Fundal height not compatible with dates

This is my 3rd pregnancy and things couldn't be stranger. At both 8 and 12 weeks I measured right on then measured 4 weeks ahead at my 16 week check. We had an ultrasound that confirmed I was only 16 weeks pregnant. At my 20 week check I measured 28 weeks and at my 24 week check I measured 34 weeks, all according to my fundal height. We had a second ultrasound which confirmed I was only 24 weeks pregnant. I am overweight, but as of 31 weeks had only a net gain of 1-3/4 lbs. We did find a fibroid that measured only 56 mm at the 24 week ultrasound. Only one baby was seen at both ultrasounds, but both were documented as "poor" technical quality.

At 31 weeks, I definitely feel like I should be giving birth any day. I have no history of measuring large. I feel tons of kicks and squirms, but I never feel the baby roll around. For about 3 weeks now the baby has been able to get into positions that are very uncomfortable to me, but I am never able to move him. It's like he has no where to go.

What's the deal? Can a single fibroid make that big of a difference? Do my symptoms suggest twins? Is this just going to be some freak thing?

Thanks for any insight or suggestions.
Cinnamon

P.S. My glucose test was normal.

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ABOUT THE EXPERT

Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

Dear Cinnamon,

Some of the midwives I work with have a joke - have one baby, have two babies, have four babies but never three. The third baby is often a lot of work for the mother and for the midwife. They are not typical pregnancies - often completely different in terms of symptoms and they will surprise you in the strangest ways.

If you are overweight, the tape measure is not often very accurate in measuring fundal height and correlating it with dates. We don't believe that the tape is very accurate until after 20-22 weeks anyway.

If this is the same provider measuring each time, the tape is just a reassurance that baby is growing, but as you mentioned the fibroid could also be growing. They should keep an eye on this and should not avoid the issue by saying "poor technical quality". If the machine or the technologist is not up to the task, they should refer you to someone who is.

Baby's position may be constantly changing which might impact the measurements. The abdominal musculature is not as strong as it was with the first two children and this allows the baby to find varied positions which are uncomfortable and confusing to the person measuring. A fibroid could get in the way of baby's movements or of your ability to move him, depending upon where it is located and how large it is.

I would recommend that you have serial ultrasounds to monitor the fibroid and see if someone can get a better picture. Don't worry about the fundal measurements if the baby is appropriate for dates on ultrasound. I hope you are getting a diet high in protein and vitamins and minerals. Women who are overweight tend not to gain as much, but your weight gain is quite small for your dates.

I wish you well and hope the baby finds a comfortable spot and stays put - head down.

Good luck.
Peg

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