Fetal Growth Concerns: What to Do When Doctors Disagree

My baby is not growing enough?

I am nearly 38 weeks pregnant, but recently my doctor informed me that the baby's placenta is calcified and the weight is insufficient, only around 2400 grams, and there is a slight decrease in amniotic fluid.
They suggested inducing labor to allow the baby to grow in a more favorable environment.
However, another doctor said my baby weighs around 2700 to 2900 grams and that my cervix is not yet ready for delivery.
I would like to ask the physician what I should do.
Also, why is there such a significant difference in the weight estimates from the two doctors? If I choose to wait for natural labor, will it have any impact on the baby?

Ai Jun, 20~29 year old female. Ask Date: 2001/06/11

Dr. Zhan Deqin reply Obstetrics and Gynecology

1.
The weight of the baby is estimated using ultrasound, and there may be variations in the calculated weight depending on different doctors or the position of the child.

2.
It is recommended that you seek a third opinion from another doctor for further evaluation.

3.
Unless the pregnancy is overdue or there are signs of fetal distress, early induction of labor is not advised.
If you have further questions, please visit the obstetrics and gynecology clinic for an examination.

Reply Date: 2001/06/11

More Info

When faced with conflicting medical opinions regarding fetal growth and the timing of delivery, it can be a source of significant stress and confusion for expectant parents. In your case, you are nearing the end of your pregnancy at 38 weeks, and you have received differing assessments about your baby's weight and the condition of the placenta and amniotic fluid. Here's a comprehensive approach to understanding your situation and what steps you can take.

Understanding the Medical Opinions
1. Fetal Weight Discrepancies: The difference in fetal weight estimates (2400 grams vs. 2700-2900 grams) can arise from several factors, including the methods used for measurement, the timing of the ultrasound, and the inherent variability in fetal growth patterns. Ultrasound measurements can sometimes be inaccurate, especially if the baby is in a position that makes it difficult to get precise measurements. Additionally, different practitioners may have varying thresholds for what they consider "normal" growth.

2. Placental Health: The mention of placental calcification indicates that the placenta is aging, which can happen as the pregnancy progresses. While some degree of calcification is normal, excessive calcification can affect the placenta's ability to deliver nutrients and oxygen to the fetus. This is why your doctor may be concerned about the baby's growth and suggest early delivery.

3. Amniotic Fluid Levels: Low amniotic fluid (oligohydramnios) can also pose risks to the baby, including restricted movement and potential complications during labor. It is essential to monitor this closely, as it can affect the baby's well-being.

What to Do Next
1. Seek Clarification: It’s crucial to have open communication with your healthcare providers. Ask for clarification on the reasons behind their recommendations. Understanding their rationale can help you make a more informed decision. You might also consider asking for a third opinion from another qualified obstetrician.

2. Consider a Follow-Up Ultrasound: If there is uncertainty about the baby's weight or the condition of the placenta and amniotic fluid, a follow-up ultrasound can provide more current information. This can help assess whether the baby's growth is on track and if the placenta is functioning adequately.

3. Evaluate Risks of Waiting: If you prefer to wait for natural labor, discuss the potential risks and benefits with your healthcare provider. While many women successfully go into labor naturally, if there are concerns about the baby's growth or the health of the placenta, waiting could pose risks. Your doctor can help you weigh these risks against the benefits of allowing more time for the baby to develop.

4. Monitor Symptoms: Pay attention to any changes in your body or the baby's movements. If you notice decreased fetal movement, increased discomfort, or any other concerning symptoms, seek medical attention immediately.

5. Mental Health Considerations: The emotional toll of pregnancy complications can be significant. Consider discussing your feelings with a mental health professional or a support group for expectant mothers. This can provide you with coping strategies and emotional support during this challenging time.

Conclusion
Navigating conflicting medical advice can be daunting, especially during such a critical time as late pregnancy. It’s essential to advocate for yourself and your baby by seeking clarity, considering additional evaluations, and weighing the risks of waiting for natural labor against the potential benefits of early delivery. Always prioritize open communication with your healthcare team, and don’t hesitate to seek support from trusted friends, family, or professionals. Your peace of mind is crucial as you prepare for the arrival of your baby.

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