Brief Answer:
STEROIDS SHOULD BE TAKEN.
Detailed Answer:
Hello XXXXXXX
Thanks for writing to us with your health concern.
Would you mind uploading the
ultrasound scans mentioned ?
As such, if the
BPD and HC are less than the fifth percentile, then there is definite
IUGR ( intra uterine growth restriction.)
If this is due to
placental insufficiency, then the baby would generally have reduced abdominal circumference ( AC ) compared to the BPD and HC, which will be well maintained.
When BPD and HC are specifically stunted in relation to the rest of the baby, the causes are generally infections or chromosomal anomalies, and then this would show from early on in
pregnancy, and not this late at 35 weeks.
Hence, I would like to look at the scans personally before offering a more specific opinion.
ALso, if truly the BPD and HC are showing the lag, yes Steroid injections are better given.
This is true that the maximum benefit is when delivery is within 7 days of administration of steroids, however, with such severe IUGR, if the picture deteriorates further, then delivery would have to be conducted anytime, so steroid administration is justified.
There are risks known with steroid injections, but the benefits outweigh the risks.
It is standard procedure to administer these steroids in case of severe IUGR.
Was a colour Doppler done, it should be done too.
ALso, ask your wife to keep strict tabs on fetal movements, ask her to lie down in the left lateral position three times a day, one hour each, after breakfast, lunch and dinner, and count the fetal movements.
Total of these 3 hours movements should be 10 or more.
Also, strictly monitor the blood sugars and blood pressure.
All the best
Please feel free to discuss further.