How accurate is a level II US for weight? (Late Term)

[[email protected]]

Some of you may remember me posting weight problems with our baby 2
weeks ago. Well shes due on the 14th and they are telling us that the
baby still has not grown enough. Hes about 5 pounds. My question is I
see alot of people say let term Ultrasounds are not accurate. What
about level II and bio physical profiles? They are talking about
inducing her. Im not sure what to do.

[Donna Metler]

FWIW, my perinatologist told me that the level III U/S/BPP could still be
off by a lb either way-which is one reason that he felt safe going ahead and
letting me deliver when she measured 6 lbs 10 oz at 35 weeks rather than
trying to stop labor, because she'd still be at a healthy birthweight, even
if it was a lb heavy.

So, the weight may not be accurate. However, if the baby hasn't grown enough
in 2 weeks, it still may be reasonable to induce early, since IUGR is judged
based on growth, not on weight, especially since you're effectively at
full-term. What does the BPP look like? How is the oxygen and nutrient flow
to the baby?

--
Donna DeVore Metler
Orff Music Specialist/Band/Choir
Mother to Angel Brian Anthony 1/1/2002, 22 weeks, severe PE/HELLP
And Allison Joy, 11/26/04 (35 weeks, PIH, Pre-term labor)

[[email protected]]

They said the BPP looks normal as they can tell. They also said the
placenta flow looks fine as well. I was feeling ok about this and now
Im a wreck again. What is the point of inducing this late?

[Nikki]

wrote:
> They said the BPP looks normal as they can tell. They also said the
> placenta flow looks fine as well. I was feeling ok about this and now
> Im a wreck again. What is the point of inducing this late?

Because sometimes the babies are better off out then in.

I don't have any specific advice since I'm not that knowledgeable but I
strongly recommend that you get a second opinion. I went for a second
opinion at the end of my second pregnancy. I felt a lot more at ease and
comfortable with the final decision. That feeling can really affect the
birth experience IMO.

--
Nikki

[Ericka Kammerer]

wrote:

> Some of you may remember me posting weight problems with our baby 2
> weeks ago. Well shes due on the 14th and they are telling us that the
> baby still has not grown enough. Hes about 5 pounds. My question is I
> see alot of people say let term Ultrasounds are not accurate. What
> about level II and bio physical profiles? They are talking about
> inducing her. Im not sure what to do.

Accuracy is quite low. How worrisome are the actual
values? The trend is more important than single values. Is
the baby growing? Not growing? Growing, just slowly? Are
we talking about a baby who is in the 10th percentile, or
one who is off the charts? Are we talking about a baby
who is growing a tad more slowly that usual, or one who
nearly isn't growing?
If there is evidence that the baby really isn't
being adequately nourished in utero, then induction may
well be warranted. The key is to distinguish this
situation from a situation where the baby is just a tad
smaller than normal or growing just a tad slower than
normal.

Best wishes,
Ericka

[Ericka Kammerer]

Nikki wrote:

> wrote:
>
>>They said the BPP looks normal as they can tell. They also said the
>>placenta flow looks fine as well. I was feeling ok about this and now
>>Im a wreck again. What is the point of inducing this late?
>
>
> Because sometimes the babies are better off out then in.
>
> I don't have any specific advice since I'm not that knowledgeable but I
> strongly recommend that you get a second opinion. I went for a second
> opinion at the end of my second pregnancy. I felt a lot more at ease and
> comfortable with the final decision. That feeling can really affect the
> birth experience IMO.

I would agree with getting a second opinion--try to
find someone who has a really good reputation. If everything
else looks normal, I'd be reluctant to induce if the other
indications were borderline rather than significantly abnormal.
Still, I'd probably feel a bit more comfortable with a second
opinion. Also, ask for lots of details. Ask what precisely
the worry is, and how likely it is to happen. If the answers
sound more like CYA than real arguments, that's something
to weigh as well.

Best wishes,
Ericka

[Donna Metler]

> wrote in message
ups.com...
> They said the BPP looks normal as they can tell. They also said the
> placenta flow looks fine as well. I was feeling ok about this and now
> Im a wreck again. What is the point of inducing this late?
>
Same as inducing at any other point-if the situation is such that the baby
is healthier outside than in, or the mother's health is such that she can't
physically carry longer without risk to her, it is reasonable to consider
delivering early. If the baby truly isn't growing in utero, it might be
better for the baby to be delivered early.

[Johns News]

Well at 36 weeks the baby was 4.10 pds. 2 or more weeks later he is only 5
pds even. We kind of got a second opionion because this came from the Doctor
at the hospital who goes over the results of the BPP. The OB was going to
call us back with how to proceed but of course he didnt as this isnt deemed
an emergency. At least to him...

He has grown, the rate is very slow according to them. They said he should
have grown 1/2 pd a week. They also say other than size there doesnt seem to
be anything else wrong thats visable and hes extremely active. It figures,
its going to be maddening til the end. My wife mentioned that they told her
her uterus may be small and restricting growth.

-John

"Ericka Kammerer" > wrote in message
...
> wrote:
>
> > Some of you may remember me posting weight problems with our baby 2
> > weeks ago. Well shes due on the 14th and they are telling us that the
> > baby still has not grown enough. Hes about 5 pounds. My question is I
> > see alot of people say let term Ultrasounds are not accurate. What
> > about level II and bio physical profiles? They are talking about
> > inducing her. Im not sure what to do.
>
> Accuracy is quite low. How worrisome are the actual
> values? The trend is more important than single values. Is
> the baby growing? Not growing? Growing, just slowly? Are
> we talking about a baby who is in the 10th percentile, or
> one who is off the charts? Are we talking about a baby
> who is growing a tad more slowly that usual, or one who
> nearly isn't growing?
> If there is evidence that the baby really isn't
> being adequately nourished in utero, then induction may
> well be warranted. The key is to distinguish this
> situation from a situation where the baby is just a tad
> smaller than normal or growing just a tad slower than
> normal.
>
> Best wishes,
> Ericka
>

[H Schinske]

wrote:

>Some of you may remember me posting weight problems with our baby 2
>weeks ago. Well shes due on the 14th and they are telling us that the
>baby still has not grown enough. Hes about 5 pounds.

He was estimated at four pounds at 36 weeks, right? And this is just about two
weeks later? This puzzles me. I was under the impression that it was the
*difference* between two measurements that was the best evidence whether the
baby was growing appropriately, and if they have measurements estimating a half
a pound a week weight gain, that sounds absolutely average, and on track to be
six pounds at term, well out of IUGR range I would have thought. Perhaps
there's a specific measurement or two that isn't going up as much as they'd
like to see? I just don't know.

--Helen

[Johns News]

Hi Helen,

If he was 4.10 pds at 36 weeks and now only 5 pds even thats only a 6oz
weight gain. A 1/2 pd would have been 8 oz so they are saying hes shy 10 oz
in the last 2 weeks of what he should be. At 36 weeks they said he should
have been at least 5 pds. Now at 38 weeks hes just hit 5 pounds. Thats the
concern I guess. So I guess at his current rate he would weigh in at around
5.6 pds on her due date. They just dont think hes growing fast enough.

"H Schinske" > wrote in message
...
> wrote:
>
> >Some of you may remember me posting weight problems with our baby 2
> >weeks ago. Well shes due on the 14th and they are telling us that the
> >baby still has not grown enough. Hes about 5 pounds.
>
> He was estimated at four pounds at 36 weeks, right? And this is just about
two
> weeks later? This puzzles me. I was under the impression that it was the
> *difference* between two measurements that was the best evidence whether
the
> baby was growing appropriately, and if they have measurements estimating a
half
> a pound a week weight gain, that sounds absolutely average, and on track
to be
> six pounds at term, well out of IUGR range I would have thought. Perhaps
> there's a specific measurement or two that isn't going up as much as
they'd
> like to see? I just don't know.
>
> --Helen

[Irrational Number]

As one person's experience, my baby was
measuring 7 lbs by ultrasound about two
weeks before birth and at birth, he was
9.5 lbs.

-- Anita --


wrote:

> Some of you may remember me posting weight problems with our baby 2
> weeks ago. Well shes due on the 14th and they are telling us that the
> baby still has not grown enough. Hes about 5 pounds. My question is I
> see alot of people say let term Ultrasounds are not accurate. What
> about level II and bio physical profiles? They are talking about
> inducing her. Im not sure what to do.
>

[Emily]

Johns News wrote:

> Hi Helen,
>
> If he was 4.10 pds at 36 weeks and now only 5 pds even thats only a 6oz
> weight gain. A 1/2 pd would have been 8 oz so they are saying hes shy 10 oz
> in the last 2 weeks of what he should be. At 36 weeks they said he should
> have been at least 5 pds. Now at 38 weeks hes just hit 5 pounds. Thats the
> concern I guess. So I guess at his current rate he would weigh in at around
> 5.6 pds on her due date. They just dont think hes growing fast enough.
>

By 4.10 pds do you mean 4 lbs 10 oz?

Emily

[Johns News]

Yes 4.10 at 36 weeks. He is 5 pds now at 38 weeks.

"Emily" > wrote in message
news:ZR4Bd.829982$8_6.661823@attbi_s04...
> Johns News wrote:
>
> > Hi Helen,
> >
> > If he was 4.10 pds at 36 weeks and now only 5 pds even thats only a 6oz
> > weight gain. A 1/2 pd would have been 8 oz so they are saying hes shy 10
oz
> > in the last 2 weeks of what he should be. At 36 weeks they said he
should
> > have been at least 5 pds. Now at 38 weeks hes just hit 5 pounds. Thats
the
> > concern I guess. So I guess at his current rate he would weigh in at
around
> > 5.6 pds on her due date. They just dont think hes growing fast enough.
> >
>
> By 4.10 pds do you mean 4 lbs 10 oz?
>
> Emily

[Emily]

Johns News wrote:

> Yes 4.10 at 36 weeks. He is 5 pds now at 38 weeks.

That makes more sense. I'd first read 4.10 as 4 and
1/10 pounds, which would mean nearly 1/2 lb gain per
week.

Emily

[Larry McMahan]

> wrote in message
oups.com...
> Some of you may remember me posting weight problems with our baby 2
> weeks ago. Well shes due on the 14th and they are telling us that the
> baby still has not grown enough. Hes about 5 pounds. My question is I
> see alot of people say let term Ultrasounds are not accurate. What
> about level II and bio physical profiles? They are talking about
> inducing her. Im not sure what to do.
>
After reading the other replies, I will now stick my oar in the water...

I am not completely clear on how slow the weight gain is. I would
consider waiting at least another week and doing another u/s. If the
weight gain percentage is no worse, I would continue to wait at least
until week 40 and perhaps beyond. 5 pounds at week 38 is a bit low
but not out of the normal range. I would probably wait to see something
on the u/s like placental calcification before agreeing to induction.

Just my $.02

Larry

[Anne Rogers]

>> They said the BPP looks normal as they can tell. They also said the
>> placenta flow looks fine as well. I was feeling ok about this and now
>> Im a wreck again. What is the point of inducing this late?
>>
> Same as inducing at any other point-if the situation is such that the baby
> is healthier outside than in, or the mother's health is such that she
> can't
> physically carry longer without risk to her, it is reasonable to consider
> delivering early. If the baby truly isn't growing in utero, it might be
> better for the baby to be delivered early.
>
but given here the only issue seems to be the weight, I would want to
continue the pregnancy with careful monitoring, early induction carries a
high risk of c-section. If the placenta is functioning fine, you wife may
just be programmed to produce small babies.

[Ericka Kammerer]

Johns News wrote:

> Well at 36 weeks the baby was 4.10 pds. 2 or more weeks later he is only 5
> pds even. We kind of got a second opionion because this came from the Doctor
> at the hospital who goes over the results of the BPP. The OB was going to
> call us back with how to proceed but of course he didnt as this isnt deemed
> an emergency. At least to him...
>
> He has grown, the rate is very slow according to them. They said he should
> have grown 1/2 pd a week. They also say other than size there doesnt seem to
> be anything else wrong thats visable and hes extremely active. It figures,
> its going to be maddening til the end. My wife mentioned that they told her
> her uterus may be small and restricting growth.

Okay, here's an article that gives some guidelines for
diagnosing IUGR and conditions for induction.

http://www.aafp.org/afp/981015ap/vandenbo.html

You'll note that the table on induction doesn't recommend
induction for BPP scores over 6, which I would imagine your
wife's is if they said everything looks fine. So, that would
be one thing to look at. You may need to talk to your doctor
and get a lot more precise numbers. Ask for actual test results
and actual percentiles, not just overall assessments like
"fine" or "normal."

That article also gives you situations where suspected
IUGR can be more worrisome than others; for example, you might
be more conservative in your approach if your wife's blood
pressure has been high.

It does appear that the baby is low on the percentiles
for growth (by weight--you should also check size by head
circ and ratio of head circ. to abdominal circ), but does
not appear to be dropping much by percentiles, which may
point more towards a constitutionally small baby, especially
given the good BPP results.

I would want to exercise a little caution because *if*
the baby is just constitutionally small and *if* the baby is
being well-nourished inside, it may actually benefit this
baby to cook *longer* rather than shorter. You need to
distinguish, to the best of your ability, whether the baby
is just constitutionally small but well-nourished or
whether the baby is small due to lack of nourishment.

Best wishes,
Ericka

[Pologirl]

Johns News wrote:
> > Well at 36 weeks the baby was 4.10 pds. 2 or more weeks later he is
only 5
> > pds even.

Is that 4 pounds, 10 ounces, which is about 4.6 pounds; or 4.1
pounds, which is about 4 pounds, 2 ounces?

Either way, remember that the error on any weight estimate from
ultrasound, at this point in the pregnancy, may be a pound or more.
So your baby *may* actually have gained a perfectly normal amount
of weight during the past two weeks. The physicians cannot know
that the baby has gained insufficient weight, and because most
babies do gain well and your baby's other metrics look excellent,
the conservative (meaning medically responsible) thing for these
physicians to do now is...nothing.


Ericka Kammerer wrote:
> You need to
> distinguish, to the best of your ability, whether the baby
> is just constitutionally small but well-nourished or
> whether the baby is small due to lack of nourishment.

John says the physicians told him the baby is extremely active.
So the baby *is* well nourished. A poorly nourished baby will
*not* be extremely active. This is a key point; don't let it
get lost amid all the details and what-ifs.

[Anne Rogers]

> http://www.aafp.org/afp/981015ap/vandenbo.html
>
Thanks for posting that Ericka, I've bookmarked it for later reference.

[Johns News]

This is very interesting. My wife is very pro listening to the doctors where
I am much more cautious. By my estimation the baby would be 5.6 pds at 40
weeks. That only 2 ounces from the so called healthy birth weight. I will go
over these things with the doctors and post back as well.

Thank you all!

John
"Ericka Kammerer" > wrote in message
...
> Johns News wrote:
>
> > Well at 36 weeks the baby was 4.10 pds. 2 or more weeks later he is only
5
> > pds even. We kind of got a second opionion because this came from the
Doctor
> > at the hospital who goes over the results of the BPP. The OB was going
to
> > call us back with how to proceed but of course he didnt as this isnt
deemed
> > an emergency. At least to him...
> >
> > He has grown, the rate is very slow according to them. They said he
should
> > have grown 1/2 pd a week. They also say other than size there doesnt
seem to
> > be anything else wrong thats visable and hes extremely active. It
figures,
> > its going to be maddening til the end. My wife mentioned that they told
her
> > her uterus may be small and restricting growth.
>
> Okay, here's an article that gives some guidelines for
> diagnosing IUGR and conditions for induction.
>
> http://www.aafp.org/afp/981015ap/vandenbo.html
>
> You'll note that the table on induction doesn't recommend
> induction for BPP scores over 6, which I would imagine your
> wife's is if they said everything looks fine. So, that would
> be one thing to look at. You may need to talk to your doctor
> and get a lot more precise numbers. Ask for actual test results
> and actual percentiles, not just overall assessments like
> "fine" or "normal."
>
> That article also gives you situations where suspected
> IUGR can be more worrisome than others; for example, you might
> be more conservative in your approach if your wife's blood
> pressure has been high.
>
> It does appear that the baby is low on the percentiles
> for growth (by weight--you should also check size by head
> circ and ratio of head circ. to abdominal circ), but does
> not appear to be dropping much by percentiles, which may
> point more towards a constitutionally small baby, especially
> given the good BPP results.
>
> I would want to exercise a little caution because *if*
> the baby is just constitutionally small and *if* the baby is
> being well-nourished inside, it may actually benefit this
> baby to cook *longer* rather than shorter. You need to
> distinguish, to the best of your ability, whether the baby
> is just constitutionally small but well-nourished or
> whether the baby is small due to lack of nourishment.
>
> Best wishes,
> Ericka
>

[Hillary Israeli]

In >,
Johns News > wrote:

*Hi Helen,
*
*If he was 4.10 pds at 36 weeks and now only 5 pds even thats only a 6oz
*weight gain. A 1/2 pd would have been 8 oz so they are saying hes shy 10 oz

How do you figure? 4.1 lbs plus 0.5 lbs (aka 1/2 pd or 8 oz) is 4.6 lbs.
You say he is now estimated at 5.0 lbs. That's almost an entire pound gain
- 14.4 oz, to be precise :).

*in the last 2 weeks of what he should be. At 36 weeks they said he should
*have been at least 5 pds. Now at 38 weeks hes just hit 5 pounds. Thats the
*concern I guess. So I guess at his current rate he would weigh in at around
*5.6 pds on her due date. They just dont think hes growing fast enough.

7.2 oz/week would seem close enough to me. But I'm not an OB.

--
Hillary Israeli, VMD
Lafayette Hill/PA/USA/Earth
"Outside of a dog, a book is a man's best friend. Inside of a dog, it is
too dark to read." --Groucho Marx

[Unadulterated Me]

Hillary Israeli wrote:


> How do you figure? 4.1 lbs plus 0.5 lbs (aka 1/2 pd or 8 oz) is 4.6 lbs.
> You say he is now estimated at 5.0 lbs. That's almost an entire pound gain
> - 14.4 oz, to be precise :).

It's 2:00am and my brain stopped worked about 4 hours ago so I may be
reading this wrong, but 4lb 1oz plus 8oz (half a pound) is 4lb 9oz isn't it.
The difference between 4lb 1oz and 5lb is 15oz.

Andrea

[Ericka Kammerer]

Hillary Israeli wrote:

> In >,
> Johns News > wrote:
>
> *Hi Helen,
> *
> *If he was 4.10 pds at 36 weeks and now only 5 pds even thats only a 6oz
> *weight gain. A 1/2 pd would have been 8 oz so they are saying hes shy 10 oz
>
> How do you figure? 4.1 lbs plus 0.5 lbs (aka 1/2 pd or 8 oz) is 4.6 lbs.
> You say he is now estimated at 5.0 lbs. That's almost an entire pound gain
> - 14.4 oz, to be precise :).

He means the baby was 4 pounds 10 ounces at 36 weeks
and 5 pounds 0 ounces at 38 weeks, for a gain of 6 ounces over
two weeks.

Best wishes,
Ericka

[[email protected]]

Thats correct Ericka. Im wondering though, Is there any measurment for
the size of a uterus? Being the doctor has told us the placenta flow is
fine, they told us the uterus may be too small contstricting the baby's
growth. We go to the OB tmw where Im sure he will want to induce. The
specialists at the hospital has suggested it and he isnt going against
them (cya)

Still I want to know, what is the risk of leaving him in until his due
date of the 14th? What is the risk of taking him out early?

[Ericka Kammerer]

wrote:

> Thats correct Ericka. Im wondering though, Is there any measurment for
> the size of a uterus? Being the doctor has told us the placenta flow is
> fine, they told us the uterus may be too small contstricting the baby's
> growth.

Honestly, I have never heard of such a thing for a normal
pregnancy. There can be physical issues with the uterus, but
they normally involve obvious issues like a septate or bicornate
uterus. I have never heard of a normally shaped uterus that
just wouldn't grow big enough to support a baby. That seems
pretty far-fetched, especially given that a constitutionally
small baby seems a much more likely explanation.

> Still I want to know, what is the risk of leaving him in until his due
> date of the 14th? What is the risk of taking him out early?

You know, this is one of those situations where it's
really hard to tell. The fact that he *is* growing, if slowly,
and that the BPP came back so well are very positive indications.
If he's well nourished in there and just constitutionally small,
then he's definitely better staying in until he's ready (whether
that's the 14th or even later). So the question is whether
there's a problem that you're just not able to detect for sure.
This could happen with any pregnancy. There are risks to taking
him early. Inductions can be stressful for the baby (uterine
hyperstimulation, among other possibilities). Inductions can
fail, in which case you can end up with a c-section that poses
increased risks for mother and future babies. If dates aren't
rock solid, you could actually be taking the baby early and
face iatrogenic prematurity issues (not to mention the small
size would be normal in that situation, so the risks would
have been assumed with no corresponding benefit).
It would be great if there were a slew of studies
comparing induction vs. expectant management in your particular
situation so that you could weigh accurate risks and benefits,
but unfortunately you're unlikely to get very clear information.
Here's what I could find:

http://tinyurl.com/4bz4c
This one seems to suggest that induction doesn't help unless
there are clear indications of trouble (particularly maternal
hypertensive disorders or oligohydramnios), and that in fact,
APGAR scores were lower in inducted term SGA infants.

Best wishes,
Ericka

[Hillary Israeli]

In >,
Unadulterated Me > wrote:

*Hillary Israeli wrote:
*
*
*> How do you figure? 4.1 lbs plus 0.5 lbs (aka 1/2 pd or 8 oz) is 4.6 lbs.
*> You say he is now estimated at 5.0 lbs. That's almost an entire pound gain
*> - 14.4 oz, to be precise :).
*
*It's 2:00am and my brain stopped worked about 4 hours ago so I may be
*reading this wrong, but 4lb 1oz plus 8oz (half a pound) is 4lb 9oz isn't it.
*The difference between 4lb 1oz and 5lb is 15oz.

But he never said 4 lbs 1 oz, did he? He said 4.1 lbs, I thought. Perhaps
I misunderstood.

--
Hillary Israeli, VMD
Lafayette Hill/PA/USA/Earth
"Outside of a dog, a book is a man's best friend. Inside of a dog, it is
too dark to read." --Groucho Marx

[Hillary Israeli]

In >,
Ericka Kammerer > wrote:

*Hillary Israeli wrote:
*
*> In >,
*> Johns News > wrote:
*>
*> *Hi Helen,
*> *
*> *If he was 4.10 pds at 36 weeks and now only 5 pds even thats only a 6oz
*> *weight gain. A 1/2 pd would have been 8 oz so they are saying hes shy 10 oz
*>
*> How do you figure? 4.1 lbs plus 0.5 lbs (aka 1/2 pd or 8 oz) is 4.6 lbs.
*> You say he is now estimated at 5.0 lbs. That's almost an entire pound gain
*> - 14.4 oz, to be precise :).
*
* He means the baby was 4 pounds 10 ounces at 36 weeks
*and 5 pounds 0 ounces at 38 weeks, for a gain of 6 ounces over
*two weeks.

Oh. I thought he said 4.1 lbs, not 4 lbs 10 oz. My bad. :)

--
Hillary Israeli, VMD
Lafayette Hill/PA/USA/Earth
"Outside of a dog, a book is a man's best friend. Inside of a dog, it is
too dark to read." --Groucho Marx

[Ericka Kammerer]

Hillary Israeli wrote:

> In >,
> Unadulterated Me > wrote:
>
> *Hillary Israeli wrote:
> *
> *
> *> How do you figure? 4.1 lbs plus 0.5 lbs (aka 1/2 pd or 8 oz) is 4.6 lbs.
> *> You say he is now estimated at 5.0 lbs. That's almost an entire pound gain
> *> - 14.4 oz, to be precise :).
> *
> *It's 2:00am and my brain stopped worked about 4 hours ago so I may be
> *reading this wrong, but 4lb 1oz plus 8oz (half a pound) is 4lb 9oz isn't it.
> *The difference between 4lb 1oz and 5lb is 15oz.
>
> But he never said 4 lbs 1 oz, did he? He said 4.1 lbs, I thought. Perhaps
> I misunderstood.

He said 4.10 pounds, as a shorthand for 4 pounds 10 ounces.
He clarified later, so I'm sure that's what he meant. Don't know
why people use that form, but it's common (similar to 32.5 weeks
meaning 32 weeks 5 days rather than 32-and-a-half weeks).

Best wishes,
Ericka

[Pologirl]

wrote:
> they told us the uterus may be too small contstricting the baby's
> growth.

What total bull****.

If I were the pregnant woman in question, no way would I agree to an
induction. More likely I would be looking urgently for a new OB or
CNM. But it is easier to just say no to these people; they cannot
induce without her consent. They can try to get a court order, but
probably not before her duedate.

[[email protected]]

The OB hasnt called us back yet. This recommendation is coming from the
doctors who go over the BPP and US at the hospital. Im not sure what
you call them. Im still cautious and sent my wife this thread so she
could read it. We see the OB tmw morning and any questions you guys
think I should ask go ahead and fire away. The whole uterus is too
small thing is not sitting well with me.

[Ericka Kammerer]

wrote:

> The OB hasnt called us back yet. This recommendation is coming from the
> doctors who go over the BPP and US at the hospital. Im not sure what
> you call them. Im still cautious and sent my wife this thread so she
> could read it. We see the OB tmw morning and any questions you guys
> think I should ask go ahead and fire away. The whole uterus is too
> small thing is not sitting well with me.

Assuming you're not all that into flat-out confrontation,
I find the easiest way to get through this sort of thing is to
sort of play dumb and ask lots of questions:

Them: We think an induction is warranted as soon as possible.
You: Why?
Them: Because the baby's too small and not growing well enough.
You: How small is the baby relative to what he should be?
Them: Well, he's under the Xth percentile.
You: What are the odds he's just perfectly healthy and normal but
small?
Them: Could be, but we're worried that something's wrong.
You: What, precisely?
You: What evidence is there that there is something wrong other
than the size?
You: How accurate/reliable is the information on size?
You: What might happen if we watch and wait?
You: What studies have been done on this issue and what
were their results?
You: What if we do induce? What are the risks associated
with induction?
You: What if the induction is not successful?
You: Are there studies showing better results for induction
with a small for gestational age baby versus watching and
waiting when there aren't any other evident problems?
You: If not, what information are you basing your recommendation
on?

....you get the picture. Just keep a pleasant and puzzled look
on your face and ask lots and lots of detailed questions. The
goal is to get them to justify their recommendation with high
quality, specific evidence.

Then, once you've had the discussion, if you're feeling
pressured, refuse to book an appointment for induction now. Tell
them you're going to go home and think it over and that you'll
let them know tomorrow what course of action you want to pursue.

Best wishes,
Ericka

[Hillary Israeli]

In >,
Ericka Kammerer > wrote:

* He said 4.10 pounds, as a shorthand for 4 pounds 10 ounces.
*He clarified later, so I'm sure that's what he meant. Don't know
*why people use that form, but it's common (similar to 32.5 weeks
*meaning 32 weeks 5 days rather than 32-and-a-half weeks).

/me smacks self in head.
I have to say, I must be a complete idiot, because while I have seen
people accidentally use the decimal form as the OP here did when they
meant to write pounds and ounces, I didn't realize it was ever done
deliberately. And I DEFINITELY haven't ever even realized anyone was
abbreviating weeks of gestation in the way you describe - if someone says
she's 32.5 weeks, I assume 32 weeks 3.5 days. I know, I know - I'm way too
literal minded.

--
Hillary Israeli, VMD
Lafayette Hill/PA/USA/Earth
"Outside of a dog, a book is a man's best friend. Inside of a dog, it is
too dark to read." --Groucho Marx

[Phoebe & Allyson]

Hillary Israeli wrote:

> while I have seen
> people accidentally use the decimal form as the OP here did when they
> meant to write pounds and ounces, I didn't realize it was ever done
> deliberately.

Our pediatricians have used that notation (pounds.ounces) consistently
in their file and occasionally on paperwork given to us. Pounds#ounces
is what they normally put on our paperwork, though. I remember seeing
it as pounds.ounces on the paperwork from the 20-week ultrasound, too.

Phoebe :)

[Ericka Kammerer]

Hillary Israeli wrote:

> /me smacks self in head.
> I have to say, I must be a complete idiot, because while I have seen
> people accidentally use the decimal form as the OP here did when they
> meant to write pounds and ounces, I didn't realize it was ever done
> deliberately. And I DEFINITELY haven't ever even realized anyone was
> abbreviating weeks of gestation in the way you describe - if someone says
> she's 32.5 weeks, I assume 32 weeks 3.5 days. I know, I know - I'm way too
> literal minded.

;-) I figured that might be the case!

Take care,
Ericka

[Kaybee]

> wrote in message
ups.com...
> They said the BPP looks normal as they can tell. They also said the
> placenta flow looks fine as well. I was feeling ok about this and now
> Im a wreck again. What is the point of inducing this late?

I can say that when and if the doctor talks about inducing this time around
I will go for it. We fought the induction with Eva and when we finally
decided to go ahead and do it we had some problems. (we let it go almost an
entire month over) She had already taken her first bowl movement
(malconium) and I had to be flushed the entire laboring. We also had lost
her heart rate a couple of times. She was smaller then they told me that
she was going to be about 2 lbs lighter.

Good luck with your decision

Kay
Eva 9/2002
little boy 1/2005
>

[Ericka Kammerer]

Kaybee wrote:


> I can say that when and if the doctor talks about inducing this time around
> I will go for it. We fought the induction with Eva and when we finally
> decided to go ahead and do it we had some problems. (we let it go almost an
> entire month over)

44 weeks?!

Best wishes,
Ericka

[Hillary Israeli]

In >,
Phoebe & Allyson > wrote:

*Hillary Israeli wrote:
*
*> while I have seen
*> people accidentally use the decimal form as the OP here did when they
*> meant to write pounds and ounces, I didn't realize it was ever done
*> deliberately.
*
*Our pediatricians have used that notation (pounds.ounces) consistently
*in their file and occasionally on paperwork given to us. Pounds#ounces
*is what they normally put on our paperwork, though. I remember seeing
*it as pounds.ounces on the paperwork from the 20-week ultrasound, too.

That's interesting. The medical records I've seen from my OB, and my
hospital of delivery (I have copies of my chart from both, um,
confinements :)) use grams or kilograms with #/oz in parentheses
afterwards [so, you might see the notation "est fetal wt 1650 g (3#10oz)"
in my OB chart, and you might see "full term male infant 4.053 kg
(8#15oz)" - in fact, you do see that, because I just copied it out of my
chart :)

I know that personally, I usually write down weights using the decimal
pound format - "wt = 61.5#" would be what I'd write down for a patient who
weighs 61# 8 oz - because that's what my scale reads out to me. Maybe
that's why I assume everyone is doing the same thing. To me though the
placement of the hash mark is key to interpretation (or the abbreviation
"lbs" - if it comes AFTER the number including the decimal portion, to me
that means the decimal denotes a fraction of a pound or that the author so
intends in any case!)

Interesting.

--
Hillary Israeli, VMD
Lafayette Hill/PA/USA/Earth
"Outside of a dog, a book is a man's best friend. Inside of a dog, it is
too dark to read." --Groucho Marx

[Kaybee]

yes I was about 44 weeks

"Ericka Kammerer" > wrote in message
...
> Kaybee wrote:
>
>
> > I can say that when and if the doctor talks about inducing this time
around
> > I will go for it. We fought the induction with Eva and when we finally
> > decided to go ahead and do it we had some problems. (we let it go almost
an
> > entire month over)
>
> 44 weeks?!
>
> Best wishes,
> Ericka
>

[Ericka Kammerer]

Kaybee wrote:

> yes I was about 44 weeks

Wow, I'm astonished they went along with that (willing or
no).

Best wishes,
Ericka

[Kaybee]

"Ericka Kammerer" > wrote in message
...
> Kaybee wrote:
>
> > yes I was about 44 weeks
>
> Wow, I'm astonished they went along with that (willing or
> no).

I was shocked also specially since I had GD but all my sugars came out
great. I also think it was because we couldn't pin point my LMP. Who knows
I do know that I am not going to let it go that long again.

Kay
Eva 9/2002
little boy (any day now)
>
> Best wishes,
> Ericka
>

[Da Sol Han]

do you have a peditrician?? most important!!!! ASK while wife is
pregnant about enduction!!.
LET him/her guide you to a 2nd oppinion.

I am very scared for people, after having my 3rd child. i saw
3specialist the OB, and a doctor at the childrens hospital. ( not trying
to scare anyone) but its important you ask unheard of questions!!!!

my situation was POOR professionalism.

i was a high-risk pregnancy because of previous births both preterm
labor 1st was 6weeks early, ( i have my opinion of WHY she was born so
early) just so unreal.

in my last pregnant i had an U/S at 10wks, and another about 16-17wks,
they called me with "some concern" i should come in to be further
tested. ( only after the fact can i SEE what the gossip was about) at
20wks they finally had me scheduled for a level ii U/S..

they measued head and legnth.. then they went to the organs, and told
me..

Here is ONE kidney, marked the right side.. and Here is the left kidney
and we are concernd about! at 20wks.. the kidney was 3cm enlarged.

they even, "highlighted ALL her organs"

we asked, ARE YOU SURE the OTHER kidney is fine??? they said OH yeah..
SEE it, right there.

by the time i was 24wks, the unhealthy kidney had grown a little over
4cm. weeks of testing went by, 26wks i saw .. a "2nd" oppinion who told
me this kind of thing is normal happens more often then we know and
wouldnt get any larger and COULD go back to normal after birth with the
OTHER fuctioning kidney.

28wks, the kidney was enlarged to 6cm, (boy i cried so hard) they even
had the nerve to tell me to SUCK it UP!!

i called the "2nd" oppinion ( who was the urologist at a childrens
hospital) i asked what was happening, YOU told me it wouldnt grow
anymore.. he assured me i was OK, but confused also...

went into preterm labor, 30wks 2wks in the hospital, ( series of
ultrasounds) IMO only after the fact.. I THINK this is where they
discoverd ONLY ONE kidney existed. did not tell me.. NOR the "2nd"
oppinion at the childrens hospital lead us to believe.. there had been
2present. went as things were "normal" her kidney enlarged to 8cm's
34-35wks. ( yes CM. pedtrcian asked me if i was hearing them right)
(not to mention, a Urologist is the wrong specialist to send me to)

i asked to be enduced, 38wks, i was afraid.. my OB said yeah sure, but
the specialist who told me about it in the first place.. disagreed! (
more then ONE redlight flew up!!! but i was so pregnant i couldnt
leave!! she told me.. i would need a c-section the week b4 the baby was
8lbs, and now they THINK she is 10lbs.. THOUGHT i was diabetic.. (yes i
took the gluclose test) they said, because they didnt test me..

I THINK, they were trying to keep me as pregnant as they could, IN HOPES
the baby would die in utero.. ( all my thinking) only after the fact..
the things i saw, "what was wrong with this picture kind of thinking"
and they tried to get me to sign waivers for all kinds of things (yes i
refused)

i called my pedtrician told him they were scaring me, and didnt have a
CLUE to what they were doing.. He told me to just have the baby and HE
would do his job!!!

so with talk of lawyers, and alot of cussing at people.. i made them
prep me for a c-section( did i want them to? NO.. but insurance wouldnt
have coverd anything if i went somewhere else) so i was twice as scared,
because they were so incompitent ( and reality doesnt hit you, until
after and you ask yourself AM I STUPID)

BUT, i also didnt know about the missing kidney yet, it was only after
the c-section and the tubal.. and the DAY AFTER birth.. the "2nd"
oppinion called me.. said WE cant find the other kidney! ( my reaction)
WHAT YOU better check again!!!! and they did! ( i had my pedtrician
set up transport for the baby afterbirth to the childrens hospital ( i
didnt want ANY of these people to touch her after the hell the put me in
while pregnant)

i didnt see her until 3days later, ( in the hospital no one "knew" i
had a c-section and had to yell for meds. ( also walk myself to the car
while the Wheeled my stuff behind me) nurse had a problem cause i wasnt
fast enough.. (yeah i was glad to leave) the whole time.. no one even
knew where the baby was.. i was ONLY in delivery/recovery and they said
OH, you just had a baby!(duh) ( stuck in stupid land for 3 days pee'd
me off!!!)

when we found out about the kidney.. my OB happen to be in the room
with me, when she left.. i had to call the childrens hospital back
"news" traveled fast.. the doctors were trying to cover there "ass"
but.. i thought quick and said NO you are not to give any information
out!!!

5days after birth, they said.. she was a miracle at best guess they only
gave her 3days to live that included in utero.. so MOM (pat myself) did
a good judgement call on the enducment!!!!


we had a hard time, this all just happen in summer of 03, for some godly
reason she is alive.. and playing!! more tirant then princess. and hangs
with the best!!!! ( does not like doctors though lol ) she is
bealutiful..takes all kinds of meds to stay healthy,but its worth it.
she may need a transplant in the future.. but its worth it.