Saturday, February 11, 2012

IUGR and another "small" problem

Wikipedia(my new found love) defines Intrauterine growth restriction(IUGR) best(and simply): "IUGR refers to poor growth of a baby while in the mother's womb during pregnancy."  A broader definition would include the fact that an IUGR baby measures below the 10th percentile for its gestational age(and may include the 10th percentile)and whose abdominal circumference is below the 2.5th percentile

Of course simply put, there is nothing "simple" about IUGR. There are so many possible contributing factors. Poor Maternal nutrition and lack of oxygen to the fetus are leading factors.<- click) has a great list of probable causes, ranging from chromosomal abnormalities, diabetic causes, hypertension, infection and our very own blood clotting diseases.   

IUGR does have some unsettling facts that go along with it, it does increase fetal morbidity, in fact it is the 2nd leading cause of infant death. However, as the AAFP stresses, early detection & appropriate management can reduce the risk of infant death.   

Which comes to my next topic, and my clear recommendation. Detection of the problem?  Amniocentesis can help!

Amino-oh no..
Prior to this pregnancy if I was asked if I would like to have a amniocentesis I firmly objected. In my brain Amnio's were only used to rule out down syndrome and to give a person an option to abort. I am pro-life(although I do respect the opinions of others) and it wasn't a consideration of mine, not to mention there are some risks involved..   In fact when I found out my little one was small at 20 weeks, the Specialist threw the amnio word around and I must've had some rancid expression on my face because he said "I'll guess you aren't wild about that idea?"  "No, not at all" Was my response.  When, 2 weeks later, we went back and the baby had barely gained a single ounce he recommended it strongly, and we did it right then and there.  He wanted to check for infections & chromosome abnormalities. By this time we already had our 4G4G explanation, but he wanted to rule anything else out since I have had 2 relatively normal pregnancies that the 4G4G did not have an effect on.    I laid on the table while he did an ultrasound, looking for a good pocket of fluid, he poked around and made sure it is was a good spot(My placenta is anterior, so that complicated things a bit futher)  Finally they told me, "This will hurt a bit"  I am not normally a wuss, but I wasn't looking forward to this at all. There was pressure, and pain. I swear I could feel it through my feet, I tried my best not to tense up, but you do have a long needle in your gut, so you try it.. :-P .  The nurse asked if I was alright, "Yes"*moan* A few seconds later she asked if I was alright again, I Said "yes" once more, then she explained "Oh I meant him" Pointing to my dear husband who was a shade of green I didn't recognize on him.    It was over and done before I knew it, and I was advised to take it easy the rest of the day, no work for me, which was the best news I'd gotten by then.    All of my tests came out alright, and we concluded that the Lovanox was the best bet for me.   He has been growing, so hope is not lost yet.. 

I do recommend the Amnio's now. Its peace of mind.. No wondering about what could be going wrong. Its just not a fun procedure!  As I said before there are some risks involved, so please make sure your Doctor informs you of them.  Complete disclosure is a blessing. The main risk is fetal loss, but recent studies indicate this risk is about 1 in 1,600.  I was pretty comfortable with those stats, and mine went just fine. I was sore for a few days after, it was great sympathy fodder too HUH? I mean.. It shouldn't displace you for too long. If you have any concerns of course you should call your Dr. :)

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