Miles and IUGR Diagnosis
Definition
Intrauterine growth restriction (IUGR) refers to poor growth of a baby while in the mother's womb during pregnancy. The causes can be many, but most often involve poor maternal nutrition or lack of adequate oxygen supply to the fetus.
At least 60% of the 4 million neonatal deaths that occur worldwide every year are associated with low birth weight (LBW), caused by intrauterine growth restriction (IUGR), preterm delivery, and genetic/chromosomal abnormalities,[1] demonstrating that under-nutrition is already a leading health problem at birth.
Our Journey with IUGR
How did Miles get here? It all started with the first trimester screening test. At the first trimester blood screen, I got back a weird test result. They tested Miles for chromosomal abnormalities at that appointment and everything looked chromosomally normal. Many of these tests come up funky with no long-term issues. 10% of the time, the funkiness is related to a placental issue - turns out that Miles' placenta was part of that 10% but we would not know that for a few months. Miles at that point was measuring accordingly and looked really healthy on the ultrasound. This was week 18. But the doctor wanted me to be followed by a specialist, perinatologist, just in case. I was scheduled for an additional ultrasound every 4 weeks starting at 20 weeks.
On Thursday, April 4, I ran into the Perinatologist office to get an ultrasound on the way to my yoga class before our week of beach fun at St Simons Island we had planned. The doctor came in and told me that Miles was measuring 2 weeks behind his gestational age and that the cause was due to placental insufficiency which she could tell because there was absent blood flowing periodically through the umbilical cord. The rest of the conversation was a bit of a blur.
The Hardest Decision a Person Can Make
My doctor suggested that I get admitted at that point and get steroids (to help babies with some of the complications) because if not fetal demise in utero was a significant possibility. There are no articles on how fast the demise can happen. There are babies who demise quickly and there are babies who make it 5-8 weeks. There are no statistics to help with the decision because doctors rarely recommend waiting and seeing because of their malpractice risk. But I was lucky. I had studies NICU babies for 2 years in my time at Texas Children's. I understood what the outcomes of 1 24 week, 495 gram baby would be. Even if he did make it, he would most likely die on the outside or be severely disabled. I strongly believe that God would choose our path. And my time in the NICU had taught me that although "viability" as determined by the legal definition is 24 weeks that outcomes really change and "viability as I define it is 27 weeks. An article that helped me scientifically in this situation is as follows:
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