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My baby seems small

What does it mean if my baby seems small?

Small for gestational age refers to a baby that we think has not reached the expected weight/growth for the number of weeks of pregnancy.

How is my baby’s growth monitored?

At each antenatal appointment from 24-28 weeks your midwife or doctor will assess the growth of your baby by measuring the distance in centimetres from the top of your uterus to your pubic bone (this is plotted on a customised growth chart).

Customised Growth Chart

This can be found attached to page 16 of your handheld notes and has been individually adjusted for you and your baby. The graph indicates what should be the normal growth of your baby. More information about this is found on page 16 of your handheld notes.

If your baby is thought to be smaller than expected for the number of weeks of your pregnancy you will be referred to the Day Assessment Unit (DAU) and you will be offered an ultrasound scan (USS) within 72 hours.

What to expect when you visit the Day Assessment Unit

Please bring your handheld notes with you, allowing at least 1-2 hours for your appointment.

A full antenatal examination will be performed if there are any concerns raised by the ultrasound scan. This will include a detailed history of your pregnancy, any medical conditions, or any other concerns, including your baby’s movements.

The midwife may listen to your baby’s heart rate with either a Pinard (fetal stethoscope) or handheld Doppler (sonic aid). An electronic recording of your baby’s heart rate and movements may be performed; this is called a cardiotocograph (CTG).

What will the ultrasound scan show?

An ultrasound scan will:

  • Check that your baby is growing well and estimate the weight of your baby (there can be 10-15% difference between the scan estimate and actual weight).
  • Measure the amount of amniotic fluid around your baby.
  • Measure the blood flow from the placenta to your baby through the cord.
  • Measure the blood flow to your baby’s brain.

All of these measurements enable us to make an assessment
of your baby’s growth and wellbeing.

If all of the above observations are found to be normal, you will be transferred back to the care of your Community Midwife or Doctor.

If there are any concerns about the growth or wellbeing of your baby you will be offered closer monitoring at the hospital throughout the remaining weeks of your pregnancy. Any proposed investigations or treatment will be discussed with you in detail, but if you have any questions, please do not hesitate to contact either your Community Midwife or a Midwife from the DAU.

Useful Contact Numbers

  • Antenatal Clinic 01296 316140 (Stoke Mandeville)
  • Antenatal Clinic 01494 425569 (Wycombe)
  • Day Assessment Unit 01296 316106 (Stoke Mandeville)

Day Assessment Unit Opening Hours

  • Monday to Friday 8.00am to 6.00pm
  • Saturday/Sunday 9.00am to 5.00pm

References

De-Jong, C.L., Francis, A., Vangijn, H.P. & Gardosi, J. (1999) ‘Fetal growth rate and adverse perinatal events’. Ultrasound obstetrics and gynaecology. 13 (2) pp. 86-89

Royal College of Obstetrics and Gynaecologists (RCOG) (2002)

Guideline 31: The investigations and management for SGA fetus.

London: RCOG Press.