Sunday, November 4, 2012

Fetal Growth Scan Details - Big head, Bad position

Well, my biggest fears were that the baby would measure too big and be out of position, and that's just what happened.  However, I think there's still quite a lot to be happy and hopeful about, and I'd like to remain hopeful until the end. To recap the events thus far, I was having a fairly normal pregnancy until I nearly failed my 1hr gestational diabetes test by 4pts.  I refused to take the 3hr test, but agreed to test my blood sugar twice a day as a back up method of determining if I had GD.  At the same 28 week appointment, my belly measured 4 weeks ahead or like that of a 32 weeks pregnant woman.  This was especially concerning to the Dr's because of the GD possibility, and a growth scan ultrasound was ordered.  I wasn't concerned about either issue, since I was fairly sure I didn't have GD, and my son had also been a big belly (though not a big baby). 

I really stressed myself out the week leading up to the growth scan.  I was pretty sure the baby would measure at least a week large because my son did, but I remembered in actuality he was only 7lbs 4oz at 41 weeks.  I was worried the oversized measurement in combination with the questionable GD diagnosis would lead to an induction.  An induction would probably lead to pitocin which I had a horrible reaction to during my son's incredibly long labor

But none of that would matter if the baby was breach, and I had a feeling that his positioning wasn't right. The night before the growth scan he was moving so much, and moved himself out of the position he'd been in for two weeks.  I was bummed about this because I'd never get confirmation that he'd been head down, and if I was right and he WAS head down, he wasn't anymore.  Growth scan day came.  The first of many, many questions I asked the tech was about the position, and she said transverse.  Not breach, but not head down either.

Hand blocking the way, but look at the nose/mouth!
He looks so much like DH to me!
Then we moved on to the measuring.  I pestered the poor tech with questions every step of the way.  She quickly double checked he was a boy (can you ever confirm the gender enough?) and verified normal fluid levels.  She then measured the size of the leg bone and it came out exactly at 31w+1d every time she measured it.  I was feeling confident.  Next, she measured the circumference of the abdomen, and it came out to 31 weeks exactly.  I was feeling even more confident!  All that was left was the head circumference measurement and we were home free.  It came out to 35w+4d.  Though I was reading it on the screen, I kept asking the tech if it was true.  "Does that say 35 weeks? Is that 4 weeks ahead? Do you have a good angle? Do you think this measurement is accurate?"  She answered yes to each question all the while trying to do her job.  She continued measuring and ended up throwing out the +4days measurements so the final head circumference was 35weeks exactly.  The head alone would surely be in the 90th or 99th percentile, but her machine only does an average of everything.  All together she came up with a baby measuring in the 76th percentile and estimated to  weigh 4lbs 4oz.  Obviously I take issue with that weight since only the head is measuring large, but let's move on to my consultation with Dr. J

The good news this week is that after looking over my blood sugar log, Dr. J sort of agreed that I don't have GD.  I'd never met this doc before, and she agreed with everything I said so readily I can't trust her.  I feel like she's just agreeing with me because nothing matters right now, and will change her tune if she happens to be on call during my birth.  However, I don't have to test my blood sugar anymore for the time being, and am happy about that.  Dr. J agreed my numbers were good and home testing wasn't necessary...for now. ("for now? What do you mean, for now?" I said in my head, but decided not open that can of worms.)

She also pointed out that babies don't come out transverse, and it becomes a very uncomfortable position as they get bigger.  She believes the baby will turn one way or the other before 34 weeks, and this sounds reasonable to me.  Plus, The little guy has already moved back to however he was before the scan.  Hopefully, that is head down and so this has already been resolved.  Dr. J said she didn't think the big head was a problem at all. (This is where I started to lose all trust in her. lol)  DH and DS were with me, and she observed that we were not a small headed family. HA! I couldn't argue with that, though ;)  She said even though it would certainly not be a problem for the birth, we should do another growth scan in 4 weeks or so, just to get a final estimation of the weight.  At that statement, red flags were jumping out everywhere.  If it's definitely not a problem, then why do we need another estimate?

My immediate feeling after the appointment was still relief.  The baby was healthy, and although my fears of a poorly positioned big baby had come true, at least now I knew.  I'm confident I can birth a big baby.  It's true I had a long and difficult labor with my 7lb baby, but I feel like he stretched me out and now I can do something bigger.  I've decided to go against my husbands wishes and try to see a chiropractor specializing in pregnant women. We'll be having that discussion tomorrow. UGH. I hope I can get an appointment!  If so, I feel like that will help out a lot.

Another thing I felt was peace.  I don't absolutely have to have a natural unmedicated birth.  I think a lot of the problems with my first birth resulted from me being inflexible.  I want to be more flexible with this birth.  I need to start being open to induction now so that if it comes to that I don't stall the birth process with fear and anxiety.  It's possible to be induced without the use of pitocin, and that's something to hope for.  I think it's likely the team of doctors at that practice will allow me to go past my due date without induction.  My due date is still 9 weeks away, and we've only had one challenging measurement.  Everything else with this pregnancy looks good, and I'm still feeling very positive about a natural birth.  As we get closer to the birth I want to remain open minded and flexible about my birth options, and thankful!  It looks like no matter how the birth goes, we're getting a healthy baby!

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