal? Thank you Dr. Raichle