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Archive for May 3rd, 2010

I’m going to have a new grandchild, all being well, some time in June. I’m being non-committal about dates as there is some disagreement between scan dates and EDD by first day of last period. This situation is not unusual, the majority of my women will arrive at clinic following their dating/nuchal scan with a date a due date a few days earlier or later than the one arrived at by naegel’s rule. There in lies the first dilemma, the scan date is 3 weeks later than calculated using an obstetric calculator. At this point I generally discuss longer cycles with the parents, I started out doing this but was cut off at the pass by son pointing out to me that all the measurements were indicating a fetus whose size was above the top line. We waited for the 20 week scan, same story, big baby estimated as being due 3 weeks later than DIL’s dates. Due to DIL’s low BMI there was another scan at 28 weeks  just in case baby was not growing well. No worries there though as baby was once again on the top line. I’m a little piggy caught in the middle. I know that scans are generally accepted as being more accurate than LMP, however they can be wrong and it’s not surprising really as the measurements used are so small initially that a slight malpositioning of the probe could make days of difference. I’m torn because of several little things,their first baby, Evie, was 12 days late and only came because of induction and even then had to be helped out with the ventouse, dislocating her Mummy’s coccyx on the way.  I rationalise the lateness of Evie by factoring in that DIL was stressed due to son’s illness so her hormones were not behaving optimally for  labour to start spontaneously. Perhaps that wasn’t the cause though, was it because baby was too large for DIL? Now supposing that this baby is also late. DIL’s dates indicate a due date of 5th June, 2 weeks over would mean induction round about 17th to 19th June but the scan says that baby is due on 25th June and allowing DIL to go 12 days over would mean the pregnancy could be 5 weeks over. From another perspective, if the scan dates are correct then this baby is big, very big, will DIL be able to get it out? 2 days I did an antenatal examination, all well until I palpated. Baby feels ‘a good size’ and, at 32 weeks, is measuring in at 34 weeks.

This feels like deja vu. Amy’s Mummy had a large bump with her. I referred her in with polyhydramnios and a large baby at 32 weeks. I was right, but that didn’t stop the consultant allowing daughter to go 10 days over and to end up with an emergency caesarean for failure to progress in labour with a 9lb 12oz baby.  I’ve highlighted the discrepancies between dates, scans and size in the notes, had a word in clinic sister’s ear and eagerly await the consultants thoughts next week.

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