Concerned about size of baby's head at 31 weeks pregnant
I am 31 weeks (+1 day) pregnant. It has been a complicated pregnancy - initially I had twins but we sadly had to stop the heart of one twin at 23 weeks due to severe ventriculomegaly and other abnormalities. The remaining twin has appeared perfectly normal throughout and has been shown to be growing well.
However, today I went for a reassurance scan and was told that baby's head is measuring slightly smaller and is on a lower percentile than previously. Her head (BPD and HC measurements) is now around the 25th percentile whereas before it was around the 50th (five weeks ago at the last scan). The doctor did not seem worried by this as it is still within the normal range and she is in a breech position which he said can 'squash' the head.
However, I am extremely worried and anxious and did not feel reassured by him. I am worried that the growth of the head has slowed down and that could indicate some developmental problem. Perhaps I am over-worrying because of my history with the other twin, but I would greatly appreciate a second opinion/more information.
Could the breech presentation give inaccurate measurements (the head could actually be bigger than it looked on the scan)? If not, I don't understand why it's not more concerning that her head isn't growing at the same speed as before!?
I would be extremely grateful for your help.
Symptoms: Baby's head measuring on a lower percentile than previously
Thanks for the query.
I understand your concern.
Usually the fetus is considered as normal if the measuring parameters are within 10th to 90th percentile.
The points to be considered in your case are:
-As the baby is in breech position, sometimes accurate measurement of the BPD and HC can become difficult.
-If other parameters like AC and FL are also corresponding the head parameters, there is possibility of generalized growth retardation compared with previous scan.
-If only head parameters are at lower level, developmental anomalies should be ruled out.
-Sometimes demise of one fetus in twins can affect the other one.
So, please try to rule out factors which can lead to fetal growth retardation like pregnancy induced hypertension, less liquor, placental insufficiency etc with your doctor's help.
If all these factors all normal, as now the fetal parameters are within normal percentile, you can continue the pregnancy with regular antenatal checkups and ultrasound examinations to monitor the growth and well being of the baby.
Continuing the medicines prescribed by your doctor, adequate healthy diet and rest are important to maintain the normal growth of the baby.
These Q&A’s are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.